Is a Spiculated lung nodule always malignant?

Hello Linpvc! First of all, I wanted to thank you for sharing your experience all this time. Since I arrived at this forum (a few days ago) I have been following your updates, hoping that everything goes well and sending you good energy. The fact that the nodule has shrunk and the others, for the most part, are calcified, is certainly a very good sign. I am very happy. I have felt your anguish and uncertainty in each update, especially because of the location of the nodule that you are monitoring and the difficulties associated with the biopsy. I really trust that during these months it will continue to get smaller and will only be a bad memory, something more like a life lesson. Thank you for your good wishes for all of us. Mom and I are still waiting for the authorization for the PET-CT, which we can probably do during the week of 03/17 (just the week of her birthday 😪). If it is not bothersome, could I ask you for information about solid spiculated nodules and their possible benign etiology? I have seen that in the case of ground glass nodules it is often the case, but I have not found any encouraging information about solid nodules measuring 16 mm x 16 mm with irregular/spiculated margins. Any information is welcome to help me endure this wait and all the anguish that it entails. Thank you for everything and I wish you the best! I will be thinking about it.

Hi, none of mine are calcified. But most nodules are non calcified and most nodules are not cancer. I can’t speak to solid nodules. I just don’ have those answers. I thank you for your concern. This PetScan your Mom is having will provide more information. My PetScan showed little FDG uptake pointing toward inflammation and not cancer. Hoping the same for you. . Suggestion. Go to DuckDuckGo to search for answers to any of your questions, that’s what I do. Good luck and please keep in touch. Remember
Most nodules are not cancer. Most are non calcified and even irregularly shaped nodules can be from inflammation not cancer and there are many effective treatments if is cancer.
It’s the waiting for scans , waiting for answers that drives us crazy. We are being watched carefully. And for that I’m very thankful.

I’ve read that they can turn cancerous and it causes concern for me too . That’s why it’s good to get regular scans. I consider myself blessed that my nodules were discovered, that way if they ever turn cancerous I’ll know soon enough to treat it successfully

I've had many spiculated nodules through the years and each time were all infectious. Several times my pulmonologist were 99% certain they would come back cancerous. Biopsies proved that to be incorrect, thank God!

Thank you for sharing that. Super nice to know. wondering if previous benign results of spiculated nodules will influence your doctor's or your decision to go forth with biopsies of any new spiculated nodules in the future.

In my case each time they will only do biopsies last resort.
Of the biopsies I have had they puncture my lungs. So they of course try to avoid that! Prior benign results should not reflect treatment standards of new findings. Only my humble opinion.

I agree with your humble opinion, it makes sense to me too that prior benign results from biopsies shouldn't determine treatment plan for any new ones. However, my doctor is relying on my prior benign results to influence his treatment plan for this new one. Im having 8th ct scan for this nodule in about four months, thats a lot of radiation. I also had a collapsed lung after biopsy, took a week in the hospital to heal but id still consent to one but it is very close to my heart.

Hello everyone, and thank you for replying and for all your good wishes for Mom. We're going through some very difficult days. We've received the results of the PET/CT scan. The 16mm nodule is solid, irregular, and spiculated, located on the periphery of the right upper lobe. It presented an SUVmax uptake of 2.88 and SUVmean of 0.60, with no other hypermetabolic findings in the lymph nodes or mediastinum. I thought this was relatively good news, as up until now I'd read SUVmax values of 5 or higher as indicators worth paying attention to. However, the doctors are determined to move forward with surgery; they tell us that a biopsy isn't an option as it might not be conclusive. This was yesterday. We were extremely anxious, as we were very excited to see what information the needle biopsy would provide (with faith that it was benign) and avoid a procedure as invasive as surgery. Everyone had told us about the importance of a biopsy. The first surgeon we spoke with at the time had told us that the area was accessible for needle biopsy. Her cardiologist, in turn, told her she had a low-metabolism lesion, so we can't understand why her pulmonologist would proceed with a bronchoscopy only to visualize the airways, lymph nodes, and mediastinum, as they say they don't think they can reach the nodule. The fact that they're recommending direct surgery with the intention of a lobectomy worries me. I can understand the urgency, but I don't fully understand the aggressiveness. Could you help me with your opinions or feelings? Does anyone remember her SUVmax values on the PET/CT scan? I really thought they weren't that high, but that's the problem with reading on the internet without having the resources to interpret... the last word belongs to the doctors. 😪🙏🏻

Hello, Im so sorry to know your Mom and Your Mom are going through this.
My thoughts for all they are worth is:
It's best to go into a surgery feeling confident that the surgery is necessary but after the cardiologist questioned the need for surgery, you are now doubtful it is necessary. I don't blame you for now having concerns. You may be reassured if you get a second opinion.
Your Mom is blessed to have family that cares and is sharing this load with her.
My best to your Mom

thank you for your post. What exactly made your
biopsies necessary.