6mm lung nodule

[miketd]

I was just in the ER for shortness of breath and a very small amount of blood in my sputum. The cat scan found a 6mm nodule "in the superior aspect of right lower lobe. No Lung infiltrate." The report doesn't say if it is calcified or noncalcified and has no mention of shape. Says to have a repeat scan in 6 months.

I had a lower abdominal cat scan done about two months ago for a non related problem. That report states that my "lung bases are clear". Would this nodule have shown up in that report if it was there? I'm a little concerned if this is a fast growing nodule. Everything else has looked fine.

I'm 38 and have not smoked in over 10 years.

Thank you

[National Jewish Health]

The nodule would not necessarily shown-up on an abdominal CT Scan, but you might want to request that that scan be reviewed to see if the nodule was actually visible at that time.  Volume  (not diameter) doubling time has been used to distinguish between benign and malignant lesions.  Lung masses with doubling times  18 months are, in most instances, benign.  If the nodule was definitely not present on review of the abdominal CT Scan and if the radiologist confirms its absence could not have been attributable to either technique or the algorithms used, that does raise the question of a rapidly growing lesion, although at 6mm, volume change is exaggerated by small increases in diameter.  If deemed to be rapid growing, consideration might be given to repeating the CT in three rather than 6 months.  A 6 mm (in diameter) nodule is a small nodule by conventional standards and thus, most likely, to be benign.  

A 6 mm nodule is unlikely to be the source of blood in one’s sputum and definitely would be unrelated to the acute onset of shortness of breath.  Thus, might not have anything to do with your symptoms.  If either the blood has recurred or the shortness of breath persisted, or worsened, your doctor’s evaluation should focus on this sign and symptom now, irrespective of how you and your doctors choose to evaluate the nodule.

Acute shortness of breath in a young person, such as yourself, without an infiltrate on CT scan raises 4 major possibilities:  1) clots to the lung (pulmonary emboli), 2) asthma,  3) shortness of breath on the basis of heart disease or, 4) anxiety.

Good luck