Is a Spiculated lung nodule always malignant?

@363 Good news! I had the follow up scan in January after having the CyberKnife radiation on my lung nodule. The scan showed that the nodule had been reduced to scar tissue. I have another follow up scan to be done in July. I'll report the results here. The fact that mine was "spiculated" and had also grown some since first discovered in 2017 resulted in my decision to have the CyberKnife radiation treatment. Since deciding on radiation over surgery at age 83, I've attended a seminar with a lung surgeon at my local hospital whom I found very kind and impressive. He said that he did lung nodule surgeries on many patients in their 80s, and that they were up off the operating table and walking down the hall soon after their surgeries. He did the surgery with the Da Vinci Robot. Thus, I wouldn't rule out a surgical procedure if you choose that over radiation. But I hope you won't need either.

I had a home phlebotomist sent to perform Nodify Lung testing. My test result was consistent with an indeterminate result. My nodule is a subsolid . Biopsy is not recommended at this time. I have another CT in December. I was told not to worry at this time. But I still have my concerns.
Don't nodules grow fast if it happens to be cancer? What does subsolid really mean. I was told there are 3 different types solid, subsolid, and ground glass. What is the difference and what does that all mean. My nodule is A spiculated right upper lobe pulmonary nodule measures 5.4 x 6.6 mm, with average diameter of 6.0 mm .

Thank you for asking. Yes I did get results of the biopsy and it was good news. In spite of the spiculation, size, and every other factor that indicated malignancy.
I am waiting for a valve replacement (which is how they found the nodule) but it was the lung issue that scared me the most.
Hopefully the valve replacement will be a piece of cake (fingers crossed)
Thanks again for checking.

@ditot07 hello checking in with a follow up to your lung nodule situation. And hoping your valve replacement went well and are all healed up from that. Did your drs want you to continue to monitor the spiculated nodule after your biopsy or did they give you the all clear based on the results? I’m currently under surveillance for a small spiculated lung nodule in my right middle lobe as well as a couple others in different lobes. All mine are small subcentimer ground glass nodules with smooth round borders except for this 4.2mm spiculated one. My radiologist recommended scan again in one year and pulmonologist wants sooner scan which has me worried. Is she being over cautious or does she see something really concerning. When I asked why the sooner scan than what was recommended by radiologist she said well because you have several new nodules… I said really? why didn’t the radiologist note that on the report? There was no mention of any new nodules at all.. she just said “well I don’t know. I just think we really need to scan again now) we are currently 9 months out from the last scan where radiologist said repeat in 1 year. Any thoughts you can share is appreciated… Hope you are doing very well.

@hercules hello,

I am doing well. Thank you for asking. Valve replacement was much easier than I expected.
Regarding the lung nodule. Dr has increased the monitoring scan time from 6 months to 1 year, as there has been no change.
I absolutely get why an earlier scan would have you worried. On the other hand, thank goodness she is being cautious. That is what you want your doctor to be.
I don’t know that I have insights that would help. I totally understand how terrifying this is and wish you all the best.

@ditot07 Hi again, thank you so much for your reply. I am so glad to learn that your valve replacement went smoothly for you and that it was much easier than you expected. That is wonderful news! I am also happy to hear that your scan intervals have lengthened due to the stability of your nodule. That I also take a great news! I am still trying to wrap my head around the scanxiety that comes with all this survelliance and how to try and live my life as normally as possible between scans. The feelings of what if and associated fears can be quite paralyzing and debilitating at times. I know that is not the way to live and I am grateful for today's technology, good and thorough doctors and forums such as these where people going through similar situations can offer insight! Wishing you the best health!

@hercules
You’re human. I obsessed about that nodule. Read everything I could find. And everything I read made it worse. Believe me. I get it.
When is your scan?

I’ve had a 5mm nodule on my right middle lobe for well over 12 years. In January I had a CT and it was 7mm so my doctor ordered a follow up ct for in July. I didn’t have it done till Thursday. I have a brand new spiculated nodule in lower lobe right. And it’s already 13x11mm. I got for a PET tomorrow and I am scared to death. My husband keeps saying I’m overreacting and it could be nothing. I’m a registered nurse and I know this is bad. Am I wrong?

@valerie131 Hi just checking to see what the results of your pet scan was and your nodule situation currently. I know your post is a couple of years old though but was curious to see how you are doing. I hope this message finds you well. I am currently under surveillance of 3-4 small ground glass nodules 4-5mm but one of them is now being described as spiculated one year ago. recommendation was to follow up in one year and now at 9 months later the recommendation is to scan now. I'm not sure why the change in the recommendation, my pulmonologist was vague. Of course I am going to do it but it all has me worried sick again while I wait. Scanxiety is the worst! I was also puzzled by the fact you had a small nodule in your right middle lobe for 12 years that remained unchanged and then seemed a little bigger in January. Could it be just a margin of error. 2mm isn't that big of a difference after 12 years of stable I would think but I'm not a doctor either... Wishing you good health.

@hercules Many years ago I had a spiculated nodule. After a couple of CT scans, yearly, it was gone. I still have lung CT scans every year. Please do not be anxious, just pray about it. That is what I did. My pulmonologist was surprised when it was gone and actually called the radiologist on the phone, while I was in the office, to have him review it again. God bless. I cannot figure out whose post was the original. I hope the one with the spiculated nodule can see my reply.