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Lung Cancer

Noncalcified punctate lung nodules

09/24/2009

Question:

I was diagnosed with 6 mulitple small non-calcified punctate lung nodules varying in size of 2mm to 5mm. They were classified as being "stastically post-inflammatory in nature" consider follow up in 6 months. My doctor recently did a chest xray that came back normal. I know that nodules of this size would not show up on an xray and his explanation to me is that if they were cancerous they would have grown by now and would be seen on an xray. (CT scan was about 12 months ago). ( I am a smoker). Would you handle this the same way or should I get a second opinion or another ct scan if I am not comfortable with this?

Answer:

I would recommend following these nodules with chest CT.  While they are most likely benign, they should be followed.  In the small chance that one of these nodules is a cancer and you wait until it grows large enough to see on CXR, it may be at a more advanced stage.  I would have recommended a chest CT at 6 months.  If there is no change, then another CT in 12 months.  They should be followed without change for 2 years before they are considered benign.

I hope this helps.

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Response by:

Sandra L Starnes, MD Sandra L Starnes, MD
Assistant Professor of Surgery
College of Medicine
University of Cincinnati