2mm opacity found in chest xray - 1260625

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maddie100
2mm opacity found in chest xray - 1260625

Hello there

I hope this is the correct place to post.

I'm a 41 year old female, non smoker. I used to smoke but gave up 10 years ago. At the time, I suffered from bronchitis quite alot and also had a few bouts of pneumonia.

Over the past year, every time I get a cold it goes down to my lung which feel inflamed and I end up feeling run down and poorly. However, when doctors listen to my chest, it is clear. I feel very clogged up though and feel like there is alot of phlegm in my throat. I don't have a cough but tend to get a sore throat.

They decided to send me for a chest xray and it came back saying that there is no indication of lung disease, however there is a 'few' mm opacity in the lower right lung (meaning one opacity but only a few millimetres wide) and they suggest I rescan in 3 months.

My doctor could not advise me what this was exactly and couldn't even say that the 'opacity' was in the lung, it could be outside of it.. she also said that this would not be the cause of my reoccuring symptoms, so now I have even less answers than I started with and am also pretty worried.

If you have any advice or reassurance I would appreciate it.

Regards

Maddie

JimC
Reply To: 2mm opacity found in chest xray

Hi Maddie,

Welcome to GRACE.

The good news is that even if the finding on your xray is a lung nodule, many of these solitary pulmonary nodules (SPNs) are not cancerous. As Dr. West has said, in his Introduction to Solitary Pulmonary Nodules:

"studies have shown that anywhere from 8% to about 50% of the scans, or people getting scans, have SPNs, so that’s quite a huge range. Moreover, once a nodule is detected, we know they aren’t all cancer, and the rate of these actually turning out to be malignant has been reported to be anywhere from about 1% to 12%. With that much variability in these reports, it’s no wonder that the concept of screening for cancer vs. chasing down many anxiety-producing but non-cancerous nodules remains controversial." - http://cancergrace.org/lung/2007/11/08/lung-nodule-intro/

You may also be interested in Dr. Yankelevitz's post on management of pulmonary nodules: http://cancergrace.org/lung/2011/12/07/yankelevitz-lung-nodules-podcast/

I realize that it is easier said than done, but please try not to assume the worst. Here on GRACE, we have seen similar questions posted quite often, and many of those members did not turn out to have cancer.

Good luck with your next scan.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

maddie100
Reply To: 2mm opacity found in chest xray

Hi Jim

Many thanks for your response, that does make me feel a bit better.

What I am confused about though, is that I thought you could only see such small opacities (less than 1cm) via a CT scan and not a normal chest xray? In that case, I wonder if it a nodule at all.

Regards

Helen

JimC
Reply To: 2mm opacity found in chest xray

Hi Helen,

Yes, it's very small and the resolution of an xray is significantly lower than a CT. That's why your doctor can't even guess what it is, whether it's even a nodule in your lung. Something that small on an xray could even be an artifact of the imaging process. More reason not to worry!

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

Dr West
Reply To: 2mm opacity found in chest xray

You're right that it's most common to better characterize a questionable finding on chest x-ray (CXR) by following it with a chest CT, because the resolution of the latter is so much better. It's certainly possible to know more with a chest CT, but as Jim said, very small, sub-centimeter lung nodules are VERY common and most typically benign, especially in younger people and those without a significant smoking history.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

maddie100
Reply To: 2mm opacity found in chest xray

Thank you both for your reply, it does make me feel slightly better but I'm still panicking from time to time.

I went to see a different doctor at my surgery as my first was so unreassuring, I went home thinking the worst.

As I was so upset, my Dr has arranged a CT scan, along with the 3 monthly xray which I will have again in January.

However, when I went home and got things more into perspective, I wondered if a CT scan would perhaps be a bit over the top for a 2mm thing that they don't even know what it is. I'm also a bit wary of having that much radiation for no real good reason.

Do you think the CT scan is a good idea, or should I just get the xray first and see if there are any changes?

Many thanks.

JimC
Reply To: 2mm opacity found in chest xray

Hi Helen,

For legal and medical reasons the GRACE faculty can't tell you what you should do, but here is one consideration: If you scan again now, you will not have the benefit of seeing what has happened over time. Even though, as Dr. West suggested, the CT will be better able to characterize what appeared on the x-ray, if it is a nodule it won't tell you whether it is a stable, most likely benign nodule or one that is growing and more suspicious for cancer.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

maddie100
Reply To: 2mm opacity found in chest xray

Thanks JimC

Would the CT tell me if the nodule is benign or not? (if that is what it is).

Helen

JimC
Reply To: 2mm opacity found in chest xray

No, it won't. If it grows over time it is suspicious for cancer, but the only way to know for sure is to biopsy it. At its current size it's too small to biopsy and without evidence of growth it would be premature to do so in any event.

It's always difficult to wait, but any procedure has risks so waiting is the only real option. Stay strong!

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

maddie100
Reply To: 2mm opacity found in chest xray

Thanks again,

I'm a bit puzzled as to why my doctor would think it would be a good idea to send me for a CT scan then, but perhaps it is because they don't really know what it is.

Helen

JimC
Reply To: 2mm opacity found in chest xray

He may have ordered it because you were so upset, in an effort to help allay your concerns, since the CT might show that there is nothing there (an artifact on the x-ray) or something outside the lung. In addition, a CT now would establish a baseline for comparison to a subsequent CT.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

maddie100
Reply To: 2mm opacity found in chest xray

Thanks JimC

Sorry to ask so many questions, I'm just in a bit of a state right now.

I am going to focus on the stats you gave me above as when I go googling (yes I know I shouldn't), sometimes other sites say that nodules are cancerous 40% of the time? I'm hoping there is just wildly incorrect informaton out on the internet and the stats you and the Dr's here gave me are correct.

I wish I could calm down and focus on the 'now'.

Helen

catdander
Reply To: 2mm opacity found in chest xray

One thought about what your reading. Those figures, while very possibly made up also could be describing someone with cancer not someone who doesn't. The figures given by our doctors are as close to right as they are bound to get anywhere on earth. This is something you'll just need to move through.
While like you I plan for this to be nothing, our doors are open if you find out differently.
Good luck,

Dr West
Reply To: 2mm opacity found in chest xray

Things that are as small as a few mm are extremely likely to be benign, especially in younger patients. And I think it's a mistake to infer too much into whether your doctor orders a CT or CXR. A hope to allay fears or just be extremely cautious may be the driving force far more than any suspicion that a questionable tiny nodule is likely to represent cancer.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education