Is a Spiculated lung nodule always malignant?

Thank you so much

Hello, thank you so much for sharing this information with us. Do you remember what size this nodule was?
I'm glad to know that it was good. Sorry for my english, i'm from Argentina.
Hugs.

1cm x 1 cm
Hang in there !

I will. Thank you so much!

I have a lung condition, bronchiectasis, along with mycobacteria avium complex (bacterial condition). I have lots of nodules, and have had to have part of my lower right lung removed about 6 yrs ago. I have CT scans regularly to monitor the nodules. About 6 mo ago I got a CT result that nodule in left lung had rapidly grown to 1.2 cm and was now classified as a spiculated mass. I also learned of the 90% malignant statistic, instant anxiety except I had been warned that the mycobacteria condition can sometimes become cancerous, OR appear cancerous when it isn’t. I went 5 mo. with no answer from docs regarding cancer. Did the biodesix blood test to determine chances of cancer, but it was mid range, which means maybe, maybe not. After a UPenn visit the CT was repeated in late January. It bears mentioning that a few weeks before UPenn visit my worsening respiratory condition rapidly declined. I had to take steroids, which I am supposed to avoid. I was also given a bronchodialator/steroid inhaler. I did improve prior toUPenn visit and was probably clearer breathing and felt better than I had in years….those amazing steroids I have to avoid. Result of repeat CT after that treatment, showed NO spiculated masx at all. Mass was now back to nodule, although continues to slowly grow, now 1.5 cm. I think I possibily had walking pnuemonia for months and because I deal with ups and downs with my condition didn’t realize how sick I was until so sick doc thought I would end up in hospital. That bad CT was taken during that period and radiologist probably did not look at my history to recognize that it may NOT be a spiculated mass. I have spoken to others with my condition or other lung conditions that state they have spiculated masses that are being followed. I could have had a PET scan or biopsybut did not want to expose myself to all that radiation unless absolutely strong possibly of cancer, due to my regular over exposure of CTs. In fact, a PET scan was scheduled but cancelled after 2nd CT that showed no spiculated mass.

@churlgurl I really appreciate each of your words and explanations and that you have shared it, I really do. At the same time, I am very sorry that you had to go through all that for so many months! Almost half a year is a long time to be thinking about what it could be, asking doctors for help and without a clear answer or approach, since the study also gave indeterminate. Apparently there is a whole wide world of bacteria, viruses, fungi, parasites and other infectious agents that can cause our lungs to react in this way. I understand that they have international standards to evaluate malignancy/benignity prognoses and anticipate it, taking into account that acting quickly in these cases can make a difference. However, I would like to have found more information on the Internet, a somewhat broader range than that "90%" and that I have searched even in the most remote places on the web. The truth is that my mother, with her years of smoking, her age of 63 and a history, is inherently at risk, and apparently it is an increasingly prevalent cancer. But I'm still holding on to the hope that it's something more. I know that we all have to go through this, especially if it involves our loved ones.
Here in Argentina we have endemic tuberculosis and histoplasmosis. Mom and I usually go to the countryside to spend a few days and between the grass, the dirt, the diversity of birds and all the feces they leave behind, including the pool no matter how much we clean it, I have a slight suspicion that this is something else. But I really don't know anymore if it's about what I want with my heart to believe or the evidence that there is. In her case, the nodule is located in the right upper lobe, it is 17 mm x 17 mm, it has a pleural tail that makes contact with the vascular structure, it is irregular, spiculated and solid, with a tendency to crash. I try not to let the statistics discourage me and to hold on to the life experiences that, like you, have so graciously shared with me. How are you now? How do you feel? Do you plan to follow up on the 15mm nodule?

Thank you for your kind response. I sincerely hope there is a good result for your mother. I moved to a coastal area about 5 yrs ago. After moving here realized how windy it is and Idon’t really like it much that windy. Knowing mycobacteria is in water and dirt, also aspergillus….both of which I am positive for. Pulmonary doctor told me I couldn’t have picked a worse place to move and that I shouldnot even go out when really windy, and otherwise I should always wear a mask. Think I am going to move back to the mid west. And I am taking a break from health care. I will continue with my daily airway clearance treatments and get my CT in about 9 months. Hopefully after I move.

good news, im happy for you.

research i did on my irregular shaped nodules ( suspicious of spiculation ) says spiculated nodules can be benign in many cases. hope so for you and me.
most nodules are not cancer even spiculated ones
. even non calcified nodules are usuaually benign. its the waiting while scans ate done every six months that is the worst. i personally have stopped worrying because the largest nodule is stable and nay be getting smaller ( i have several stable nodules) a very good sign. growth and change in shape are some of the things doctors watch out for. if they become calcified that is a very promising sign. good luck 😃

i will. i have another scan in about five more months.I will be very surprised if it has grown or shown other suspicious changes. it is. non calcified but most are, it is stable or gotten smaller. Its irregular shaped but many caused from infection are irregular shaped. Its being watched so that alleviates some worry. Im letting my doctor worry. he is not that concerned he is being cautious. i wanted a biopsy to end this waiting but too close to heart. all looks suspicious for i fection and or inflammation. I was a heavy smoker for 40 years so i think i have dodged a bullet. ill keep all informed. I hope my case brings some measure of peace and hope to oothers. .