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Lung Cancer

10x13mm spiculated nodule

08/26/2008

Question:

I had a neck CT w/contrast that showed a 10x13mm spiculated nodule, followed two weeks later by a Lung CT w/out contrast that was normal except for an apical blep in a totally diff. area of the same lung. Based on second test Doctor says all is fine, but I am uneasy due to the diff. in results and do not have insurance.

Why does one test show something and the other nothing? Is it normal for two test results to be so diff.? I have lost 3 grandparents, Father, Uncle, one 1/2 sibling to Lung Cancer, all between age 40 and 54..I am 42. Should I assume the second ct w/out contrast is more trustworthy?

Answer:

I understand your concern. It is really difficult for me to say what was seen in the first CT. If you had a small infection that may also give the similar appearance and then would disappear as it gets better. Only infection would show such a dramatic improvement within two weeks. Sometimes artifacts can give a similar appearance and is not seen in the following CT. A tumor (usually can be a spiculated mass) would not disappear in two weeks. In our practice, if we see any such lesion we recommend biopsy and if it cannot be biopsied because it is still too small, we would get a follow up CT to see if it is getting bigger. You have a high risk family history and not sure if you are a smoker. Based on the fact that it is not present anymore I don't think that you will need a biopsy but may need a follow up CT or chest X-ray. My recommendation would be to see a pulmonologist with both the CTs to determine what needs to be done next.

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Response by:

Shaheen  Islam, MD, MPH Shaheen Islam, MD, MPH
Clinical Associate Professor
Pulmonary, Allergy, Critical Care & Sleep
Hematology
College of Medicine
The Ohio State University