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Respiratory Disorders (Expert Forum)
5mm lung nodule on chest xray but ct scan says no nodules or masses
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5mm lung nodule on chest xray but ct scan says no nodules or masses
by mdv, Jan 26, 2007 12:00AM
Jan 2006 had a chest xray due to having bad bronchititus. At time a 5mm nodule was noted in the retrosternal area. Only can be seen on the side view. I was unaware of this at time. In April while in hospital for another illness (had pacemaker installed after repeated syncope) a chest CT was done not knowing about xray and the report stated no nodules or massses. At the time for the pacer being but in I developed a cardiac tamponade due to the surger . Then in May was hospitilized at a different hospital due to getting Dressler's syndrome from the tamponade. Another Chest CT was done, again this reported no nodules or masses.
Spoke to primary Dr in June and he wanted a CT due to xray but insurance wouldn't allow due to the other two already done.
Here it is Jan 2007, year later, had a chest xray to check position of leads for pacer and the same 5mm nodule is seen.
I'm confused and scared. I thought CTs show more than xrays and are known to catch things that xrays don't. Again, the nodule only shows up on the xray on the side view.
I was a smoker for 35 years. I am feeling the best I have in a long time (since the pacer was put in). I'm 55 year old female.
Spoke to primary Dr in June and he wanted a CT due to xray but insurance wouldn't allow due to the other two already done.
Here it is Jan 2007, year later, had a chest xray to check position of leads for pacer and the same 5mm nodule is seen.
I'm confused and scared. I thought CTs show more than xrays and are known to catch things that xrays don't. Again, the nodule only shows up on the xray on the side view.
I was a smoker for 35 years. I am feeling the best I have in a long time (since the pacer was put in). I'm 55 year old female.
Doctor's Answer
by National Jewish, Jan 30, 2007 12:00AM
, Jan 30, 2007 12:00AM
The general recommendation regarding no change in size is stability over 2 years. That is quite conservative and 1 year with no change in size, especially of this tiny lesion, is strong evidence against cancer. The inability to visualize this 'lesion' on not 1, but 2, CT scans argues strongly against this truly being a nodule and is consistent with this shadow being vessel(s) or another normal structure.
It would be reasonable to repeat the CT scan in May 2007, one year after the last CT scan. However, my suggestion would be that your physician first request consultation with a thoracic radiologist, to review the currently available chest x-rays and CT scans and then seek his/her recommendation on how to proceed. The first question would be, if the nodule is truly present, is there any way it might not have been seen on the CT scans; such as because the CT scans were not high resolution or taken so that the lesion fell in between the sections. If the radiologist’s answer is, 'no way', if real, it definitely would have been seen on the CT scans, I would stop right there.
There has been rapid progress in radiology during the past 5 years in the use of combined techniques such as contrast enhanced CT scanning, observing time-attenuation curves on dynamic CT scanning and the use of PET scans. My second question to the radiology consultant would be if any of the new techniques provide a more definitive answer to this question?
It would be reasonable to repeat the CT scan in May 2007, one year after the last CT scan. However, my suggestion would be that your physician first request consultation with a thoracic radiologist, to review the currently available chest x-rays and CT scans and then seek his/her recommendation on how to proceed. The first question would be, if the nodule is truly present, is there any way it might not have been seen on the CT scans; such as because the CT scans were not high resolution or taken so that the lesion fell in between the sections. If the radiologist’s answer is, 'no way', if real, it definitely would have been seen on the CT scans, I would stop right there.
There has been rapid progress in radiology during the past 5 years in the use of combined techniques such as contrast enhanced CT scanning, observing time-attenuation curves on dynamic CT scanning and the use of PET scans. My second question to the radiology consultant would be if any of the new techniques provide a more definitive answer to this question?
Member Comments (3)
by Jay000, Jan 28, 2007 12:00AM
One thing that I know from research is that if a spot does not grow it is not cancer. Apparently your spot has not changed after a year.
by mdv, Mar 26, 2007 12:00AM
To: update
Just wanted to thank eveyone for their support and information. I took the CT scans to the radiologist and they compared both of them to the xrays. They said that after careful review they cannot be located on CT Scans so they must be an abnormality in vessel so no further workup is necessary.
