enlarged lymph node different than nodule? - 1264817

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enlarged lymph node different than nodule? - 1264817

good day cancergracers

yesterday my sweetie had his 6 month post robotic right pneumonectomy follow up with CT scan. Lung void filled to capacity but found 2 enlarged lymph nodes (6, 9 mm) 2 lymph node stations away from malignant node removed in right lung at sx. No mediastinum nodes positive on post sx path or yesterday's scan. he is 2 months post adjuvant chemo as well (4 rounds carbo/alimta) NSCLC adeno.

I left my notes in the car overnight and didn't have the gumption to get out of bed to go get them so I spent most of night arguing with myself over whether surgeon said lymph node or nodule. Did some research and seems that once node or nodule reach 1 cm, it's watch and wait. So his 6 month followup appt is now set at 4 months. My questions are:

1. what's the difference in lung cancer biology between node and nodule?
2. Does this rate of appearance, 6 month post sx, and location raise red flags about prognosis and change the position that surgery was curative?
3. Am I just spitting noodles? (That's how I have categorized all these "no" words.

Thanking you in advance for the wonderful service provided.

Reply To: enlarged lymph node different than nodule?

"A lymph node is an oval-shaped organ of the lymphatic system, distributed widely throughout the body including the armpit and stomach and linked by lymphatic vessels. Lymph nodes are major sites of B, T, and other immunity cells. Lymph nodes act as filters or traps for foreign particles and are important in the proper functioning of the immune system. They are packed tightly with the white blood cells called lymphocytes and macrophages." http://en.wikipedia.org/wiki/Lymph_node

Other terms for nodule are mass spot and tumor, sometimes depends on size. "A nodule is a "spot on the lung," seen on an X-ray or computed tomography (CT) scan. In fact, a nodule shows up on about one in every 500 chest X-rays. Normal lung tissue surrounds this small round or oval solid overgrowth of tissue." http://www.webmd.com/lung/benign-lung-tumors-and-nodules

It does raise red flags as your husband has just had surgery and chemo for lung cancer but it's very possible that it's inflammation or infection and will clear up or stay the same over the next 4 months. I know how difficult it is for a wife to wait with her husband. I'm afraid it's harder for our husbands. So waiting is what is in store. Help him focus on positive outcomes and get on the business of living life. I Know...Easier said than done but there are moments long and short that make it well worth the wait.


Dr West
Reply To: enlarged lymph node different than nodule?

I don't think I'd be alarmist about the allegedly enlarged lymph node(s). These can be benign even when much larger than the sub-centimeter size described in the report, and having had surgery and all of the post-surgical issues could easily lead to some inflammatory changes that could lead a few lymph nodes to be visible. Those findings are ambiguous, at worst, but it's not surprising to see substantial changes after a major lung surgery.

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