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Thursday, January 29, 2015
Small mass at base of right lung
in december of 2008 I developed pneumonia for the first time in my life. i am 57 years old and a non smoker. after a ct scan i was informed i have a 1.1cm mass at the base of my right lung. three ct csans and one pet scan later, over a 5 month period show no change in size or shape of a ground glass infiltrate. i am a non smoker , have had asthma for about 2 years and use symbicort in inhaler form. my specialist says i should have surgery to remove this mass but can not tell me exactly what the mass is or where it came from, or if it is cancerous or just scar tissue. any thoughts on what this could possibly be ? thank you.
The abnormality on your CT scan could represent one of several things: scar tissue from prior infection, inflammation, evidence of prior inflammation (such as from a fungal infection or sarcoidosis), or cancer (bronchoalveolar cell carcinoma in particular can have this radiographic appearance but ground glass infiltrates are not typical for most other types of cancer). It is impossible to determine the cause of this abnormality without obtaining a tissue sample or biopsy. This is likely the reason that your physician is recommending surgical removal--this would allow a sample of the abnormality to determine its cause and, if it happens to be cancer, the surgical removal of the abnormality may also be therapeutic/ potentially curative. In some cases, surgical removal or biopsy is recommended in a short time period after such an abnormality is identified. In other cases, it may be reasonable to continue to monitor the abnormality over a few years with regularly scheduled CT scans with plans to biopsy or remove if the abnormality gets bigger. The decision between these two paths is obviously at the discretion of the individual physician and patient.
Jennifer McCallister, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University