Very slow growing lung nodule

razp
Posts:2

Hi all - I’m not sure how I’ve gotten here but I fell down a rabbit hole and here I am.

I’m 65yr old male non smoker. I was diagnosed with a very rare type of vasculitis (churg strauss syndrome) over 15yrs who. I take immunosuppressants and have generally been ok.
In 2011 a CT scan of the lung showed a 1mm well circumscribed solid nodule in the lower right lobe. A scan in 2017 showed it had grown to 4mm and a scan last month showed it was at 7mm. So it’s extremely slow growing. My vasculitis team referred me to lung specalist who weren’t particularly concerned given the very slow growth and no other suspicious features. They recommended a repeat CT in 12 months.
However my vasculitis doctor wants me to do a PET scan asap.
What are the chances this is cancer given it’s so slow growing? Is it likely to be inflammatory related given my vasculitis?

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General Lung/Thoracic Cancer

Reply # - June 4, 2024, 04:46 PM

JanineT GRACE …
Posts: 629
GRACE Community Outreach Team

Hello and welcome to Grace.  I'm sorry you're going through this worry.  It is normal to watch a small very slow-growing solid nodule with once-a-year CT scans.  Anything less than a cm is too small to biopsy or to show up on a PET.   PET scans are usually taken when a diagnosis of cancer is gotten to see if there are other fast-growing nodules in the body...looking for metastatic disease.  Too, even a relatively fast-growing cancer (normal growth speed for lung cancer)in the lung won't show up on a pet when it's that small. 

 

I don't know about lung inflammation related to vasculitis.  Inflammation, infection, and cancer all look too similar on PETs and CTs to be sure which you're looking at.  It may help you decide whether or not to use this resource if you know how it will affect care. 

 

Take care,

Janine

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

Reply # - June 4, 2024, 05:07 PM

razp
Posts: 2

Thanks you very much. So in summary the course of action taken suggested by lung specalist (re scan in 12 months) seems appropriate? And a PET at this stage is probably not required?

Reply # - June 5, 2024, 08:07 PM

JanineT GRACE …
Posts: 629
GRACE Community Outreach Team

I can't say what is appropriate for you that's only something your professionals with all your information can do.  However, when someone has a solid nodule less than a cm that has shown slow growth it would typically be watched with yearly scans. Anything that you might do to it is likely to cause more harm than good so the standard is to watch and wait.  I'd ask the vasculitis doc if the PET has anything to do with vasculitis.  Generally speaking, if your lungs are working well then poking around in them isn't any pulmonologist's first thought. 

 

Please keep us posted and best of luck,

Janine

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

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