lung nodule with chronic cough for years

[niecy1221]

I've had a chronic cough for 10 years and have been treated for allergies and asthma only to find out that's not the cause.  I've had two CT's that showed two small masses (one approx. 9mm).  I was referred to a lung surgeon who will not perform surgery because he says there's no guarantee that he could reach it.  He's recommending a PETscan in the next 3 months.  He believes it non cancerous but does not guarantee it.  I do have a shortness of breath but continue to walk/jog 4 miles a day.  I've never been a smoker but has been exposed to second hand smoke as a child.  All tests performed have come back negative - they can't definitively say its sarcoidosis or any other lung disease.  I've had a bronchoscope and do not know what to do next.  The cough is extremely embarrassing!

[Dr Sharma]

Hi there. Chronic cough needs tuberculosis to be ruled out. I hope you are not taking any regular medicines with irritant cough as the side effect. The symptoms related to lung cancer are cough, shortness of breath, chest pain, wheezing, hemoptysis or blood coughing out. Easy fatigability, weight loss and night sweats are also present. It may lead to shoulder pain if nerves are invaded or hoarseness if vocal cords are paralysed and dysphagia.  Multiple pulmonary nodules are commonly encountered in metastatic disease of the lungs. Other less common causes are infections, arteriovenous malformations, wegener’s granulomatosis and lymphoma. Secondary lung tumors manifest as discrete nodules, usually multiple, interstitial infiltrate or endobronchial lesions with or without distal atelectiasis and charcterisitc round appearance on x-ray chest. Any cancer has the ability to spread to lungs most common being bladder, colon, breast and prostate cancer. You will need a PET scan to confirm and differentiate from pneumoconiosis since malignant cells have higher rate of glucose metabolism.  Thus, the principle of PET scan is intracellular accumulation of FDG and preferential accumulation of glucose in malignant cells, leads to visualization of malignancy on PET scan. It is the diagnostic and staging tool in cancer, assesses malignant potential in a pulmonary nodule if it is solid and more than 1 cm in dia. management would depend on the diagnosis. Primaries would need to be searched if these are secondaries. You can discuss with the pathologist the feasibility of transthoracic needle biopsy of the nodule. Hope this helps. Take care.

[julieben]

Hopefully the PET Scan should be helpful.  Sorry about your cough, hopefully it is nothing serious.  Glad all your tests are coming back negative.