Can a CT scan tell if a lung nodule is cancerous? The short answer is no. A CT scan usually isn't enough to tell whether a lung nodule is a benign tumor or a cancerous lump. A biopsy is the only way to confirm a lung cancer diagnosis.
However, your doctor may suspect a lung nodule is cancerous if it grows quickly or has ridged edges. Even if your doctor believes the nodule is benign or noncancerous, he or she may order follow-up chest scans for some time to monitor the nodule and identify any changes in size, shape or appearance.
Commonly called a “spot on the lung” or a “shadow,” a nodule is a round area that is more dense than normal lung tissue. It shows up as a white spot on a CT scan. Lung nodules are usually caused by scar tissue, a healed infection that may never have made you sick, or some irritant in the air.
If your nodule is large or is growing, you might need more tests to see if it's cancer. This might include imaging tests, such as CT and positron emission tomography (PET) scans. Another test might be a procedure called a biopsy. This involves removing a piece of the nodule for testing in a lab.
Most lung nodules are benign, or non-cancerous. In fact, only 3 or 4 out of 100 lung nodules end up being cancerous, or less than five percent.
The Mechanics of Pulmonary Nodules
There is very little growth or change, if there's any at all. Cancerous pulmonary nodules, however, are known to grow relatively quickly—usually doubling in size every four months but sometimes as fast as every 25 days.
If lung nodules are large or malignant, they may cause symptoms, including: Chronic cough. Blood-tinged sputum. Shortness of breath.
Well recognized features such as spiculation, pleural retraction, pleural thickening, the bronchus or vessel sign (airway or vessel leading directly to lesion), or part solid characteristics are all associated with a significantly increased risk of malignancy in pulmonary nodules, especially when evaluated at thin ...
Lobectomy is the removal (resection) of the lobe of the lung affected by lung cancer. This is the most commonly performed lung cancer surgery. A bilobectomy is the removal of two lobes and is only done for tumors of the right lung where the tumor involves two adjacent lobes.
How are lung nodules managed or treated? Small, noncancerous lung nodules don't usually require treatment. You may need treatments, such as antibiotics or antifungal medications, if you have an infection. If the nodule grows, causes problems or is cancerous, you may need surgery.
Nodules between 6 mm and 10 mm need to be carefully assessed. Nodules greater than 10 mm in diameter should be biopsied or removed due to the 80 percent probability that they are malignant. Nodules greater than 3 cm are referred to as lung masses.
The most common causes of lung nodules are inflamed tissue due to an infection or inflammation (called granulomas) or benign lung tumors (such as hamartomas). Less common, malignant lung nodules are typically caused by lung cancer or other cancers that have spread to the lungs (metastatic cancer).
Location. Location of nodules in the lung is another important predictor as nodules on the upper lobes are more likely to be malignant. Although etiology of this predilection is unclear, higher concentration of inhaled carcinogens could be a possibility.
If there is a higher chance that the nodule is cancer (or if the nodule can't be reached with a needle or bronchoscope), surgery might be done to remove the nodule and some surrounding lung tissue. Sometimes larger parts of the lung might be removed as well.
The smaller the nodule, the more likely it is to be benign. Also, benign nodules grow very slowly, if at all, while cancerous nodules on average can double in size every four months or less. Nodule content, shape and color: Another way to tell a benign lung nodule from a malignant one is to test its calcium content.
Your Recovery
It is common to feel tired for 6 to 8 weeks after surgery. Your chest may hurt and be swollen for up to 6 weeks. It may ache or feel stiff for up to 3 months. For up to 3 months, you may also feel tightness, itching, numbness, or tingling around the cut (incision) the doctor made.
Biopsies are usually not recommended when nodules are small because it is very difficult to biopsy them safely. Doing a biopsy when a nodule is small can cause harm such as trouble breathing, bleeding, or infection. Biopsies are often done for nodules that are 9 mm or larger.
In general, a lung nodule can be removed very safely and using a minimally invasive surgical approach. Your surgeon may want to perform a bronchoscopy to take a closer look at your nodules and take a biopsy.
Benign lung nodules and tumors usually cause no symptoms. This is why they are almost always found accidentally on a chest X-ray or CT scan.
Treatment for lung nodules may range from a “watchful waiting” approach for benign nodules, to surgery, chemotherapy and radiation therapy for malignant nodules. If the nodule is benign, your physician will monitor the nodule periodically with CT scans, to determine if any changes in size or shape have occurred.
A lung mass is an abnormal growth or area in the lungs that is more than 3 centimeters in diameter. Anything smaller than this is classified as a lung nodule. Lung masses can be benign (non-cancerous) or malignant (cancerous).
Lung nodules are quite common and are found on one in 500 chest X-rays and one in 100 CT scans of the chest. Lung nodules are being recognized more frequently with the wider application of CT screening for lung cancer. Roughly half of people who smoke over the age of 50 will have nodules on a CT scan of their chest.
In general, small nodules indicate you should get LDCT screening every year for at least 2 years. Medium- and large-sized nodules should be screened again sooner, according to the nodule density.
Lung nodules are small masses of tissue in the lung that can be cancerous, although the majority are non-cancerous. Dust and chemical exposure, infection or other tumors can all cause a lung nodule to form.