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Want to have nodule removed, had biopsy which showed behind bone. Suggest?

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Practicing since : 2008
Answered : 1197 Questions
Yes,I want to have my nodule removed,it was seen in 2010.I had one attempt Biopsy but it is behind a bone...Pulmanary says he perferrs to check on but Iam afraid of so much radiation> It is getting now the size of a pea first seen in 2010..My primary said out, what do you think?
Posted Fri, 4 Oct 2013 in Lung and Chest disorders
Answered by Dr. Anjana Rao Kavoor 1 hour later
Brief Answer:
Slow growing nodule. CT scan recommended.

Detailed Answer:
Thanks for writing in to us.

I have gone through your medical history in detail.

A lung nodule, when first diagnosed, is often a cause of worry to the patient and doctor as until biopsy is done and pathological diagnosis is made, treatment cannot be decided. However, there are certain tell tale signs in a nodule which point towards a benign condition. I would like to discuss that with you and assure that its not something scary that you have in your lung.

1. A solitary pulmonary nodule is defined as a discrete, well-marginated, rounded opacity less than or equal to 3 cm in diameter which may be benign or malignant. Lesions larger than 3 cm are considered masses and are treated as malignancies until proven otherwise. As yours is size of pea, it is very small indeed to be malignant and also it is very slow growing.

2. A doubling time of less than 1 month or longer than 18 months makes malignancy unlikely. If your nodule is not growing too fast then it is not too worrisome.

3. Chest radiographs may demonstrate calcification, which often indicates that the lesion is benign. You have not mentioned this point.

4. Border of the nodule: a well-defined, smooth edge may indicate a benign lesion.

As the above are technical factors that will be best understood by doing CT scan and comparing with earlier scans or radiographs, it is important for you to get a CT scan of your chest done. I reassure you that Chest CT scan is a very much needed investigation for you and also as the nodule is behind bone, the CT scan might be a decisive factor in proceeding with further treatment if necessary.

Radiation is not an issue in CT scan machines nowadays. Considering the risk benefit associated with your condition, I would recommend you go for a CT scan chest.

Hope your query is answered.
Do write back in case of doubts.

Dr. A.Rao Kavoor
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