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JackieJMC

11 MM Nodule Plus Multiple Small Nodule

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Today I received my results for an abdominal / pelvic CT with contrast that I had done for left side back and abdominal pain.    There was nothing remarkable found concerning my kidneys, liver, pancreas, bladder, etc but the following was reported on the the bottom of of my right lung (not left where the pain is).

11 mm nodule in right lower lung. There are additional satellite
tiny tree-in-bud nodules surrounding the dominant nodule. Remainder of the
visualized lung appear unremarkable.

My results came through the patient portal where the scan was done and my GP is out for the weekend.  I'm very scared right now and have been searching for any information on what this might mean.   I have no respiratory symptoms at all and was shocked to see this.   I hope it is okay to post this here.  I've read that nodules alone may be benign but I don't understand the tree-in-bud nodules. 

I've had a lot of symptoms lately that have been very frightening but don't understand how this fits in and am very frightened by it.  Any thoughts are appreciated.

Best Wishes,

Jackie.

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Hi Jackie and welcome. It's pretty scary to get a report like that with no explanation! Nodules can be caused by a lot of different things, infections, inflammation, and sometimes cancer.  Sometimes the cause is unknown and the nodules come and go on CT scans.  I've heard a lot of different descriptions of nodules, but haven't heard of tree-in-bud  so I looked it up. Seems like this is a form of nodule in the shape of a tree with branches and round things on the ends of the branches. Although this shape of nodule can  indicate cancer, they're more likely to be  caused by various kinds of infections.   11 mm is a pretty small nodule so these satellite nodules must be really tiny.Keep in mind that I'm not a doctor and that your doc is the best one to interpret test results for you.  I suspect your doc will order a CT of your chest to see what the rest of your lungs look like.  Keep at it until you get explanation for the nodules and relief from your pain. You might want to ask for a referral to a pulmonologist (lung specialist) to help CT interpretation and  diagnosis.  Waiting for test results is usually anxiety producing and frustratiig. Hang in there and keep us posted.

Bridget O

 

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Thanks Bridget!

It is so nice of you to respond and to look up the tree-in-bud reference.  I know it is a mistake but I did a lot of looking around on it this afternoon also to see what that was.   It sounds like it is usually caused by various kinds of infections but can be cancer as well but it was very unclear to me.   I don't know what to think.  I don't have any signs of an infection or any breathing problems generally at all.  Just the abdominal and left side (other side) pain I had the CT for.    Yes, the satellite modules were actually described as "tiny" by the radiologist.  I pulled that quote from the report.  I'm very scared now but know I have to wait to see what next steps are.  This was something I wasn't expecting to see on the CT report at all.   

Thank you for responding.  I posted here because I saw how kind an welcoming you all are.   I hope this is a case of a strange, benign nodule but am worried since I've tended to be pretty good about knowing when something is off in my body.  :(

Best Wishes,

Jackie.

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Hi Jackie,

unless you have been diagnosed via biopsy with lung cancer, don’t jump to any conclusions. CTScans pick up many different things. Make sure you schedule an appointment with your Dr. so that you can take the next steps to follow up so that you can get to the bottom of this. Sending thoughts and prays your way. 

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Thank you Lorrie,

Thank you for your kind note.  I am definitely trying to remain calm and follow through on next steps without panic.   I really appreciate the prayers.  It means a lot to me.

Best Wishes,

Jackie.

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Hi Jackie ... 

It really is a scare to find these things and I found the doctors say very little which sends our minds into overdrive!!! I’d say as someone said above the next step would be getting another CT scan of your whole lungs if they didn’t get them all in last scan. They basically don’t tell you much as really they can’t ... they can’t reassure you just in case it is something suspicious and they can’t say what it is because they don’t know...yet. Don’t panic yet there is not enough info.

I had to have a lung CT ... then wait 3 months... then have another lung CT to compare ... was no change to nodules so now have seen specialist and he wants another in 6 months. 

Dx 

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Just an update.   I had a follow-up chest CT and this was the report: 

There is a smoothly contoured lobulated soft tissue nodule seen in a
subpleural location right lower lobe epicenter on image 54. This measures 12 x
10 mm and corresponds to the nodule seen on prior CT. Appears to be several
smaller adjacent satellite nodules measuring 3 mm or less. No additional
nodules are identified within the lungs.

My doctor is getting me set up for a pet scan and an appointment with a thoracic surgeon.  

My doctor said that the nodule was not spiculated which is good.

But, noncalcified and lobulated.  Not so good.  :(

My stress level is through the roof.  Just wanted to give an update.

JMC

 

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Jackie,

Try not to worry till you have something definitive to worry about.  I say that because I was an expert in worrying and it did not change my treatment or outcomes one bit! From my understanding of pulmonary nodules, there is still a vast sea of uncertainty from my read of the CT report. Surf that sea till the PET results are in.  Be prepared for an uncertain PET.  Sometimes small nodules don't give reliable uptake results.

Stay the course.

Tom

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Thanks Tom,

I really appreciate your response.   Unfortunately, I have the internet and the subpleural thing sounds bad also. 

Thank you so much for your response.   At least my doctor is being very responsive so that is a good thing.

Best Wishes,

Jackie

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A good thing: whatever it it appears to be all in one place, as well as not very big.Tom is right about PET scans being unreliable with small nodules. t single nodule didn't light up the PET at all, but was in fact an adenocarcinoma. Probalby didn't because it was small and slow growing -- also a good thing. 

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Thanks Bridget,

Yes.  The good news was that there wasn't anything else on the chest CT.   I need to try to focus on the positive and just work through the steps of finding out what is going on.  The uncertainty is very hard for me.  My doctor also reminded me that nothing else unusual showed on the abdominal CT but still has me set up with a gastro (I had a clean colonoscopy six years ago) and an MRI of my spine since I originally came to her with abdominal / back pain.

Thank you for your kindness.

Jackie.

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Hope all is well. I was sent to a pulmonologist when I had a nodule discovered in my right middle lobe. Have have many tests after and it is cancer and will be removed.  Throughout this process the most stress for me was waiting for scan results. After I knew what I was dealing with I was fine. It is just admitting I am not in control of this situation.  No good worrying about thing we can not control. Pick things you can control and do and focus on them. No respiratory signs is great. All indications are it is in one spot. So if it is infection , cancer or what ever it is easier to treat. Thats really good. A lot of positives there. Best of luck to you. 

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I want to thank everyone on this forum for your wonderful support and kindness.  It has been a very frightening time for me and I was unable to update as things went on because I struggled to remain positive.  I do want to give a follow-up that may be reassuring to some new members here.

Following the discovery of my nodule, I was referred for a pet scan and to a cardiothoracic surgeon due to the size (over a centimeter) and shape (lobulated) of the nodule.  The PET scan lit up fairly weakly on the nodule (about 2 per my doctor) and my surgeon thought that the lobulation seen might actually be a group of overlayed benign nodules rather than a single lobulated nodule.   I was given the choices of watching and waiting, needle biopsy or surgical vats biopsy. 

I made the choice to have a surgical vats biopsy to allow for additional biopsy of lymph nodes and more extensive surgery if needed.  I really just wanted whatever it was out immediately and this choice was supported by my general doctor and my surgeon.

I had the surgery on Friday and the nodule was determined to be a benign granuloma (or group of them). I am home today and resting well.  I wanted to post this to thank everyone here for your support and to let people who come here new know that there is more than one possible outcome even in cases where a nodule seems fairly suspicious.

I can't tell the members of this group how much I appreciate your kindness and courage.  I have been touched and changed by your strength.

Thank you. 

Jackie.

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So glad for your happy news!  Sorry you had to have the surgery, but now you can rest your mind and get on with your life.  

I'm assuming they just re-sectioned the nodule itself?  Did not remove the lobe?

Thanks for sharing your reassuring experience.  Even though I was convinced in my own mind that my nodule was cancerous (and it was), my surgeon reminded me that until they examine it they can't know for sure.

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Thanks LexieCat,

Yes.  They just removed and biopsied the nodule during the surgery.  When it was found to be a granuloma, the surgery was finished.  I'm sure a much easier surgery than removal of a lobe.   I'm relieved and glad I went with this route. 

Thanks again so much for your help.

Regards,

Jackie.

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Congratulations on such an incredible outcome.  I’m in a similar situation as you were. I just opted for the same procedure.  I’m hoping for similar results.  🤞🏻

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