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CT scan found non-calcified nodule. Former smoker. Should I be more concerned?

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Pulmonologist
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I just had a CT scan for calcium (heart scan) That went fine but they found a non calcified 4x5 mm nodule. My family Doctor said not to be too concerned and we can check it out again in 4 months. I am a fomer smoker (quit 26 years ago) Should I be more concerned and mor eagressive?
Posted Mon, 21 May 2012 in Environmental and Occupational Hazards
 
 
Answered by Dr. Gyanshankar Mishra 15 hours later
Hi,

Thanks for posting the query on XXXXXXX

After going through your query, I would like to comment the following:

1. You seem to have undergone a cardiac ct for calcium scoring (coronary calcium scan).

2. Since you have history of high blood pressure and cholesterol levels, you are at a risk of coronary artery disease and hence this procedure was indicated in you.

3. You can calculate your exact risk on this website:
WWW.WWWW.WW
4. If you know the calcium score of the test then the risk can be stratified.

5. Considering the non calcified nodule and its small size (please mention the location of the nodule), the risk is not significant at present, however you need to continue you medications for hypertension and cholesterol along with life style modifications as advised by your doctor.

6. You should again repeat the investigation after 3- 4 months.

7. That yo have left smoking is a good news and you need to keep it up.

8. I suppose you already have undergone ecg and stress echo assessments. If not then please get them done.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

Above answer was peer-reviewed by
 
Follow-up: CT scan found non-calcified nodule. Former smoker. Should I be more concerned? 2 hours later
Nodule was in left lower lobe. It is the nodule that is concerning me the most. My doctor did not seem real concerned but I'm very worried its cancer.
 
 
Answered by Dr. Gyanshankar Mishra 4 hours later
Hi,

Thanks for the follow up query and the very helpful additional information about the size of nodule.

1. You do not seem to have any symptom at present.

2. Sub-centimetric nodules in the left lower lobe seem to have been detected on ct thorax.

3. I would like to inform you that, fewer than 1% of very small (<5-mm) nodules in patients without a history of cancer are malignant. Thus 99 % of such nodules are not malignant.

4. If no risk factors for malignancy are present , then the nodule need to be observed for 12 months and a CT thorax plain and contrast be repeated at 12 months. If the nodule has remained unchanged then no further follow up.

5. PET (Positron emission tomography) is an optional alternative.

6. FNAC or biopsy from such small lesions is very difficult.

Thus in absence of any clinical features or risk factors, observation is the best strategy.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
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