I read a ton about lung nodules yesterday, mostly on this forum. In fact, it took my entire day away from me. I'm not nearly as panicked as I was when I made the discovery but not breathing totally easy yet. So, these are the main points I learned from reading all the experiences of others who have dealt with newly detected nodules:
1) If the radiologist had any suspicion about the malignancy of the nodules, it would have been expressly worded in the report. We know they err on the side of caution with including such possibilities, e.g. "suspicious for metastatic cancer," so the neutral wording in my husband's report is a good sign.
2) Lung nodules are found on about 50% of thoracic scans, and about 90% of those found are harmless.
3) What the radiologist detects as "lung nodules" can be fibrosis/scarring or inflammation and can be caused by infections such as pneumonia or bronchitis. I would assume that congestive heart failure, which my husband had last winter into the spring, could be a cause as well. Chemo can also cause them - benign in addition to cancerous - as a result of inflammation.
4) Under .4 cm is too small for a PET to detect. Also too small to biopsy. Nodules must be at least .8 cm to be on a PET or be biopsied.
RADIOLOGY NOTES WITH FOCUS ON LUNGS
April 12, 2017 CT abdomen with IV contrast at SVMC (local hospital cancer center with not the most up-to-date technology)
Lung bases: Clear. There is note of a small amount of pericardial fluid. Free air: None. Free fluid: Small amount of free fluid seen in the cul-de-sac.
June 17, 2017 PET/CT skull-mid-thigh non-contrast followed by contrast at SVMC
Thorax: No evidence of hypermetabolic lesion in the mediastinum, hila or lungs.
July 30, 2017 MRI abdomen non-contrast followed by contrast at SVMC
NB: HX- to evaluate rest of liver. The lung bases are clear.
October 3, 2017 MRI upper abdomen non-contrast followed by contrast at MGH (most advanced/powerful technology)
LYMPH NODES: Borderline portacaval lymph node measuring 1 cm in short axis (1701:25). Nonspecific subcentimeter cardiophrenic lymph nodes. “LUNGS” not listed.
May 23, 2018 CT with contrast at MGH
Lungs and Airways: The central airways are patent. There is mild diffuse bronchial wall thickening keeping with bronchitis. There are scattered nodules measuring up to 4 mm including in the RIGHT lung on image 59, and LEFT lung on image 44 and 46.
No indication whether the nodules are solid, part-solid, or ground-glass which would direct follow up recommendation.
https://radiology-universe.org/2017_Fle ... endations/