Nodule in lung. Is it cancer?

[miketd]

I posted this in another forum, but had no reply.

I was just in the ER for shortness of breath and a very small amount of blood in my sputum. The cat scan found a 6mm nodule "in the superior aspect of right lower lobe. No Lung infiltrate." The report doesn't say if it is calcified or noncalcified and has no mention of shape. Says to have a repeat scan in 6 months. Blood work was normal.

I had a lower abdominal cat scan done about two months ago for a non related problem. That report states that my "lung bases are clear". Would this nodule have shown up in that report if it was there? I'm a little concerned if this is a fast growing nodule. Everything else has looked fine.

I'm 38 and have not smoked in over 10 years.

Thank you

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
You have done the right thing by seeking a second (and third!) opinion. Since there is no nodule visible on careful review of the films by three other doctors, I think it is reasonable to just forget about this and go by your doctors advise of a follow-up scan after a year.
Occasional inter-observer and even intra-observer variation occurs in the interpretation of images.
Good Luck!

[miketd]

Thank you for the quick answer.

I have been able to show my film to two lung doctors and a radiologist. None have been able to find this nodule. The first doctor(the one who asked a radiologist to take a look at the film) said he asked for an official reading to be done by another doctor just so there is record of me being there. If they find nothing again, he recommends forgetting about it or coming back in a year for peace of mind.

How hard is it to misread a CT scan? He said the first Doc probably saw something and mistook it for a nodule. The first report also said my heart was enlarged even though the x-ray showed it normal size. Just wondering about some of these things.

Thanks again.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
The previous scan did not specifically scan the lung, and only commented on the basal portions of the lung seen when the diaphragm was imaged. It is quite likely that the nodule (if present at that time) was missed as it lay in the superior part of the lower lobe.
Thus you can not be sure that this is a "fast growing" nodule.
The nodule is small in size. Also, there is no spiculation, infiltration, or irregularity of the nodule, nor involvement of lymph nodes. Thus there is no cause for alarm or panic, and it is a reasonable advise to wait for 6 months for a repeat CT scan. However, if you are worried, you may request your doctor for a PET scan. Although not strictly indicated for you at this time, it will help put your mind at ease.
All the best, and God Bless!