Do i need a secnond opinion?

[cgrigs]

I was found to have a 2x3mm subplueral nodule in my r lower lobe on a ct scan of the chest in 01/2007, a high resolution ct was done 03/2007 and found the same nodule as well as a second 4mm nodule in my right lower lobe as well.  I just had my repeat exam for this year to check the status of these 2 nodules and the following was found: A 0.3 cm nodule is now in my left lower lobe, the subplureal nodule is listed as " 0.4cm stable" and the other r lower lobe nodule is listed as "0.5cm stable", they also describe another subplureal nodule in the left apex, no size give but listed as "stable", as well a a nodule at the r major fissure no size given but listed as "stable".  they also are now discussing multiple small pretrachel nodes normal in size as well as anterior carina and left mediastinal nodes and subcarinal nodes and small nodes at both axilla.  I am concerend as i went from having 2 nodes to 5 and now apparenlty my lymph nodes are visable on my examination and were not mentioned in 2007.  Should i be more concerned about these findings and or pushing for some type of biopsy,  im not that type of patient and have a rn telling me that a friend had the same fidings for years and 10 years later was dx c lung ca and is now terminal.  i have smoked in the past have been exposed to second hand smoke my whole life, and have had non hpv cervical cancer as well in the past.  My doctor doesnt seem to feel these are any risk....should i be pushy?

[Fernando Roque, MD]

Hi.  If any of those nodules grow to a size of 1 cm or more, then a biopsy would probably be warranted.  For the meantime, I think your doctor is right to simply monitor these nodules by doing intermittent chest CT scans, just to see if these will progressively increase in size. I can understand your anxiety about the whole thing, but lung biopsy is not without its risks, and the procedure should only be done when absolutely necessary.