Connect
← Return to Is a Spiculated lung nodule always malignant?
Discussion
Is a Spiculated lung nodule always malignant?
Lung Health | Last Active: 1 day ago | Replies (211)Comment receiving replies
What size was your nodule?
Due to the small size of my nodule Biopsy and Petscan won’t be meaningful.
So doctor suggested the watch and wait approach.
My doctor said that infection, inflammation is a possibility and if it shows any growth on next scan we’ll do surgery.
But given all the data regarding spiculated lung nodules with the up to 90% it’s hard to believe that I will be one of the rare cases where it turns out to be just infection or inflammation..
However the data and studies also mostly refer to nodules that are > 1cm.
Not much information is available on smaller nodules with Spiculation, So I don’t know if the risk of 90% applies to smaller nodules as well?
According to The Fleischner guidelines for smaller nodules with suspicious borders such like Spiculation a follow up in 3-6 Months is recommended.
I think it’s just a matter of time till my nodule grows and is then confirmed malignant and with any growth the possibility of it spreading increases.
Therefore I’m debating whether I should just insist on getting surgery right away to get rid of it as soon as possible.
Replies to "What size was your nodule? Due to the small size of my nodule Biopsy and Petscan..."
I had a spiculated nodule of 1 cm found in my left lower lobe and my doctor also wanted to watch it. It stayed the same size for 1 1/2 years and then doubled in size so he said it was time to get it out. I had my left lower lobe removed 5 years ago. I am so used to it being gone it causes me no issues. My bloodwork indicated I did not need chemo or radiation. I feel thankful for that.
Marchettia in AL
I would insist on surgery!I am having a biopsy and my nodule
Has some spikes on the top?
Hello, It's Sept 2025 and I wonder how you are doing now? I have many of the same questions about spiculation of smaller nodules. I have 3-4 small ground glass nodules that were discovered a year ago on my first LDCT lung cancer screening. At the time they were all described as 4-5mm ground glass with indistinct margins. Now one year later there is no change in size but now describe smooth margins in all but one, one has "spiculated margins" It is 4.2mm ground glass. The recommendation was repeat scan in one year. My pulmonologist does not seem alarmed. My question is does anyone with similar situation, small spiculated nodule feel that one year is too long to wait to scan again? The first scan that had described the margins as indistinct in all of the nodules was reported by a different radiologist than the one that read the second scan. Could this just be a matter of reporting differences between two different readers or could the difference in describing the borders really represent a change or morphology of this one nodule. I have a follow up appt with my pulmonologist in 6 months and I intend to bring all of this up to her but as of right now she seems to follow the recommendation of the radiologist that I be re-scanned in one year. Thanks for any insight or replies. Hope you are in good health!
Connect
They removed a 3.1cm mass from my upper right lung (stage 1b not 1a because of size). However, the measurements on CT scans refer to ground glass, semi solid and solid parts so it is difficult to compare to your 5mm. Did they say it was solid or semisolid?
I have three and six month follow-up scans and they know my other nodules are adenocarcinomas (all thought to be primary cancers). But the objective is to preserve lung tissue/capacity for quality of life so one can't just cut them out. My two largest nodules were in good locations for surgery. And I am having Video Assisted Surgery which is a lot easier on a person. My other nodules will probably have radiation ...and they want a certain size for that also.
I relate to your desire to do something. I am the same.
Look for a Pulmonologist who specializes in lung cancer (Pulmonologists specialize in certain areas), and be sure the institution offers the latest treatment options for lung cancer - like Video Assisted Thoracic surgery and more advanced radiation, other targeted therapies. An experienced Specialist will know when and how to treat.