Nodule close to heart

[NinjaJack]

Its been a while since I posted about my PET scan results.  So let me refresh, diagnosed with Melanoma in Sep 2018.  Surgery to remove tumor and lymph nodes.  It was stage 1 so no other treatment.  Starting in May of last year I got a CT scan for abdominal issues I am being treated for and it showed possible neoplasm in left lower lobe.  In Sep 2019, another CT scan showed nodule in lower left at 2 x 1.5 cm and also GGO in upper right lobe.  Oct 2019 did PET the showed lower left 1.9 x 2.1 cm 8.1 SUV and right 3.5 x 1.9 cm at 7.6.  A bronchoscopy was done but only on right side and only involved washings.  They did find E. Coli in my lungs so I went on antibiotics for 3 weeks.  CT scan after antibiotics still shows lower left nodule at 2.4 x 2 cm.  It also showed calcified mediastinal lymph nodes.

So now my new pulmonary Dr wants to send me to Emory in Atlanta to have them biopsy the nodule.  The only problem is that it is very close to my descending aorta.  He showed me on the scans and it looks like it is right up against the aorta.  So his concern is about the needle pointing at my heart to do the biopsy.  He is confident that the Dr at Emory will be able to do the procedure.  He called it an EBUS.  Can anyone share experience with this?

Has anyone here had nodule that is right next to the heart?  If so, what king of symptoms were you having? 

Thanks for your help.

Jack

[Curt]

I didn’t have EBUS.  I opted for the more aggressive wedge resection.  Nodules the size you’ve noted usually don’t  present any symptoms, even if they are close to the heart.  The difficult part about lung cancer diagnosis is the fact that most people are completely symptom free until late stage.  The needle biopsy so close to your heart is a concern, but finding out if the nodule is cancer and the type as early as possible is also important.   The earlier you find out the better your treatment options.  I’d the other nodules cleared after antibiotics that is positive.  The remaining one could just the residual Infection and not cancer. has that remaining nodule shown up on a PET scan?   Has it appeared since the last PET scan you had?    

[NinjaJack]

Curt,

Yes, the lower left showed on the PET scan at 1.9 x 2.1 cm with 8.1 SUV.  The CT scan after this PET scan and the antibiotics still showed the lower left nodule at 2.4 x 2 cm.  And I have only had the one PET scan back in Oct 2019.  Most recent CT scan was Dec 2019.  My pulmonary Dr doesn't want to repeat the PET scan since that lower left nodule has not been biopsied yet.  My previous pulmonary dr wasn't very proactive and I had to convince him to do the bronchoscopy that ended up being a waste of time since all he did was just washings.  He didn't even attempt to reach the left side.  In his defense, though I believe they typically only go on one side to prevent collapsing both lungs.  My new pulmonary Dr said the left nodule was too deep for him to reach with his scope.  So that is why he is referring me to Emory. 

I am just thankful that this new pulmonary dr is taking this serious.  Hope to get scheduled soon.

Jack