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Forum Name: Lung Cancer

Question: 8 cm spot on lung scans, but nobody knows what it is


 licutaa - Wed Dec 24, 2008 9:28 pm

Hello,
My husband, 51, non-smoker, had pneumonia a few weeks ago. However, on the X-ray an 8-cm diameter spot of unknown origin was also found. It showed up later on another X-ray as well as on a CT scan. A PET scan showed only mild uptake and today the doctor said cancer would be very unlikely (my husband feels well and is recovering well from the pneumonia). However, the doctor still wants to do a lung biopsy (bronchoscopy), even though he suspects the problem might be with the heart. What could this spot be, what should we expect? Is it part of an existing organ (lung, heart), or a growth - the doctor could not answer, but should the CT scan not provide the answer? If it is a growth and it is benign would surgery solve the problem? Are we looking at surgery at all? Thank you very much in advance.
I simply cannot understand why after all these scans we cannot even be told whether this is a lesion or a tumor, whether it's on the lung, heart, or something else...
 Dr. Tamer Fouad - Mon Jan 05, 2009 11:33 am

User avatar Hi there,
It would be impossible for me to give you a definitive answer of course. However, are you sure it's 8 cm? not 8 mm? You seem to be describing a spot - 8 cm would be quite a large mass.

Apparently this spot is located central in the scans - a CT should be able to suggest what the origin is. If it is a mass certain criteria may help to differentiate malignant from benign but if its a small spot this would be rather difficult.

A bronchospy may be the only way to tell whether it is benign or malignant. However, the mild uptake on PET is comforting as this may be a residual effect of pneumonia.

Lesions that are larger than 3cm are mostly malignant. Lesions smaller than 2cm are more commonly benign. Border spiculation (jagged edges) suggests malignancy as opposed to rounded borders which suggests benign lesions.
Calcification generally suggests a benign lesion but eccentric calcification may suggest a carcinoma.

Lesions that are malignant tend to have a volume doubling time (growth to double volume) between 20 and 400 days, where volume doubling of a nodule corresponds to a 30 percent increase in its diameter. Increased density argues against malignancy.
I hope this helps!

Best regards,
 licutaa - Mon Jan 05, 2009 7:07 pm

Hello,
Thank you very much for taking the time to reply, it is greatly appreciated. It is indeed an 8 cm diameter "mass", the word "spot" was not the best. In the meantime, the doctor changed his mind about doing the bronchoscopy. My husband is scheduled for a sonocardiogram and also an MRI this week, instead. The doctor, a pulmonologist, said that the "mass" has a round, smooth appearance, which would be good (non-cancerous), but we are looking forward to obtaining more information as to what this mass really is and where exactly it is. The doctor mentioned the possibility of it being a blood "bubble" - but considering the size would my husband's life not be hanging from a thin hair right now? Also, no doubt all these tests are needed, but it is all taking too long. We are very scared, to say the least... Best wishes and, again, thank you.

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