My husband recently went for a routine physical, and the doctor found a small mass on his chest xray. They repeated the xray 6 wks later, and noted no change in the mass (i.e. no growth, lessening, etc.). They are now referring him for a CT scan. (I believe the mass is on the left upper lobe, though not positive.) What can be possible and likely causes of this mass? Any info is appreciated! Thanks.
A nodule is usually a small, round shadow seen on chest x-ray anywhere in the lungs. Nodules are due to infections, inflammation, or tumors. A nodule that is 1 centimeter in size or less is very unlikely to be cancer. Your husband will need to have more testing done to know what could be the cause. A chest CT scan is usually the next test that is done because it is more sensitive and shows more detail than a chest x-ray. The shape, smoothness, and density of the nodule will be seen on the CT scan. This will help in determining what could be causing this. If your husband has had previous chest x-rays or CT scans it would be helpful to locate them. Then his doctor could compare them with his most recent chest x-ray and CT scan. The comparison could be most helpful to his doctor, in interpreting these findings and the cause of the nodule.
Nothing can be said about the cause of a nodule that has not changed in 6 weeks. A nodule must not change for 2 years to be considered stable. A nodule that will eventually grow may be stable for 6 months. The important thing is that it has not grown after 6 months. So it is appropriate to repeat the CT scan in 6 months, again in another 6 months, and then, if no change is seen repeating the CT scan 2 years from when the nodule was first discovered.
"A solitary pulmonary nodule (SPN) is a small, round or egg-shaped lesion (abnormal tissue) in the lungs. SPNs are typically asymptomatic, and they are usually noticed by chance on a chest x-ray that has been done for another reason. They are usually less than 3-4 cm in diameter (no larger than 6 cm) and are always surrounded by normal, functioning lung tissue.
SPNs are fairly common abnormalities on chest x-ray images: nearly one of every 500 chest x-rays shows a newly diagnosed SPN. In the United States, physicians are challenged each year by more than 150,000 new cases of SPNs.
Sixty percent of all SPNs are benign. In certain geographical areas where there are infectious agents (especially fungi) that cause SPNs, the percentage of benign SPNs increases remarkably (in some areas as high as 90% to 95%). Malignant SPNs may be primary Stage I lung cancer tumors or metastases from other parts of the body.
Determining the malignancy of an SPN is an integral and challenging part of diagnosis. One of the goals of diagnosis is to avoid unnecessary invasive procedures, such as surgically removing part of the lung because of a benign SPN. Benign SPNs can be treated in simpler, noninvasive ways. "
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