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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Nodules In Both Lungs Growing. History Of Lung Cancer In Family, Smoker. Suggested Waiting For A Year For Scan. Suggest

I need help... I had a nodule in both lungs one was4mm and the other was3mm over 2 years they have grown and I have developed a new 3mm nodular and a somewhat nodular , lineral pleural based opacity noted along the anterointerior aspect of the lfet major fissure which may represent subpleural nodule versus parenchymal scar with in the past year. I have never had pneumonia and I am test to tb due to working in the healthcare field. My doctor wants to wait one more year for another ct scan which I dont think is a good idear. I have a family history of lung cancer and i have smoked for 25 years, what do I do?????
Fri, 8 Nov 2013
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Pulmonologist,  's  Response
Hi,
Histopathological confirmation is essential for a diagnosis. Options in your case are CT guided FNAC/Biopsy , bronchoscopy and lavage. Taking fnac/ biopsy from subcentimetric nodules is technically very difficult with increased risk of pneumothorax. It is for this reason that you doctor wants a wait and watch approach so that if any of the lesions increase in size, then they can be biopsied. Since the lesions haven't evolved much over a duration of 2 years chances of malignancy seem to be less likely. Whole body PET scan may help you know if the foci have any hot spots. Also you need to quit smoking.
Get all your lymphnodes examined clinically.
You need to get evaluated with a Pulmonologist for detailed clinical evaluation. Follow up CT is an acceptable option.
Regards
Dr. Mishra
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Nodules In Both Lungs Growing. History Of Lung Cancer In Family, Smoker. Suggested Waiting For A Year For Scan. Suggest

Hi, Histopathological confirmation is essential for a diagnosis. Options in your case are CT guided FNAC/Biopsy , bronchoscopy and lavage. Taking fnac/ biopsy from subcentimetric nodules is technically very difficult with increased risk of pneumothorax. It is for this reason that you doctor wants a wait and watch approach so that if any of the lesions increase in size, then they can be biopsied. Since the lesions haven t evolved much over a duration of 2 years chances of malignancy seem to be less likely. Whole body PET scan may help you know if the foci have any hot spots. Also you need to quit smoking. Get all your lymphnodes examined clinically. You need to get evaluated with a Pulmonologist for detailed clinical evaluation. Follow up CT is an acceptable option. Regards Dr. Mishra