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8 mm nodule found on chest CT

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I went to the ER on 12/13/09 for severe chest pain and palpitations. While there, they did a CT scan of the chest with contrast to rule out PE. No PE, but they did find an 8 mm nodule in the left lingula. In mid October of 2009, I went to the ER for what I thought at the time was appendicitis but it turned out to be kidney stones. They did a CT of the abdomen and pelvis without contrast that did not show the nodule. I do radiology transcription for a living and know that a CT abdomen and pelvis will show the lung bases. My question is, could it have been there but because of the noncontrast versus contrast issue, could it have been there before and just not showed up? They've recommended to have another CT scan in 3 to 6 months. I have been smoking since the age of 15 (48 now) and have extensive family history of lung cancer. Also recent history of 45 lbs of unintentional weight loss (within a 3-month period) and persistent cough. Thank you for your help.
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replied January 18th, 2010
You have essentially answered your own questions.

Stop smoking, right now; and obtain another CT scan of your chest (with IV contrast) in 3 to 6 months to reasssess this pulmonary nodule. If it is enlarging, or if other new nodules have arisen, then you will need to undergo a biopsy to obtain a diagnosis. If the nodule remaains stable on serial CT scans over a period of 2 or 3 years, then it is most likely to be a benign nodule.

Sincerely/ Robert A. Wascher, MD, FACS

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