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One nodule in each lung


buzzy

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I recently had a CT during that found one nodule in each lung.

The left nodule in the lower lobe was found in July during a visit to the ER for a Kidney Stone.  It was measured at 6mm.

A week ago I had a follow up CT that was a dedicated chest CT.  The nodule in my left lung was measured at 7mm.  They also found one on the right lung that was 13mm.  The one in the right lung is also in the lower lobe and wasn't seen in July.

The radiologist wrote that he suspected inflammation of infection on the right one and wants a chest x-ray in 4 weeks to recheck it.  He, nor my GP seemed concerned about the 1mm growth in the left one and suggested a follow-up CT in 12-18 months on it.

I thought that seemed strange and requested an appointment with a pulmonologist which has been set up to happen in about a month.

Both nodules are non calcified, non spiculated with smooth edges.

I am 49 and have never smoked.

I am a worrier and am definitely concerned and consumed by this.

Are bilateral nodules a huge red flag for cancer?

Why would my GP and radiologist feel the 1mm increase from 6 to 7 not be a big deal?

At this point I have not been diagnosed with anything and I hope me posting doesn't offend anyone who is fighting lung cancer right now.  I'm just looking for information and advice while awaiting my appointment with my pulmonologist.

Thank you for reading.

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Buzzy,

Welcome here.

You are right to be concerned about the nodules in your lungs.  All nodules are red flags for cancer.  Your appointment with a pulmonologist is a good next step but a better step for consideration would be a consultation with a medical oncologist.  To easy your mind, topics you might explore with your pulmonologist are a biopsy or PET scan.  A biopsy at this juncture might be the better route.

Stay the course.

Tom

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Thank you for the reply Tom.

My heart goes out to all of those on here that have been diagnosed. I'm terribly fearful at this point and can't imagine the mental stress an actual diagnosis brings.

My GP has been great and keeps telling me that all this is likely benign, incidental findings but when I research the topic I get less and less confident that it is.

I have been thoroughly tested the past few years.

Colonoscopy (April 2015) was clean.  Diagnosed with likely IBS.

CT scan in July that showed first nodule also showed kidney lesion.

Ultrasound in August diagnosed lesion as simple benign cyst.

2nd kidney stone CT in September showed second kidney cyst.

Oct. MRI diagnosed it as another benign cyst.

Kidney Stone removal surgery in November was followed up with full abdominal ultrasound in early December to make sure everything was healing correctly.

None of the CT's, Ultrasounds or the MRI found any red flags. Spleen, bladder, gallbladder, pancreas have been normal with no worrisome findings on any of them.

That is why this last chest CT is so disheartening. I really thought I was in the clear.

GP said even with two nodules the chance of cancer is small. Said any mastastic issues would have most likely been seen in one of the many test.

He is convinced the first nodule is or will stablize and the second nodule is an infectious one that will not be an issue.

I guess I'll find out more in a few weeks but praying he's right.

Thank you and anyone else who reads this or comments on this. My wife gets tired of my worry and it's nice to talk about this without putting more of a burden of concern on her.

 

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Hi Buzzy,
Tom gave you great advice. Just 1 note to ease your mind and bit. A 1mm change can be nothing more than a difference in the type of ct ordered (36, 58 or some other numbers I can't remember exact details) the pix aren't taken every __ mm and if it was 1 number you get closer details. The other difference could be exactly where in you the CT started. If they happen to start at the exact edge of the lesion it could look bigger than if it started part way through that first mm the end of the lesion appeared to be gone, aka smaller.

I suck at explaining but a mm is small and where it is between slices or on them will allow for a .5mm difference between 2 or 3 CTs.

This was explained to me when I had my first 1mm difference between 2 scans 3 months apart. I wish I could make it sound better. Ask your doctor about it next time & I'm sure they will make it sound crystal clear.

Fingers crossed all is benign!!
Mary

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Thank you Mary. 

I guess you're saying that a 1mm difference might be documented by a radiologist but that small of growth might not really indicate growth.  That eases my mind a bit.

My GP seems to not be concerned with it.  He also seems convinced the new one (13.5mm) they found on the right is incedental and due to infection or inflammation.

My only concern is that I can't recall having any respiratory sickness or issues between July and December that would have caused the nodule to appear.

He went ahead and gave me a z-pack but I've been coughing more since taking it than I did prior to the CT findings.

Part of me worries that the nodule(s) are cancerous and symptoms are beginning to show up.  Another part of me thinks I have read about lung cancer coughs and symptoms and I am subconsciously causing myself to have them.

I'll hopefully get some solid information from the pulmonologist in a few weeks.

Thank you again for the reassurance on the growth issue with the first nodule.

One last question for you and Tom.

Is it possible for the two single nodules, in two separate lungs, to be unrelated to each other like my GP is suggesting?

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Buzzy,

To your question -- possible for 2 nodules of a different type and unrelated in each lung.  Yes, anything is possible.  Search here for WebMd's discussion about lung nodules.  

And I want to reinforce Mary's explanation of how small 7 or 13mm is.  7mm equals just a little larger than 1/4 inch, and 13mm is a little bigger than 1/2 inch.  To visualize, a 1/4 inch nodule would be about the diameter of the eraser on a #2 pencil.  A 1/2 inch diameter is the size of the home button on an iPhone.  These are worthy of concern but small.

Stay the course.

Tom

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Hi buzzy

Great advice from everyone. I had my upper left lobe removed in 2007 and have been all clear since. On a ct scan in march, ground glass opacity showed up in my right lung. The radiologist thought it may have been an infection and suggested a follow up ct in 4 months. On the July ct scan every thing was all clear. They think it was just an infection from the flu I had in February. 

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Thank you Bruce. I hope you continue to have good health.

I'm petrified. I know I shouldn't go down the google rabbit hole but I do and when I do, I read nothing positive about having one nodule in each lung. It seems bilateral almost always means malignant or mastastic.

I'm trying to stay positive but am bracing myself for bad news. I only hope that if it is malignant it is caught at an early enough stage to give me a chance to beat it.

I really love you guys. I need honesty and hope. I feel I get that here.

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The Google hole is a VERY not good place to go when trying to tippy toe around some severely raw nerves!! I think I spent 47 hours on Google 1 day in between tests. Yes, I did the math! LOL!
After I had been NED (No Evidence of Disease) for 2 or 2.5 years Valerie Harper (Rhoda) let the world know that her lung cancer had metastasized to her brain. I not only immediately suffered debilitating headaches, I was sure that they started weeks before the news broke. Needless to say it's been another 2.5- 3 years later and the brain still seems to be a ok! Well, as good as it ever was , I think. Ha!

Pardon my laughs, I have always used jokes. Sometimes for good reasons & sometimes so totally ridiculous that even the most demented monster couldn't laugh at it. Just me. Sorry.

Or, not sorry cuz everyone should laugh if they can!!!

Take care,
Mary

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Tom, Mary and Bruce,

I wanted to share what I felt was some positive news with you that I got today.

Ive been wheezing the past few days so I went to my GP to see what he thought.  Before he examined me he wanted to talk a little about my nodule concerns.  He showed me a report from a ct I had in late September when I had a second kidney stone ER visit.  Since it didn't mention the 6mm nodule found in my left lung in July, he requested that the radiologist that read my December ct checkup to go back and reread the sept ct as a favor.  The radiologist found the nodule and measured it at 7mm, so between Sept. 27 and Dec. 22 there was no change which is a good sign.

After he listened to my lungs he suggested I get a chest Xray to check on the bigger 13.5mm nodule as well as get a look at what might be causing my wheezing.  He called me back a couple hours later and said he had some good news.  The radiologist read the chest Xray as completely clean with no sign of pneumonia or nodules.

Now, he was quick to point out that the Xray is not nearly as sensitive as a ct and that both nodules are likely still their but the fact that it found nothing meant that the 13.5mm nodule that was new in December had most likely not grown and very likely had shrunk some. He said a 13.5mm nodule would most likely show up.

So my good news was that the left nodule is likely stable at the moment and the bigger nodule has shrunk or might even be gone if it was an infection.

Im still going to a pulmonologist on Jan 23 and he will look over all my scans but this was a good day.  

Im still not out of the water and expect another ct this spring, but it was nice to get some positive news.

i want to thank all three of you for taking time to inform and encourage me.  I will keep giving updates and definitely plan on checking in often to keep up with you and others.

 

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  • 3 weeks later...

Update:

I saw a pulmonologist yesterday and really like the guy.  He took time to go over all my CT scans and x-rays, showing me the nodules and telling me exactly what he was seeing and thinking.

First, he thinks the two nodules are totally unrelated to each other.  I said I was concerned about them being bilateral and he said that his gut told him that they were not related but we would keep and eye on them.

The original, smaller nodule at the base of my left lung that measured 6mm in July has remained stable in his mind.  He showed me the comparison of it in Sept. and Dec. and said in his mind it hasn't grown at all and might be beginning to show signs of calcifying.

When I asked about the 6mm vs. 7mm he gave me the same answer you all have given me on here.  He talked about the slices and how intricate a 1mm difference is.  He said he thinks it was between 6 & 7 mm in July and still was between 6 & 7 mm in December.

The bigger, 13.5 mm nodule at the base of my right lung was a different case.  He said the way it developed and the way it looked gave every indication of it being an infection/inflammation.  He even felt it could have been an early stage of pneumonia that the medication stunted before it could really blow up.  Anyway, he said he really felt like it did not look like either lung cancer or metastases. 

He did say that the chest x-ray that was clean in early January didn't really give him any useful information.  The nodule of the left is too small to show up on x-ray and the one on the right is basically hidden by the diaphragm.

He is going to have me get another CT in April more for the bigger one on the right than the one on the left which he feels looks stable.  If the one on the right hasn't grown or has gotten smaller, he said we will follow up in another year or so.

He told me to get back to running, and not dwell on it.  He said if he really believed anything looked suspicious he would move much more quickly.

Anyway, I wanted to update you all.  Hopefully I'll get good news in a few months.

I hope you are all doing well and thank you once again for being so kind and caring to me through this experience.

I really appreciate you all.

 

 

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That's great news, buzzy! Thank you for the update. I'm happy that the pulmonologist was able to give you good news and that you can get back to running. Keep us posted on your next CT!

Lauren
--
Digital Community Manager
LUNGevity Foundation

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  • 2 weeks later...

Buzzy,

First,
FANFORKINTASTIC!!

Second, I have NO idea why this conversation hasn't shown up on my radar before today! I am SO sorry I didn't see it and reply sooner! When I see that Tom didn't reply either, I actually feel less guilty because I believe it must have been a computer glitch. He is a darned good guy and would never let you go unanswered if he saw it.

Not that I'm a bad person... I just pop in late at night here on the east coast and sometimes I only have time for an answer or two. Until I got the phone app I was really off for a while with computer issues.

So glad things are looking up! I will keep fingers, toes, legs & occasionally eyes (hehe) crossed for you that you never see any growth again!!

Take care,
Mary

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Buzzy,

Way good news!  The reason I didn't answer is because the wife and I decided to take a last minute cruise.  So I was off the internet when you posted information about your pulmonologist report. (I did have spotty WIFI connections in port and tapped out several short answers but for most part, I'm in catch up mode).

Stay the course.

Tom

 

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