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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does: Right Upper Lobe 5 Mm Non-calcified Nodule And A Vague Nodule Versus Focal Inflammation Or Fibrosis Indicate?

I am trying to understand what is meant by - right upper lobe 5 mm non-calcified nodule and suggestion of a vague subcentimeter satellite nodule versus focal inflammation or fibrosis; although the nodule may be inflammatory/granulomatous, a pulmonary metastasis or early primary neoplasm the result of a baseline CT study following Chemotherapy after surgery for ovarian cancer.
Fri, 23 May 2014
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Oncologist,  's  Response
It means a 5 mm lesion (shadow) seen on the CT scan in right lung in its upper lobe (Right lung has three lobes: upper, middle and lower). Since the nodule size is very small 5mm (half of a centimeter), the radiologist has not been able to give an exact disgnosis and he has given a differential diagnosis (meaning it can be one of the following) of the following:
1. Inflammatory/granulomatous lesion: secondary to infection or foreign body etc
2. Pulmonary metastasis: metastatic disease to lungs is a possibility since you have a primary ovarian cancer
3. Early primary neoplasm: A primary lung cancer in its very early stages because of the small size.

Since the size of the lesion is very small, a biopsy would not be possible to confirm the diagnosis. I would suggest a repeat CT scan after 2 months to see if the nodule size has increased. If the size remains stable, its likely to be benign. If it increases to > 1 cm, a PET scan or a biopsy can be done.

I hope I have answered your query. I would be more than happy to answer if you have any further queries.
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What Does: Right Upper Lobe 5 Mm Non-calcified Nodule And A Vague Nodule Versus Focal Inflammation Or Fibrosis Indicate?

It means a 5 mm lesion (shadow) seen on the CT scan in right lung in its upper lobe (Right lung has three lobes: upper, middle and lower). Since the nodule size is very small 5mm (half of a centimeter), the radiologist has not been able to give an exact disgnosis and he has given a differential diagnosis (meaning it can be one of the following) of the following: 1. Inflammatory/granulomatous lesion: secondary to infection or foreign body etc 2. Pulmonary metastasis: metastatic disease to lungs is a possibility since you have a primary ovarian cancer 3. Early primary neoplasm: A primary lung cancer in its very early stages because of the small size. Since the size of the lesion is very small, a biopsy would not be possible to confirm the diagnosis. I would suggest a repeat CT scan after 2 months to see if the nodule size has increased. If the size remains stable, its likely to be benign. If it increases to 1 cm, a PET scan or a biopsy can be done. I hope I have answered your query. I would be more than happy to answer if you have any further queries.