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Doctors Lounge - Surgery Answers
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| delady
- Mon Aug 01, 2005 6:31 pm |
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Hi,
13 months ago, the dr. found a lung nodule during an xray for some bruised ribs. Since then, I have had follow-up ct scans done every 3 months. There has not been any growth or change in the nodule until now: March '05 scan showed the nodule to be 9.9 x 6.7mm in density, 12.9mm in length, 9.4mm in width, and 11.9mm in depth. The volume then was 352mm3. My current scans shows density to be 12.2 x 8.3mm, 16.6mm in length, 11.0mm width, and 13.1mm in depth. The volume is now 482.3mm.
My questions are: Are these changes enough to be more than normal concerned? With these changes, should I have the nodule removed and biopsied or could this wait another 3 months. I also have a small enlarged lymph node in the upper mediastinum that measures 6.7mm in diameter. My dr. has explained that he can't say if the nodule is cancer or not, yet I had a pet scan that was negative 3 months ago. He has suggested I make the decision whether to wait and see or have surgery. I don't want to have surgery if these changes don't warrant it. It's hard to get him to say what I should do but he did say that if I waited and the next ct scan shows ANY, slight or not, changes from this one I will need the surgery. I am 50 years old and smoked about 2 packs a day for 35 years.
Thank you so much for any adivce you can give me.
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| Dr. A. De la Guerra
- Fri Aug 26, 2005 8:56 pm |
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 Hi delady, if you are over 40yo, have a smoking history, and a pulmonary nodule that wasn't there 2 years ago (or there's no way to prove it) and if you found an enlargement of the nodule, you should have it removed.
To be (almost) sure that a SPN is benign you should have no evidence of growth after 2 years of follow-up.
Other options are PET scan or percutaneous needle biopsy (for small nodules the accuracy depends on the skill of the radiologist).
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