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Is a Spiculated lung nodule always malignant?
Lung Health | Last Active: 14 hours ago | Replies (260)Comment receiving replies
I'm a never smoker, unknown family history (adopted), 62 y/o, female otherwise reasonably healthy until a recent coronary artery calcium score CT scan on 04/2026 identified a 2 cm nodule in LLL; I had a CT with/without contrast back in December for a small intestine block which only called out consolidation in the LLL. 6/4, I had a pet scan showing nodule SUV 1.8; my pre biopsy CT 6/12 showed stable solid non-calcified peri-bronchial nodule with associated focal architectural distortion and spiculated margins measuring 2.4 cm. There are several other solid non-calcified and ground-glass nodules scattered throughout the lungs, largest in the anterior sub-pleural right upper lobe measuring 7 mm. My pulmonologist is working it up assuming it is malignant with baseline blood work for genotyping. I had a Nodify (Biodisix) blood test that suggested <4% risk for malignancy but the morphology of spiculation wasn't called out at that time so not sure if Biodisix included that feature in their risk algorithm. I will have the results back from my biopsies (nodule and nodes) in the next several days. I am very happy to find this group for support and additional information sharing - it's hard to take it one day at a time, try not to meltdown emotionally, and helpful to not be "alone."
Replies to "I'm a never smoker, unknown family history (adopted), 62 y/o, female otherwise reasonably healthy until a..."
Welcome to Mayo Connect @peg1224 , Waiting for results can be one of the most difficult times in the diagnosis process. It sounds like your pulmonologist is taking steps to take good care of you, in nailing down what these are at the cellular level. While it's difficult to wait, each step in the process is helpful to form the full picture of what's happening. And more importantly, what to do next.
I know it's hard but try to keep busy to keep your mind on something else. Those 'meltdowns' are understandable too. You're allowed to be scared, but also know that there are so many good treatments available today for lung cancer. Your docs are on top of this. Please let us know when you get more information on the tests. Hugs.
@peg1224 UPDATE
I have been diagnosed with Low-grade B-cell lymphoproliferative disorder with lymphoplasmacytic differentiation.
Currently, my differential diagnosis includes marginal zone lymphoma with lymphoplasmacytic differentiation, and lymphoplasmacytic lymphoma; possibly LPL Waldenström's macroglobulinemia. The pulmonologists are transferring my care to a heme-oncologist and I will have additional tests to determine MYD88 status, a low grade B-cell lymphoma FISH panel and blood and urine protein electrophoresis and immunofixation tests.
I'll migrate my group membership to a specialty lymphoma group after this post - but it IS possible to have a nodule that initially looks like classic adenocarcinoma be diagnosed as something very different!
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@peg1224 you are doing everything right..and the fact you have had biopsies will give you the answers and praying that they are non cancerous growths.
Please keep us informed if possible and wishing you all the very best