"empty" lesions?

I recently had a chest CT scan done.  The report described a 2.5x 2.3 cm mass along with several smaller masses next to it in my upper right lung.but it also identifies these masses as being empty or hollow. Although I have been very tired during the past year I have had no significant shortness of breath & tests taken 1.5 years ago showed my lungs as being clear & only 1year older than my then currant age of 52. They want to do a needle biopsy but I've heard that cancer can spread if it is cut into.  Has anyone had a similar report who can tell me about the findings? Are there any other scans or tests that I should ask for before they do a biopsy?  Also...what is the difference between large & small cell lung cancer?

[HeinrikMD]

Hi,
I am assuming that you are a smoker.
The empty lesions are likely areas of lung that are damaged- over time, they would form areas of air packets that do not perform the function of air exchange. Healthy lung has a network of air passages that culminate in small balloon-like structures called alveoli that expand and contract during normal breathing. If their walls break down forming larger areas for air - you cannot expect it to expand and contract as a unit - this would then appear as empty areas on the scan. Those areas are likely early areas that will become emphysema.

You are correct that there is some concern for spreading cancer during the needle procedure - consider the alternatives of an open chest operation to obtain a diagnosis. The risk of potential seeding through the needle tract would be much less that the risk of the open surgery. Other methods would be to use scopes to access certain areas for the biopsy - the advantage would be there if the area seems too far from the chest wall to reach with a needle, or if the area of suspicion is adjacent to large blood vessels connected to the heart.  The other thing to consider is that - while there is fear that puncturing the cancerous mass would trigger it to spread elsewhere, well actually- once it has attained a size that a biopsy can readily target - it doesn't really need any help from a needle or a puncture, because it likely has the capacity to spread by itself by hitching a ride on a nearby blood vessel that it has linked to itself.

The general classification is small and non-small cell lung cancer. The distinction was traditionally based on the response to some of the older chemotherapy drugs. In general, small cell lung cancers tend to have a more dramatic response. So historically, small cell lung cancers get more chemotherapy and non-small cell cancers get less (for some cases and circumstances not at all). Small cell lung cancers are more rapid in spreading and over-all may be more difficult to control. Non-small cell lung cancer is the more common variety, and thankfully, over the years better drugs have come along so that these patients also benefit from chemotherapy and the old paradigm that one almost always gets chemo the other one shouldn't has changed.

[curious777]

Thank you so much for all the information.

[HeinrikMD]

you're welcome

[jsgerber76]

hi there, my 51 year old husband received a call yesterday morning from his doctor telling him he found an xray from a year ago that had been overlooked it shows a 8MM leision oin his lung now we are concerned that if it is cancer, it's spread because they OVERLOOKED it??? WHat can you tell me.  He does not smoke cigarettes but does smoke pot for his sleep aphnea.
He is going in for another xray.

[riolor]

  what about my case i have also mass lesion in the lungs den my doctor advise m to go over with biopsy is it safe for me to over go that kind of test. cost the size is already 2.3x5x6.5 cm .can you advise me