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Questions on CT showing New 4B Spiculated Nodule
Hi, I've attached a copy of the CT Scan I had yesterday. I'm scared and I'm hoping some people can perhaps answer my questions.
What I know:
I have Type 2 diabetes that is well controlled on Metformin
I feel fine other than some hip pain that has been xrayed and told it was normal aging and nothing remarkable.
I am a 68 yr old widow with no living family or other form of support so I don't have transportation because I cannot drive.
I am a smoker 🙁 and I have diabetes that is well controlled. Again, I feel very good.
I am overweight and do not get enough exercise.
There is no history of Cancer in my Family
The last CT I had was almost 15 years ago and was in the ER when I had the Swine Flu. Nothing was mentioned to me then other than they asked "Has anyone ever mentioned that you might have Empysema?"
I cannot drive
Here are the questions I have:
1. How high is the probability that this is malignant and, if so, what tests will tell me what stage? The spiculated part is really concerning.
2. My primary care doctor says this is not her area of expertise and wants to give me a referral. I live on a remote island and will have to travel a far distance including over an hour on the ferry one way to get to a pulmonologist or whoever she refers me to so I want to be sure I get to the right doctor. If something is wrong I would like to go to the doctor that will be with me all the way through not just anyplace that gives a PET/CT. Is this a reasonable request?
3. What comes next AND how quickly? PET/CT? Biopsy? I am in the process of selling my house and moving to an area closer to medical care. When I say "in the process" I mean I have received offers but have not yet found a place to move to yet. Do I have time to wrap this up and be settled in a new place closer to the doctor or should I put everything on hold and try to get Angel Flights to treatment if any is necessary? I really don't know how quick any of this happens!
THANK YOU ALL SO MUCH! I will post more as I get more info. Following is yesterdays CT report:
CT LUNG SCREENING WO CONTRAST
Clinical: PERSONAL HISTORY OF NICOTINE DEPENDENCE
Comparison: June 25, 2021
Procedure: Noncontrast chest CT using low-dose screening technique. CT was performed using one or
more dose reduction techniques: Automated exposure control; adjustment of mA and/or kV according to
patient
size; or iterative reconstruction. Lung lesion Category designation and management based on ACR
Lung-RADS 2022 guidelines.
Unless otherwise stated, any renal cyst, thyroid nodule, or adrenal nodule mentioned in this report
warrants no additional evaluation or follow-up.
Findings:
LUNGS: There is a new irregular pulmonary mass within the left upper lobe inferiorly measuring 1.0
cm.
Stable 6 mm nodule within the inferior right lower lobe.
Mild bandlike scarring versus atelectasis within the inferior right upper lobe.
Emphysema.. Unremarkable airways. PLEURA: Normal
CARDIAC: Normal heart size.
CORONARY ARTERY CALCIFICATIONS: None
MEDIASTINUM: Normal caliber of the aorta and central pulmonary
10/18/25, 3:45 PM My PeaceHealth - Test Details
Study date: Oct 17, 2025 2:48 PM
Collection date: Oct 17, 2025 3:10 PM
Result date: Oct 17, 2025 3:18 PM Result status: Final
arteries. No lymphadenopathy.
BASE OF NECK AND CHEST WALL: No significant abnormality.
UPPER ABDOMEN: No significant findings. SKELETON: Unremarkable for age.
IMPRESSION:
LungRads Score: 4B - Very Suspicious.
Follow-up: Very suspicious follow up Chest CT, PET/CT, Sampling, and/or pulmonary referral
Other significant findings: No.
Emphysema.
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I would recommend getting referred to a pulmonologist soon that word suspicious is something to be concerned about
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2 ReactionsHi, I’m sorry that you’re feeling so stressed but it’s very hard to stop until you’re more informed about your situation. I can tell you what happened after they found a suspicious nodule in my upper left lobe, the next thing they would do is take a PET/ ct scan to check for cancer which lights up if it is cancer, the size is also a size that can be biopsied to get more information about it. It isn’t necessarily cancer because it can also be an infection which also lights up on a PET scan. I understand how you feel but until they complete their tests they will discuss what they want to do, it’s in the early stage being small, once they have completed their tests you will have to wait for all the answers you’ll need to know moving forward, best wishes for your results.
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1 ReactionI see where they use the word irregular for the 1 cm mass. Did they actually say spiculated. Yes if spiculated very concerning. Spiculated masses are almost always malignant. When my primary doctor called me to tell me, I had a spiculated mass. She had me into a pulmonologist office the next day. I would get in to see pulmonologist right away
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3 ReactionsSorry for the punctuation in my previous post to you, but I’m using voice control.
@susies215
Thank you so much! In re-reading the report I only see irregular. I don't see spiculated and I don't know why I thought that but I can tell you I never heard the term before this CT so I either heard it from someone or picked it up in the crazy amount of research I've been doing.
I'm going to go with irregular 🙂 Can you tell me what the difference is between spiculated and irregular?
Thank you so much. I am so grateful for your insight!
@snorfish a spiculated mass is a very specific type of irregular mass with what appears as spikes coming from it. Mine was diagnosed as spiculated right away and like I said almost always malignant. An irregular mass is less specific and may be benign or malignant from my understanding. Maybe your Dr used the term. I would still see a pulmonologist right away. Hope everything turns out to be ok
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2 ReactionsA lung nodule can also have smooth edges and be malignant, whereas a spiculated nodule can also be caused by infection because they both have spiked edges, I was also told that a lung nodule is called a mass when it’s bigger than 3 cm., the best way to be sure is a PET/CT scan and a biopsy, at this point everything is speculation.
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2 Reactions@susies215
Thank you < 3
My primary says "this is not her field of expertise" so she is going to refer me to the Pulmonologist of my choice. I guess I'm just going with the one with the best reviews that can get me in the quickest.
Do you know if it is possible for the pulmonologist to see my radiology report and send me directly for a PET/CT or will I have to go to his office first?
I ask only because I live on a fairly remote island which has over an hour ferry ride both ways and then at minimum one hour drive both ways.
@frouke
Thank you. This gives me a little hope when I was feeling hopeless. < 3
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1 ReactionSee if your primary care doctor can give you a referral to a telemedicine referral to the pulmonologist. He/she can then determine further testing. Most likely for a PET scan or biopsy
Attached is the pdf file for lung CT findings. 4B very suspicious Keep on top of this and hope everything works out for you
Lung-RADS-2022 (Lung-RADS-2022.pdf.pdf)
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