Is a Spiculated lung nodule always malignant?

Hi Sue, Have not been instructed to do airway clearance. I was prescribed a Qvar ready inhaler for a few months and an albuterol inhaler to use as needed when the bronchiecstasis disease was found 3 yrs ago on a CT scan. After that it was follow-up ct scans annually which showed a slow progression of the bronchiecstasis until April of this year when they found a spiculated 13 mm nodule in my upper right lung and further disease progression. Follow up was a biopsy via a robotic bronchoscopy at the hospital. The results of the biopsy show that I have non tuberculin avian intercellular micro bacteria. The report did not specify any additional detail. I received the results if my most recent lung function test today and all was normal except for being mildly low in diffusion. I see the infectious disease doctor next week on July 14th. I would love to know your thoughts on what questions I should ask her. I live in the S.F. Bay area . Do you have any recommendations of medical facilities in this area that are cutting edge in the treatment of this type of medical condition? Thanks for following up.

I have a solid, spiculated nodule in RML that is abutting the pleura. My dr. has referred me to a thoracic surgeon. I’m scheduled for a pet scan in a few days. I’m wondering the level of worry this nodule warrants

@linpvc I looked back at your earlier posts, and it seems this nodule has been with you for quite a while. Were you referred to the surgeon by a pulmonologist or a primary care doctor?

If it was your PCP, you might want to ask for a referral to pulmonology in case there is an infectious cause for the nodule. Infectious spiculated nodules can "light up" on a PET scan similar to cancerous nodules. You would want to be sure which it is before undergoing surgery - especially since I think you have lung issues.

Which doctor is sending you to a surgeon?

This is a new module. The one you are referring to has been stable for two years not a concern. This one is growing and spiculated My pulmonologist has referred me

@alsi, it is rather new. It was found at1 cm the 6 mo later it was 13 mm then just 3 months later it was 17 mm.

@sunbeam1951 For complex conditions involving Bronchiectasis, National Jewish Health (NJH) in Denver is considered the top facility. But if that is not a possibility, there are over 30 centers of excellence around the country - you can find a list here:
https://social.bronchandntm.org/directory/find-a-bronchiectasis-and-ntm-center

@linpvc I wonder if anyone mentioned doing a biopsy and how soon. It seems the referral to a thoracic surgeon will involve this discussion. Have they ruled out infectious disease? Not sure if you posted the size of speculated nodule. It is worrisome and I'm glad you are going to see the right medical doctor to help identify this nodule. All the best and will pray for positive outcome.

I would suggest to get a second opinion I had a speculated mass and they told all the possibilities like infection , inflammation etc. After receiving the test to rule out those, turned all negative, I knew my speculated mass was malignant. It was devastating. It's now been one year and I'm doing very well. Have been thru surgery and chemo. Now on target therapy. Doing fairly well. I did seek a second opinion from a completely different institution.
Good luck and I hope yours is a different path.

@lala56 Hi, thanks for the response. It is, at last scan, 17 mm. It grew to this size quickly. I’m getting a pet scan soon. I’’d like to get a surgical biopsy because a needle biopsy left me with a collapsed lung and a painful stay in hospital for a week. All test for various infections, came back negative.

@lala56 Thanks for the reply. I’ll have a biopsy soon after I get a pet scan. I’m hoping the scan will show reduction in size then no biopsy required.