lung nodules of indeterminate orgin in 40yr old male nonsmkr

bulldoglvr · New User Joined: 06 Jun 2005 Posts: 6

My husband recently had a chest xray that showed a small lung nodule, so a CT scan was done to evaluate it. The CT scan showed multiple (11 to be exact) nodules ranging in size from 4mm by 4mm to 7mm by 8mm. He has several in his lower right lung field, but had a few also located in his left lung. He also had one nodule on each lung within his pleura area. The CT also indictate a Borderline sized right Hilar Lymph node measuring up to 9 mm in size. One of the 7mm nodules was listed as ill defined. The Radiology report says that the multiplicity of the nodules indicates a possiblity of Metatastic disease versus non-calcified granulomas.

My husband is 40 and is a non smoker. He may have been exposed to second hand smoke as a child. He was referred to a Pulmonary specialist who says the nodules could be Histoplasmosis, or could be lung cancer. My husband is an avid gardner and we live in Missouri which the doctor says is endemic for Histoplasmosis.

The only way to tell is to wait 3 months and take another CT to see if the nodules are changing. At this point the Dr. felt the nodules were too small for any other type of determination to work. Any information or advice would be helpful as my husband is quite worried due to the multiplicity of the nodules. He is having a colonoscopy done as well as a Prostate check up at the Pulomonary doctors suggestion to rule out any problems in those areas that might cause disease. My husband's paternal side has a history of prostrate cancer and his paternal grandmother died of breast cancer.

Max · Regular Joined: 30 May 2005 Posts: 25

Didn't the Doctor order a Bronchoscopy?

http://my.webmd.com/hw/lung_cancer/hw200474.asp

korusgirl · Regular Joined: 25 Apr 2005 Posts: 26

Hello Bulldog,
I am almost in the same position as you are right now, only a few weeks ahead of you and I have been just about dx. with lung cancer.
You do NOT need to wait 3 months. Call your physician or pulmonologist and tell him you want a Pet Scan which is kind of like a cat scan but is 90-95% accurate for picking up cancer. I have read on the internet in places that Pet Scans are not accurate for picking up cancer in small lesions, but I have questioned my pulmonologist and chest surgeon, who both have confirmed that the Pet Scan will indeed pick it up if it is small.
You need to do this yesterday if that was possible.
No one can wait three months full of anxiety and fear, wondering if a nodule is growing and metastasizing in their body. It is better to find out earlier and be able to clear your mind of the angst, one way or the other. And in your case, living in Mo. you may indeed have something here that is not cancerous!
Best of luck,
Joyce in Upstate NY

bulldoglvr · New User Joined: 06 Jun 2005 Posts: 6

No he didn't order the scope because he said the nodules were too small. All of the nodules are 4mm or larger but none are 1 cm. There are several which are 7mm, and one that is 8mm. The doctor felt that since my husband is a non-smoker cancer was unlikely and said he wanted to do another CT in 3 months. I have been reading about the PET Scan and there again the Dr. felt it might not be effective unless the nodules were larger. We will most likely ask them to do a PET scan instead of the followup CT scan. Histoplasmosis usually presents as calcified nodules according to my limited internet education on the subject. Since the CT report said uncalcified nodules that does worry me, even though my husband could very likely have contracted Histoplasmosis at some time or other.

kenmatson · New User Joined: 09 Jun 2005 Posts: 2

38, non smoker, found 4 nodules and was scared by my local doc it was lung cancer.

Went to the Univeristy Hospitals Ireland Cancer Center in Cleveland (#14 in the nation for cancer) for a second opinion and have been diagnosed with Histoplasmosis. But, many people have had the antibodies and they can never be sure if it is lung cancer. I was in Bat Caves in Puerto Rico weeks before I had symptoms, so they thought I could have gotten it there.

The docs said I could also wait 3 months and do another CT scan, but recommened a thoracic biopsy. They said, what if we are wrong and it is cancer. Basically then lost 3 months.

http://www.answers.com/topic/thoracoscopy links to the procedure.

This tells them a lot about the nodule they remove versus a needle. I go in Monday for the procedure and have done tons of research on this subject.

The bronchosopy is definately easier, but in my case the nodules were tough to get at with the scope.

If you have Questions, email me.

kenmatson@juno.com

leo · Site Admin Joined: 23 Sep 2004 Posts: 1574

Hello

Pulmonary nodules are sometimes quite tricky to figure out. A PET scan could definitely be done, but I don't think it would be able to differentiate between histoplasmosis or cancer, since both will light up. The presence of multiple nodules raises the possibility of metastatic disease, meaning cancer spreading from somewhere else, that's why the doctor ordered a colonoscopy and PSA, as these would be the most likely sites that could have primary tumors.

best regards,
Leo
_________________
Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.

ngering · New User Joined: 13 Jun 2005 Posts: 4

I too am a little (ok A LOT) confused and scared....I went in to the hospital, having some tightening in my chest that turned out to be muscle spasms.....long story short, the radiologist called a few days later after reviewing my chest Xray, finding a nodule in my left lung that was suspicious.
I went in for the CT scan, and just got the results today....there is 1 nodule present in my left lung, about 7 mm in size.

I was told to not worry about it, and have it re-checked in 3 months.....

....everything in me is screaming no way can I wait for 3 months to know what exactly is going on in my body.

I'm 35 and a smoker.....what should I do......wait, or is there any other kind of test that could be done to releive my mind?

korusgirl · Regular Joined: 25 Apr 2005 Posts: 26

Hi ngering,

Yes, there is certainly a test that will tell you what it is.
Don't wait. Read my email above.
If you get a petscan, and the nodule is cancerous, it will light up.
I like you, wasnt an ostrich, and couldnt wait!
So I went back, to doc, very frustrated and he sent me for a pet scan.
Which showed it was cancer.
Good Luck to you,
Joyce from upstate ny

thecoinguy1955

Hi Joyce,

So sorry your pet scan lit up. I'm having a pet scan tomorrow morning and am frazzled. There's a single pea size spot in the top of my right lung that was found just about 5 months ago when I had an MRA for my carotids, which was confirmed last week with a ct scan.

When did you get the results of the Pet scan back?

Rgrds
Tom Sad

ngering · New User Joined: 13 Jun 2005 Posts: 4

what exactly is a Pet Scan? I already had the CT Scan with Contrast......is this the same thing as a PEt Scan?

kenmatson · New User Joined: 09 Jun 2005 Posts: 2

(38, Male NS) Had 2 of 4 nodules removed from my lung Monday and they could tell right away that they were not cancer. You cannot be absolutely sure without a biopsy of some kind. They are telling me it looked infectious, would could be a result of the Histoplasmosis or something else. They are running numerous tests to be absolutely sure. I was told that a PET scan wouldn't give all the answers needed. I went in Monday, went home Tuesday and think I will go to work Thursday.

Good luck with the rest of you. I don't know that I could wait 3 months, but the chances at 35 it is cancer is very slim, even as a smoker.

I am a VP of a Cancer Insurance company and have seen many misdiagnosis', that is why I have been so proactive. My only advice, GO TO A NCI recognized cancer hospital if at all possible. I got out of my small town and drove to Cleveland Ohio to the best in the state. Your doctor's feelings are nothing you should worry about and get 2nd or 3rd opinions until you are completely satisfied. I wish you all the best.

korusgirl · Regular Joined: 25 Apr 2005 Posts: 26

You have to understand I am just going through all of this myself over the last few weeks.
But a pet scan works with an injection of radioactive glucose ...cancer gobbles the glucose up (after fasting overnight). So, if it is cancer, it will light up.
I have checked and double checked with my pulmonologist and chest surgeon and they say it piccks up very small things as well.
I got a phone call from my pulmonologist the day after memorial day. He was on vacation. But he got a call.
and called me. I had it done the previous Friday.
Docs like to move as quickly as possible if it is cancer so I would say if you dont get a call in three working days, its probably ok.
Good luck everyone,
Joyce Upstate NY

thecoinguy1955

No it's not a cat scan.

korusgirl · Regular Joined: 25 Apr 2005 Posts: 26

Here is hoping from me that all is well with you!
Prayers too!
I go for my bone scan today.

Joyce from Upstate NY

ngering · New User Joined: 13 Jun 2005 Posts: 4

Good luck to you with your bone scan....I'll be thinking of you and hoping for the best Joyce...... Wink

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