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Is a Spiculated lung nodule always malignant?
Hello,
58M, Nonsmoker, No history of cancer
I went to a pulmonologist due to coughing, shortness of breath for over 2 years and got diagnosed with allergic asthma.
Ct scan showed 5 lung nodules all on the right lung.
2 are calcified -most likely granuloma,
2 perifissual- which are most likely benign
1 subpleural nodule 5mm
1 spiculated nodule 5mm
The spiculated lung nodule worries me the most
I did research and all data and studies say that spiculated nodules are malignant with a predictive value of up to 90% ..
Doctor wants to just monitor it with follow up Ct scans.
I read that in rare cases infections, Inflammation or sarcoidosis can have Spiculation but Generally such nodules are a sure sign of Malignancy.
Anoyone on here who has experience ?
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@missyo,
I recently found out I have a 1.2 cm spiculated pulmonary nodule, in the LUL, not in an easily reached area. Discovered July 20th, 2nd CT on the 20th of October. They wanted me to wait 6 months for 2nd CT, I replied "No, meet you halfway, at 3 months." There are many more solid nodules >8mm with smooth borders. I am high risk, cancer survivor, and cancer therapy survivor. There's a lot of things wrong with my lungs. I call it The Heinze 57 of lung diseases, and now the sputum I cough up has blood in it. Before that my cough was dry and nothing came up for almost 3 years. I'm not feeling very positive at this time 😕 Thank you for letting me get this out of my system. @country
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3 Reactions@penelope25, It sounds like you've been unfortunate enough to have been through a lot medically. That's given you the conviction to advocate for yourself. Did you mention the sputum and blood to your pulmonologist? It could be caused be many things, but I wonder what they thought. I know it's easy to jump ahead to worst case scenarios but try to focus on what we know today. Hugs.
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2 Reactions@i had a biopsy after a negative PET because of the size. It was 22mm. But. It turned out to be an infection and follow up scans showed it completely resolved. Just passing on.
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5 Reactions@junerose42 Update: I had biopsy of my lung nodule in August. The results were inconclusive - the technician couldn't get any tissue from the nodule, as its small and located in the mid lobe which makes it difficult to get. My pulmonologist recommended proceeding with treatment, either lung surgery to remove it along with part of my lung or CyberKnife radiation. I chose the latter as at age 83 I didn't want to undergo lung surgery. I had 3 CyberKnife treatments in September, on a Tuesday, Wednesday, and Thursday. I didn't feel anything during the treatments, but during the week after I felt fatigued. Since then, I feel fine. Radiation oncologist said I should schedule a CAT scan in January 2026 to see if the nodule is gone. I have that scheduled and will let you know the results. I'm grateful for the CyberKnife option, and just hope it worked!
Thank you so much for posting this..I have a 8mm spiculated nodule in the middle lobe which cannot be biopsied and we are now just watching as I too do not want my middle lobe to be removed on the maybe..
I am praying this worked for you and it is something I discussed with my thoracic surgeon should my nodule grow. wishing you the very best
@junerose42 , Thanks for posting an update. I'm glad the cyberknife was well tolerated too!
I'll be looking forward to your update in January. 🙂
@363 Thank you for your message and your prayers. I will let you know the results of my CAT scan scheduled for January 2026. My spiculated nodule had grown larger than yours. Mine started out at 9mm in 2017 and increased to 15mm earlier this year. The fact that it grew along with the spiculated shape caused my pulmonologist to recommend the biopsy. I spent the entire day in the hospital, including a slight pneumothorax (lung collapse), but the technician didn't get any tissue from it. The mid lobe is difficult to find in a biopsy. Before having the needle biopsy, my pulmonologist sent me for a consult for a bronchosopy biopsy, but that doctor said he wouldn't be able to find it going down my throat to the lung. So I am in the "maybe" land of treating something that might be benign and might be cancer. Odds were in favor of malignant, however, due to the growth and the shape. I hope yours doesn't grow and you can just keep watch on it rather than having to move to CyberKnife or surgery.
@junerose42 Thank you so very much for your kind wishes..
Where I live in Canada the CyberKnife radiation is not available so I am pleased you received it..It is available in only 3 hospital settings in all of Canada but we do have something similar but the CyberKnife I have read is the most accurate especially while breathing with lung nodules.
I will pray and wish you all the very best with the CT in January and yes please keep us posted.
@363, I just read your post and you mentioned that you live in Canada, my reason for asking is that I recently read about Cyber Knife and it really got my attention.. I’m guessing that we don’t have this in our country yet, I can’t have any more surgery after one lobectomy and a wedge section removal surgery. My recent ct scan showed a nodule 8 mm. in URL that has grown a bit, of course I know only too well what this means, I just don’t know how I will get through this one without using chemotherapy or radiation.
The CyberKnife radiation is available in 3 cities in Canada..Ottawa, Halifax, and Montreal..
I am so sorry you now have a nodule after going through one lobectomy and a wedge section removal.... that is alot to go through...perhaps it is benign hopefully and pray that it is..what is your next step with follow up...CT...