Pulmonary Nodule and Chronic Cough

[lissyoz]

I am a 23 year old nonsmoking female.  I have never smoked, but have been exposed to second hand smoke.  My mom smoked when I was young, and my dad has smoked my entire life.  Last November, I went to the doctor because I had had a cough for 2.5 months.  The doctor ordered a chest x-ray.  They found a nodule in the lower lobe of my left lung.  I had a CT which showed that the nodule is about 2.4cm.  I then had an inconclusive PET scan.  Since then I've had two additional CTs, which continue to show a smooth noncalcified nodule.  My doctors would like to do a needle biopsy, but the nodule is sort of wedged up against my heart and my diaphragm, which they say makes a needle biopsy impossible.  It’s been a year now since my cough started and the various decongestants I’ve been prescribed haven’t had any effect.  The cough doesn’t keep me up nights or anything, but it is annoying and every time I cough I’m reminded that the doctors can’t tell me what is wrong.  My pulmonologist has talked about surgery since it seems to be the only way to tell what the nodule is, but I don't know if that is necessary.  I guess what I really want to know is does what my doctors have told me make sense and what should I do next?  Is there anything I can do besides wait for my next CT?

Thanks.

[National Jewish]

Usually smoothness and being less than 2.0 cm in size are characteristics of nodules that are not cancer.  Stability in size and appearance of a solitary nodule for 2 years is strong evidence that the nodule is not cancer.  The same stability for one year, especially in a 23-year-old non-smoker, is very encouraging.  However this nodule should still be watched.  Your initial CT scan was in November 2005.  Nearly a year has passed, but you should wait for the one-year CT scan in November 2006.  If the nodule is unchanged and cough is your only symptom, you and your doctors should continue to watch the nodule and not do any surgery.  Yours almost meets the criterion of size, but again, the most important thing is that there hasn’t been a change in size over time.

In the meantime your doctors should look for causes of your chronic cough other than the nodule.  The more common causes are asthma, sinus problems with postnasal drip and gastroesophageal reflux disease (GERD).  The nodule is probably not the cause of your cough.

[CAKANAN]

I am sorry you have this nodule and cough. I read your comment because I recently found out that I have a 3.6cm nodule in the left lung apex.  Unlike you I don't have a cough but in the past
15 years whenever I did get a cough it was dry and incessant.  Unlike you I am 53 but I am non-smoker(female)although Ialso grew up with parents who smoked and during college I worked a number of years as a bartender in smokey environments.  My nodule was found during a routine Chest Xray for elective vein surgery that I was scheduled to have this past 9/5/06.  Unlike you, my PET Scan showed a 10.5 uptake value in the left lung apex.  On 9/1, I had a bronchoscope done which was NON DIAGNOSTIC meaning the Dr could not get an adequate tissue sample. I am waiting to see a Dr at a renowned cancer clinic because I need another biopsy and this could be cancer.
CT guided Needle Aspiration has been recommended but I don't know if that will be successful. Have you had a bronchoscope?
Did your PET scan have any SUV (uptake value) greater than 2.5?
I know you probably have searched on the net for info. but here is a site that seems to help me understand SPNs better.
www.emedicine.com/med/topic3559.htm (see page 6-8 of Solitary Pulmonary Nodule  Article by Sat Sharma,MD  Please keep in touch.

[aklieber]

I too have lung problems that are not identified.  2 yrs ago I was found to have multiple lung nodules in both lungs, both big and small.  I had many scans, bronchoscopy for biopsy, could not get a speciman as the nodules are around my heart.  I have had regular scans at 3, 6, 12 months and were essentiallty the same until now.  Now they are more active and prominant and the radiologist says etiology unknown.  So, now they want to go back in and see about another biopsy.  I am trying not to worry but of course, it affects my life and I do worry.  I am not sure where to go from here.  In the last 6 months, they have been ruling out diseases such as sarcoidosis, hemachromatosis, histoplazmosis and others and they come back normal.  Does anyone out there have comments on this that they have gone through?  I am a ex-smoker, quit 10 years ago.  Had a bad accident 25 years ago that affected my lungs but healed past that.  Please respond.

[Zackary]

I am a 57 year old women who went through 2 years of complaining of this strange cough and always tired.  When I finally got my GYN Doctor to do a Chest x-ray they told me I had Cancer.  They did a Biopsy of my right lung and it was inconclusive.  They finally decided to do surgery and I still had no answere but they removed the nodule in my right lung and left the one in the lower left young and this was in 1995.  I still had no answere but they cleaned the infection in my lung and removed the nodule.  I wanted an answere so I went to an Infection Disease Dr and he knew right away and also tested the Biopsy and I had Histoplasmosis.  It has been 11 years and today I was told that the spot in my left lung has increased in size.  I have been having the strange cough again but thinking it was alergies (allergies) but this nodule was never incased so now I don't know what to expect. When I was diagnoised my Phosperious levels were high.