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Lung Cancer

2mm Subpleural Nodule

09/28/2010

Question:

I have had a CT with the following findings: 2mm subpleural nodule at the right middle lobe. I`m 66 years old, non-smoker, moderatively active, non-drinker, white, male. Should I be overly concerned?

Answer:

A nodule in the lung can represent an infection, scar or tumor. The risk of tumor is high in someone over 50 who is smoker or has family members with lung cancer or other cancers. To prove a nodule is infection or cancer, we can either biopsy the nodule or send it for culture. However, a nodule has to be of sufficient size to biopsy safely. Any nodule smaller than 10cm is hard to biopsy. In this case, we decide to monitor it with serial CT scans to determine if it is increasing in size, shape or changing in character.

An infection may disappear on the follow-up scan when treated. A scar will remain the same, whereas a tumor will grow. As it gets bigger it can then be biopsied successfully. Because some tumors grow slowly, we usually do serial scans for a period of 2 years.

The risk of the 2 mm subpleural nodule being a malignant lesion is low given that you are non-smoker. But, at this stage we cannot be 100% certain. So the best approach will be to repeat a CT scan in 3-6 months. Your physician or pulmonologist can decide when to repeat a scan based on your risk factors.

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Response by:

Shaheen  Islam, MD, MPH Shaheen Islam, MD, MPH
Clinical Associate Professor
Pulmonary, Allergy, Critical Care & Sleep
Hematology
College of Medicine
The Ohio State University