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Lung nodule, should we wait?
May 6, 2001

My husband (CD4 150, VL Non detectable) had a 2.5cm nodule show up on a CT scan in his lungs. The pulmonologist was unable to reach the nodule when he did a bronch. The pulmonologist said the nodule doesn't "look" like it is cancerous to him. A 2 month follow-up CT scan showed that the nodule hasn't increased (or decreased) in size. The Pulmonologist is just wanting to watch the nodule. (CT scan every 3 months for 2 years.) Is this normal proceure for this type of nodule?

Response from Dr. Dezube

No you should not wait. A nodule, particularly a 2.5 cm one, is NOT a normal finding. If the pulmonologist can not reach the nodule via bronch, then the next logical step would be a fine needle biopsy under CT guidance; basically this means that the radiologist, using the CT to guide him, places a needle directly in the nodule. This is the procedure which most of my patients in similar situations go through; it is a relatively easy procedure. I share with your concern about waiting since if your husband has a curable disease in his lung, you want to diagnose it as early as possible. Occasionally, we take such patients to the operating room to remove the nodule; in that way you solve two problems at once-- you get a diagnosis and you get rid of the nodule. Good luck. Please write back and tell me what the nodule turns out to be. BD.


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