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Lung Cancer

Stable 3mm noncalcified pulmonary nodule

08/30/2007

Question:

recently had CT chest, abdomen,pelvis to check for recurrent ovarian cancer. Diagnosed w/ovarian cancer Aug. 2003, hysterectomy and chemo. CT 5/31/06 showed 3mm noncalcified pulmonary nodule which is unchanged/stable on CT 6/20//07. Chest CT showed-biapical pleural and parenchymal scarring consistent w/old granulomatous disease Tiny 3mm noncalcified pulmonary nodule right middle lobe. COULD THIS NODULE BE RECURRENCE OR METASTASIS OF OVARIAN CANCER? My PPD test was negative May 2007. What granulomatous disease could I have had? I appreciate any answer and information. Thank you.

Answer:

These small non-calcified nodules are called "indeterminate" because it is difficult to make a diagnosis based on their appearance alone. The possibilities include both benign and malignant disease. With a prior diagnosis of ovarian cancer the risk of metastatic cancer is possible. However, with these tiny nodules, it is difficult to obtain a diagnosis short of a major operation. It would also be reasonable to continue to follow these with serial chest CT scans every 3 months for 2 years. If there is no evidence of progression in size or number then it would be safe to assume their benign nature.

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Response by:

Abbas  Abbas, MD Abbas Abbas, MD
Formerly:
Assistant Professor of Surgery
College of Medicine
The Ohio State University