New spot on lung

Posted by bbeers @bbeers, Sep 16 7:48am

Hi, was diagnosed with MAC 2 years ago. Pulmo and ID Dr's did not start me on meds, had no symptoms. I recently went for my 6 month check-up and they saw a new spot on my lung. Dr. doesn't think it's lung cancer but can't be sure. Could be an infection or a new spot of MAC, or lung cancer. I am on an antibiotic to see if it clears it up. I go back in three months and get a CT scan. If not cleared up or has gotten bigger, he will do a Bronchoscopy and take a biopsy. Question to all: has anyone ended up with lung cancer from MAC and do you think I should request a bronchoscopy now rather than wait 3 months. My concern is that if it is cancer I want to start treatment right away, not 4 or 5 months from now. I do see my family Dr. next week and will get his opinion on what I should do. Just wondered if anyone has had to face something like this. I so appreciate the time and effort spent by everyone on this site to answer our questions with such care and concern. Thank you.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

Did it look like a nodule? size? I've never seen any data in regard to lung cancer and NTMs. I'm more worried about CT scans. I've had an unbelievable amount of CTs in the past 20 years. I just had a similar experience, my August CT showed a new nodule since my May CT. NJH doctor said she wanted to get another CT in 2 months. She didn't think it was cancer; she thought it was either mucus or possibly my MABC or some other infection. I have (had?) MABC but have been testing negative-though that's no guarantee it's gone.

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Keys here are : 1. Is it over 1 centimeter in size? 2. Is it fast growing? 3. Is it spiculated? 4. A yes to all the above would require a PET scan

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Profile picture for kathyjjb @kathyjjb

Did it look like a nodule? size? I've never seen any data in regard to lung cancer and NTMs. I'm more worried about CT scans. I've had an unbelievable amount of CTs in the past 20 years. I just had a similar experience, my August CT showed a new nodule since my May CT. NJH doctor said she wanted to get another CT in 2 months. She didn't think it was cancer; she thought it was either mucus or possibly my MABC or some other infection. I have (had?) MABC but have been testing negative-though that's no guarantee it's gone.

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Thank you for sharing your situation with me. Wishing you a good outcome.

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Profile picture for Rick @rstel7272

Keys here are : 1. Is it over 1 centimeter in size? 2. Is it fast growing? 3. Is it spiculated? 4. A yes to all the above would require a PET scan

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Hi Rick, mine is 1 centimeter, wasn't there in March's CT and nothing was mentioned about spiculated. I was coughing up some mucus with a little green in it, but not a lot. Mostly white.
I will talk this over with my family Dr. to see if he thinks I should pursue an earlier CT with the Pulmo Dr. . I don't want to imply that I don't trust my Pulmo Dr. but I think a second opinion is wise. I appreciate you responding to me. Take care

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Profile picture for bbeers @bbeers

Thank you for sharing your situation with me. Wishing you a good outcome.

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I should add, my Dr at NJH told me that she did not think it was lung cancer since cancer would not have grown so fast between May and August. I did look it up and found that only 3 or 4 nodules out of 100 are lung cancer-so for us with BE it's likely infection, inflammation, or mucus. I'm hoping that's the case for you. Also, years ago I had a PET scan when I had hundreds of nodules in my lungs, I later went to NJH and my Dr there told me the PET cannot distinguish between cancer and infection. Not sure if the scan has evolved but food for thought. Glad to hear you are being your own advocate. Good luck.

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Profile picture for kathyjjb @kathyjjb

I should add, my Dr at NJH told me that she did not think it was lung cancer since cancer would not have grown so fast between May and August. I did look it up and found that only 3 or 4 nodules out of 100 are lung cancer-so for us with BE it's likely infection, inflammation, or mucus. I'm hoping that's the case for you. Also, years ago I had a PET scan when I had hundreds of nodules in my lungs, I later went to NJH and my Dr there told me the PET cannot distinguish between cancer and infection. Not sure if the scan has evolved but food for thought. Glad to hear you are being your own advocate. Good luck.

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Thank you for the additional information. That gives me more hope that this is either just an infection or a new spot of MAC. Will keep you posted on what transpires.

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Profile picture for bbeers @bbeers

Thank you for the additional information. That gives me more hope that this is either just an infection or a new spot of MAC. Will keep you posted on what transpires.

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Yes, please keep me posted. Just curious, are you nebulizing 2x/day with 7% saline? And is your doctor taking regular sputum cultures, and testing for everything?

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Profile picture for kathyjjb @kathyjjb

Yes, please keep me posted. Just curious, are you nebulizing 2x/day with 7% saline? And is your doctor taking regular sputum cultures, and testing for everything?

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Hi, No, not nebulizing and not taking regular sputum cultures. What would be the reason to do cultures if not on the Big 3? Thank you Kathy

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For those of us with BE, nebulizing and airway clearance (e.g. huff coughs) will help keep the airways clear. The goal is to reduce exasperations and the subsequent infections. There are only a few studies out there on nebulizing for MAC treatment, but the few I have read have shown a potential link with nebulizing and spontaneous conversion. I was diagnosed with MABC in November 2024, and my Pulmonologist ordered the compressor and wrote script for the saline, the same day he gave me the diagnosis. By May 2025 my MABC cultures were negative. There is a study starting in Portland with 100 participants looking at using nebulization with 7% saline as a treatment for MAC. My hunch is that they will see an increase in spontaneous conversion. As for sputum cultures, I was sending in monthly sputum samples to NJH and I was not on antibiotics. NJH labs do NTM colony counts and that helps determine the disease progression or improvement. There was a post a few days ago on this site that listed 31 or 33 BE NTM Clinics, maybe you can find one close to you. The fact that you were diagnosed with MAC 2 years ago and nebulizing was not brought up, is a red flag. I had a local Pulm and ID doctor but I chose to go to NJH and I am so glad I did. There are really great videos and studies posted on this site=in just the past week. Also if you have time, you can find the 2025 BE NTM Patient and Family Conference on You tube. It's about 7 hours of lectures but you can see the individual lecturers (to the right of the screen). Kathy

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Profile picture for bbeers @bbeers

Hi, No, not nebulizing and not taking regular sputum cultures. What would be the reason to do cultures if not on the Big 3? Thank you Kathy

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They do cultures to find out if you have MAC or other organisms growing.

Do you have bronchiectasis on the CT's?

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