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What Is A Nodule
However, I’ve been told nodules are a form of cancer, though hopefully benign. They are often seen while doing a CT scan for your COPD. When I had my scan, my pulmonologist said that I had a nodule. He said that in six months, they will redo a CT scan to see if the nodule is the same or if its changed and grown. I will have my follow up CT scan soon. Am I scared? No. When others have asked if they should be scared, I say no. We shorten our lives with worry, and I dont care to give up any more life than I have to. When my turn comes and I have another CT scan, Ill deal with it then.
Acute Respiratory Distress Syndrome
As COVID-19 pneumonia progresses, more of the air sacs become filled with fluid leaking from the tiny blood vessels in the lungs. Eventually, shortness of breath sets in, and can lead to acute respiratory distress syndrome , a form of lung failure. Patients with ARDS are often unable to breath on their own and may require ventilator support to help circulate oxygen in the body.
Whether it occurs at home or at the hospital, ARDS can be fatal. People who survive ARDS and recover from COVID-19 may have lasting pulmonary scarring.
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The Risk Of A Lung Nodule Being Cancerous Is Higher If Asbestos Exposure Occurred
A lung nodule, also known as pulmonary nodule, spot on the lung or coin lesion, is a small growth which forms inside the lung. Because lung nodules are not associated with any symptoms, they are often detected during X-rays, CT scans or other imaging tests. Roughly half of these tissue growths are benign, having developed as a consequence of a prior infection or due to an enlarged lymph node. However, the other half of lung nodules is malignant.
Occupational asbestos exposure is likely to result in lung cancer within 15 to 35 years, as the level of airborne fibers was very high in the workplace before the 1980s and most employees have been in contact with asbestos for several years in a row. Therefore, if you had a high-risk job in the past and a nodule has recently been detected in your lungs, it might be cancerous. To determine whether a lung nodule is benign or malignant, your doctor will:
- monitor its growth while benign nodules develop very slowly, cancerous masses tend to grow quite rapidly, generally doubling their size every four months
- perform a biopsy a biopsy is the most accurate method of determining the nature of a lung nodule, as the content of the growth will be carefully examined by a pathologist
If a benign lung nodule has been found in your lungs and you start noticing one or more of the following symptoms, you should seek medical assistance as soon as possible:
- chest pain
Can A Ct Scan Tell If A Lung Nodule Is Cancerous
The short answer is no. A CT scan usually isn’t enough to tell whether a lung nodule is a benign tumor or a cancerous lump. A biopsy is the only way to confirm a lung cancer diagnosis. But the nodules characteristics as seen on a CT scan may offer clues.
To determine whether the likelihood of lung cancer is high or low, physicians usually look at three distinct characteristics of the nodule: the size of the spot, its shape and whether the nodule is calcified.
- If the CT scan shows small nodules , the probability of them being cancerous is low. Larger nodules are more worrisome.
- Rounded nodules are less likely to be cancerous than spiculated ones.
- Calcified lung nodules contain calcium deposits that sometimes form in response to infection. These nodules are most likely noncancerous.
Another key sign physicians look for when trying to determine whether a lung nodule may be cancerous is the difference in the size of the nodule between one scan and another taken at a later time. Cancerous nodules are more likely to grow. If the white spot enlarges between scans, that might be an indication of lung cancer.
So, while a CT scan can’t confirm whether your lung nodule is cancerous, it may determine whether further imaging tests are warranted. If this is the case, your doctor may order a PET scan and/or a biopsy of the compromised lung tissue.
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How Are Lung Nodules Detected
Lung nodules look like a white, round shadow and are commonly found during lung cancer screenings using low-dose CT scans. A low-dose CT scan uses advanced x-ray technology to create a detailed 2D image of your lungs. As a result, lung cancer experts can find and track tiny lung nodules early. Because early detection is your best chance of treating lung cancer, its important to get screened as soon as youre eligible.
Lung nodules can also appear on other imaging tests, such as X-rays, used for unrelated purposes. Whether your lung nodule appeared during a lung cancer screening or other imaging tests, its unlikely that you experienced any related symptoms.
How Your Care Team Will Determine If Your Lung Nodule Is Cancerous
To determine if your lung nodule is cancerous, your care team will thoroughly review your medical history, including your risk factors for developing lung cancer, such as:
- Having a family history of lung cancer
- Exposure to second-hand smoke
- Prolonged exposure to certain gases
A team of experts will also carefully inspect your CT scans to better understand the size and location of your lung nodule. If it is small, it is unlikely that they will perform any additional tests or biopsies. However, if your lung nodule is large or suspicious, they may perform surgical and non-surgical biopsies to test for cancer. At MedStar Health Cancer Network in Baltimore, we offer the newest and most promising technologies for early diagnosis of lung nodules, including:
- The superDimensionTM System for performing minimally invasive biopsies of tissue anywhere in the lungs
- Endobronchial Ultrasound, a minimally invasive outpatient procedure for obtaining tissue or fluid samples from the lungs and surrounding lymph nodes with less pain and risk than traditional lung biopsies
All results are reviewed by our multidisciplinary team of experts. This includes board-certified thoracic surgeons, radiologists, and pulmonologists, so you can expect an accurate and timely diagnosis. When treatment is necessary, our comprehensive treatment plans range from complex surgeries to clinical trials and advanced therapies that are hard to find elsewhere.
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Treatment For Lung Nodules
Once the cause of your lung nodule is determined, your doctor and care team will discuss your next steps with you.
In most cases, if your lung nodule is small and your cancer risk is low, your doctor will suggest monitoring it through a series of X-rays over time to track its growth and any changes. Non-cancerous nodules grow slowly, if at all, while cancerous nodules grow quickly. If the nodule hasnt grown or changed over a period of a few years, it can be left alone.
If your lung nodule is large, determined to be cancerous or causing you to have symptoms, your doctor may recommend having it removed it surgically. If surgery is recommended, your doctor will discuss all options with you.
How Are Lung Nodules Diagnosed
If you have been told that you have a lung nodule, it is important that you bring a copy of the actual CT scan or chest X-ray with you to your appointment at the BWH Thoracic Surgery clinic. These scans generally come on a CD/DVD. The scan will be uploaded to the computers in our clinic, and your surgeon will review the scan with you.
If additional testing is needed, your surgeon may also conduct the following diagnostic tests and procedures:
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Lung Nodule Care At Geisinger
Our pulmonology team is here to diagnose, monitor and provide treatment for lung nodules thats right for you. We offer:
- Knowledge and experience Your pulmonology teams combined years of experience and research give them the expertise necessary to diagnose, treat and help you manage lung nodules. Learn more about our pulmonologists.
- Personalized care When you need treatment for lung nodules, our pulmonology team will work one on one with you to create a treatment plan thats tailored to your specific needs. With proper treatment and management of lung nodules, we can make sure that you stay healthy.
- Convenient locations and appointments With pulmonologists available in Geisinger clinics and hospitals throughout Pennsylvania, you dont have to travel far to get the care you need. We also offer extended clinic hours and minimal wait times to be seen, so you get care thats convenient for you.
How Are Lung Nodules Managed Or Treated
Small, noncancerous lung nodules dont usually require treatment. You may need treatments, such as antibiotics or antifungal medications, if you have an infection.
If the nodule grows, causes problems or is cancerous, you may need surgery. Surgical procedures to remove noncancerous and cancerous pulmonary nodules include:
- Video-assisted thoracic surgery : During VATS, your provider inserts a thoracoscope and tiny surgical instruments through several small chest incisions. Your provider refers to images from the camera to remove the nodule.
- Thoracotomy: Your provider removes the lung nodule through a larger incision between your ribs, below your shoulder blade. For several days after the surgery, a tube drains excess fluid from your chest.
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Who Is At Risk Of Developing Pulmonary Nodules
No specific population group is at more risk of developing pulmonary nodules. However, the following factors will increase the risk of a pulmonary nodule getting converted into cancer. They are:
-
Elderly people.
-
Recurring respiratory infections such as bronchitis or pneumonia.
Consult the doctor when you have pulmonary nodules and experience above mentioned symptoms.
What If I Do Have Lung Cancer
You may have heard that lung cancer is the deadliest form of cancer or seen frightening statistics. But keep in mind that every case is different. If your nodule is small, its likely to be early-stage cancer, which is easier to treat. Your age, overall health and other factors also play a role. For the best outcome, make sure your cancer care team is experienced with lung cancer and has access to the latest treatment options.
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The Pulmonary Nodule Discovered By Pneumonia: A Case Report
Dong-Mei Yuan1,2*, Jian-Ya Zhang1,2*, Yan-Wen Yao1,2, Hui-Ming Sun1,2, Guan-Nan Wu1,2, E-Hong Cao1,2, Luca Bertolaccini3, Tang-Feng Lv1,2, Yong Song1,2 written on behalf of the AME Lung Cancer Collaborative Group
1Department of Respiratory Medicine, Jinling Hospital, Nanjing 210002, China 2Research Institute of Respiratory Disease, Nanjing University, Nanjing 210002, China 3Thoracic Surgery – AUSL Romagna, Santa Maria delle Croci Teaching Hospital, Viale Vincenzo Randi 5 – 48121 Ravenna, Italy
*These authors contributed equally to this work.
Correspondence to:
Keywords: Pulmonary nodule computed tomography scans circulating tumor cells adenocarcinoma
Submitted Nov 15, 2016. Accepted for publication Jan 10, 2017.
doi: 10.21037/tlcr.2017.02.01
How To Minimize Your Risk Of Lung Cancer
The best thing you can do to reduce your risk of developing a cancerous lung nodule or lung cancer is to quit smoking. Because smoking is the primary cause of lung cancer in the U.S., quitting could save your life. From prescription drugs to virtual counseling classes, were here to support you. Talk to your doctor about saying goodbye to smoking for good.
And, if youre eligible for lung cancer screenings, dont delay. A low-dose CT scan can detect early signs of cancer, such as a lung nodule. And, it just might save your life.
Did a recent CT scan reveal lung nodules?Seek evaluation at our dedicated Lung Nodule Clinic in Baltimore today.
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How Are Lung Nodules Investigated
Most commonly a watch and wait approach is recommended. This next scan may be after a period of a few months, or for very small nodules up to one year later. At the time of the follow up scan it is possible to determine if the nodule has remained the same, become smaller or disappeared, or grown. If the nodule is unchanged or has become smaller we can be confident that the nodule is benign and no further action is required. Sometimes one further scan is recommended to confirm this after another year.
If the nodule has grown, which is the least likely outcome, your doctor will usually recommend that further tests are performed. In cases where a lung nodule turns out to be a small lung cancer, there is still an excellent chance of being cured. This is because very small lung cancers usually have not spread and so can be completely cured, even after months of surveillance.
For some patients, with larger sized lung nodules, doctors may instead recommend that further tests such as a lung biopsy are performed straight away.
What Causes A Solitary Pulmonary Nodule
The most common causes of a pulmonary nodule are either neoplastic or infectious . Pulmonary nodules may also represent lung abscess, pulmonary infarction, arteriovenous malformations, resolving pneumonia, pulmonary sequestration, and hamartoma. As a general rule of thumb, likelihood of malignancy is proportionate to the nodule’s size, the patient’s age, and history of smoking. Thus, whereas lung cancer is rare in 30-year-old individuals, in 50-year-old smokers, the chance that a solitary pulmonary nodule represents malignancy is 50% to 60%. In a 70-year-old person with a smoking history and a 2.9-cm pulmonary nodule the malignancy risk is 75%.
Drew A. Torigian MD, MA, Charles T. Lau MD, in, 2011
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Diagnosis Of Lung Nodules
Lung nodules are evaluated by chest x-rays, which show the interior of the chest cavity and computed tomography , which produce a series of images of the inside of the body, taken from different angles and depths, to reveal a high level of detail.
To help determine if the lung nodule is malignant, a PET scan may be obtained. Every living cell in the body uses glucose to function normally. Tumor cells are often metabolically active and therefore taking up more glucose. With a PET scan, a small amount of radioactive glucose is injected into a vein. The scanner then revolves around the body, identifying areas where glucose uptake is the greatest, often areas of tumor or tumor spread. A pulmonary nodule which is very hot may be due to malignancy diagnose but can also be caused by inflammation or infection.
A biopsy of the lung nodule to help determine whether the nodule is benign or malignant may before using CT guidance or through a bronchoscope, a camera inserted into the airway .
At times, certain blood tests may be helpful in deciding if the nodule has been caused by an infection or by inflammation.
What Are Lung Nodules
Lung nodules are small masses of tissue in the lung that appear as round, white spots on a chest X-ray or computed tomography scan. Because they rarely have symptoms, they are usually found incidentally in 1 of every 500 chest X-rays taken for other, unrelated ailments, like a respiratory illness.
Most nodules are smaller than 10 mm, or the size of a cherry. Larger lung nodules, or nodules located near an airway, may have symptoms such as a chronic cough, blood-tinged mucus and saliva, shortness of breath, fever or wheezing.
Nodules identified on chest X-ray typically require additional evaluation to determine what they represent, says Eric M. Hart, MD, a thoracic imaging radiologist at Northwestern Memorial Hospital.
In our part of the world, very small nodules are commonly identified incidentally on chest CT scans for reasons like chest pain or shortness of breath, or to evaluate for pulmonary embolism, says Dr. Hart. The significant majority are benign, although in certain instances they may require follow-up to prove that.
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If I Have A Lung Nodule Does It Mean Ill Get Lung Cancer
Most nodules are noncancerous , and a benign nodule will not turn into cancer. But some nodules turn out to be cancerous .
Small nodules, especially those that are smaller than 1 centimeter, are rarely cancerous. Larger nodules, larger than 3 centimeters, are usually called lung masses and have a higher chance of being cancerous than small ones.
The chance that your lung nodule is cancerous depends on many factors. Your doctor can give you an estimate if you want one.
Spots On Lungs: When To Worry About Pulmonary Nodules
If your doctor discovers a spot on your lung during an imaging study, you may worry about what it means for your health. These spots are called pulmonary nodules. Though pulmonary nodules may be a sign of lung cancer, they are much more likely to be noncancerous, or benign. This article will review pulmonary nodules, why they occur, and what happens if you have one.
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What Symptoms Should I Look For If Im Worried About Lung Cancer
Unfortunately, most lung cancers dont cause symptoms until they have spread to other parts of the body. But some people may have symptoms. Keep in mind that early symptoms of lung cancer are similar to symptoms of many other conditions, so dont panic, but do see your doctor. The most common symptoms of lung cancer are:
- A cough that does not go away or gets worse.
- Coughing up blood or rust-colored sputum .
- Chest pain that may get worse when deep breathing, coughing or laughing.
- Hoarseness that doesnt go away.
- Loss of appetite.
- Shortness of breath or wheezing.
- Feeling tired or weak.
- A respiratory illness, such as bronchitis or pneumonia, that doesnt go away or that keeps coming back.
If lung cancer spreads, it may cause:
- Bone pain .
- Nervous system changes if the cancer spreads to the brain.
- Yellowing of the skin and whites of the eyes , if cancer spreads to the liver.
- Swollen lymph nodes such as those in the neck, above the collarbone or in the armpit.