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What Do Nodules In Lungs Indicate?

Posted on Mon, 8 Dec 2014

Question: Hi, I had an MRI a year back and 3 small nodules were discovered on my lungs. I'm 43 and a non-smoker. I had a CT scan to confirm this and then had another CT scan 6 months later. After the last scan the radiologist said the nodules were stable since the last scan with largest one being 6mm. He said the nodules have the appearance of scars and there was no instruction for follow-up. My questions are 1. One nodule was 1 mm difference on one side example 4x5mm to 5x5mm, but on inquiring with several people that would just seem to be down to a very slight variation in image or the radiologists interpretation -is this correct? 2. Would you still advise another CT scan in 12 months as per the Fleischner Society Recommendations or not? I’d obviously rather not subject myself to more radiation from the CT scan and would like to forget about this. Thanks in advance for your help!

Answered by Dr. Rahul Tawde (1 hour later)

Brief Answer:
Forget about nodules for now...

Detailed Answer:
Hi,

First, I need to have the Ct-scan reports to get them analyzed myself.

1. You are right, 1 mm difference is not taken into consideration due to slight variation in image. Your nodules are still the same size to my opinion.

2. You are reporting to have run 2 consecutive ct-scan within 6 months. According to Fleischner Society recommendations (FSR), if the first ct-scan detected such small nodules (less than 4 mm), and you have less risk factors (no smoker); then, you are scheduled to run another Ct-scan after 12 months to see the progress.

You have already done the second Ct-scan after 6 months, which reported no changes in nodules. So, you can forget about the nodules, and not to be exposed to Ct-scan radiation.

If I was your caring doctor would recommend to run MRI after 2 years to see if any change.

Once again, for the moment, you can forget about the nodules, but, as they are still there, you need to schedule follow up appointments.

All the best!
Dr.Sejdini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rahul Tawde (38 minutes later)

Thank you very much for your answer! I went back after 6 months as I had another node on my esophagus that they want to check within 6 months (also fine). So as it was 6 months earlier than the recommended year for the lung nodes. Would an MRI provide an details enough image to compare to?

Answered by Dr. Rahul Tawde (1 hour later)

Brief Answer:
Need to elaborate on node on esophagus?

Detailed Answer:
Hi back,

Thank you for your follow up queries.

Here I got a bit confused unfortunately : At the first query, you have reported nodules only on your lungs, but now you are also reporting another nodule in esophagus. They are quite different things which I need to elaborate more. Can you send the ct-scan report? Or at least, you can write down the full report?

My earlier explanations were based only on lungs nodules. If you have also nodules in esophagus, then, there is place for a different discussion.

However, in either cases, MRI is a good alternative in giving details of soft tissue of the body (including of the chest area).

At the end, in your case, the Ct-scan has confirmed small nodules, which are well localized and not spread. This gives assurance.

I still need to clarify this esophagus nodule to give final conclusions.

Thank you!
Dr.Sejdini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rahul Tawde (24 hours later)

I don't have the report. The lung nodule is fine and no follow-up needed. I was stating that is why I went back in 6 months, not a year as they wanted to check the esophagus nodule and did my lungs too at the same time (instead of waiting 12 months. Sorry to confuse you.

Answered by Dr. Rahul Tawde (1 hour later)

Brief Answer:
Your complete health background is needed...

Detailed Answer:
Hi back,

It's great that there is no nodule in your esophagus. As mentioned earlier, I need to have your Ct-scan report and your all health background including:
- symptoms you have?
- other conditions or diseases diagnosed?
- other risk factors apart non-smoking?

As I lack all these data, and your doctor knows better, such data could have constrained your doctor to repeat ct-scan follow up after 6 months and not 1 year.

Anyway, I'd advise to forget the nodule and enjoy your life!
All the best!
Dr.Sejdini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar