8 months ago perfect lungs, now have a 40mm (4cm) masslike on lung? That fast?

[gumdisease]

Feb 2023 I had a chest X-ray, both lungs perfectly clear.

Oct 15, 2023 I have severe pain on my left ribcage and shortness of breath (oxygen normal). Emergency room ordered Chest CT/CAT scan. CT show my Left lung lower lobe (exactly where my pain is) has a 4cm (40mm) masslike.

CT said it looks masslike, etelectasis, infiltrate, and told me to go see Lung specialist, as it can be a cancer mass, blood clot, etelectasis (partial collapse), or even pneumonia.

Gave me antibiotics and said if it is pneumonia antibiotics should clear it up. If not then it something else.

Here I am a week later Oct 22, the left lung lobe area pain somewhat subside, but the pain still there when inhale. About 4 days after the pain now I started coughing alot and phlegm (still coughing). So this can be a secondary thing pneumonia.

Going to be seeing a Lung specialist (waiting for my insurance authorization), and further test I'm sure beside the CAT CT scan of my chest that I had in hospital.

I'm here scare, how can I go from Feb 2023 with a perfectly clear lungs, to Oct 2024 with a 4cm masslike in my lungs? Like do Lung cancer spread that fast? Because 4cm mass size would put me at stage II

How likely it is for me to have a 4cm cancer mass in my lung within 8 months period of time?

Worry.

Thank you.

[Debmarc23]

It is easy to let your mind wonder, especially googling. It is hard to wait the time it takes to see the doctor, I understand. Try to stay positive.

To answer your question about it growing fast, it depends on the type of cancer if it is cancer. Small cell carcinoma grows faster than Non Small Cell Carcinoma. Some cancers can grow that fast in short time.

Please keep us updated after your doctors appointment. Wish you the best! Try to stay positive.

[Denzie Moderator Volunteer]

There are diseases other than cancer that present this way and cause atelectasis. I'm grateful your hospital did a CT and ruled out a blood clot. If this was my body I would call the insurance company 2-4 times a day to press for the authorization

My atelectasis was likely caused as a response to surgery I had. I'd had a pleural effusion when my cancer was diagnosed in 2010 but it blew up after a surgery I had a year later.

There are a few things you can do to relieve the pain and discomfort while waiting for your doctor appointment.

Raise the foot of your bed so that your head is lower than your feet. That will help fluid in the lungs find an easier pathway out.

When lying down, lay on the opposite side. That will take a little pressure off the affected lung and give it room to re-expand.

Sit upright rather than laying down when resting.

Sending hope that this is resolved swiftly and that it is something relatively easy to manage.

[gumdisease in reply to Denzie]

Thank you Debmarc23 and Denzie for your inputs and advice.

There are contradiction in the CT readings, CT of the Abdominal rule out all my other organs are all normal, except there is a 4cm mass on the left lower lobe of my lung, which said might be infiltration but mass cannot be rule out. Mass-like infiltrate.

Then I get send to a Chest CT this time, say heart is normal, but there is a 4cm area of Atelectasis/pneumonia on the left lower lobe of my lung. Then it also said: No pulmonary parenchymal lung nodule or mass is identified.

So what it is? Two different radiologist give two different reading.

Emergency room did not diagnose me with Caner, but diagnose me with Pneumonia due to that second reading, and give me antibiotics and told me to go to lung specialist (since my biological father died of lung cancer).

Will call and make an appointment with the Lung specialist today, but I never smoke a day in my life, my father died of Lung Cancer but he was 85, I'm 39 and now suddenly I have a Small cell lung cancer that grow my lung within a short 8 months timeline grow up to 4cm? Well I sure must win the lottery then.

[Denzie Moderator Volunteer]

It's not cancer until a biopsy says it's cancer. Pain is absolutely a product of pneumonia. "No pulmonary parenchymal lung nodule or mass is identified." What that means is there is nothing affecting the functional part of the lung. If this was cancer you would expect to see parenchyma changes.

There is nothing in what you shared that mentioned spiculations which you would expect to see in a 4 cm lesion. These observations don't mean there isn't any, just reduces the likelihood.

Please note that your pulmonologist will have his own interpretation. This is important because the radiologists who read the other CTs look at CTs of many other organs, your pulmonologist only looks at CTs of the lungs.

Also note that the two different doctors may not have been looking at the same exact slice on the CT Sometimes differences in appearance can also occur due to the column of air when you held your breath. If they're done on different machines that can also make a difference.

[gumdisease in reply to Denzie]

Thank you for your advice Mrs. Denzie

The CT said: Left lower lobe lateral basal segment costophrenic sulcus masslike infiltrate. I mean if this is cancer mass, it is not a common area for cancer tumor to start right? Usually I heard it common to begin in the middle part of the lung.

I'm just curious, usually with a 4cm mass (let say if the 4cm infiltration in my lung is cancer mass), then I thought it go would go my lymph nodes, or my right lung, but nothing, it so localize that it stay there at the low left lobe of my lung only.

I thought with 4cm mass, it should be big enough for the cancer cells to break away and go to lymph nodes at least. No?

My father did died of lung cancer so I know, his mass was big, 13cm and it expand up to his left lung Hilum, you know the lung Hilum is where all the nerves are, so my father was in so so much pain. And the tumor mass metastasis to his pancreas (a big tumor in his pancreas) and that was the end. Somehow his 13cm lung mass got to his pancreas.

Mine is 4cm and in the lower left lobe of my lung, that is no where near the Hilum, but I feel so much pain like I have a broken ribs or lung collapsed, which the Chest CT scan did say I have Atelectasis/pneumonia (that one radiologist read it like that).

The pain of my left lobe lung has subside but now I'm coughing like there no tomorrow, and there phlegm. I cough so much that I literally cannot sleep at night due to the coughing.

Will be going to specialist, I was wondeirng if an MRI would show anything that a Chest CT CAT couldn't show? As my Chest CAT scan that radiologist said it 4cm area of Atelectasis/pneumonia, but not mass.

Seem like I need another Chest X-ray to see how this 4cm infiltration masslike, if it pneumonia it will evnetually heal, if it tumor mass it will not go away.

Tbh I'm not confident, my father did die of Lung cancer.

[Denzie Moderator Volunteer in reply to gumdisease]

That is an odd/rare place for a cancer. Most do start in the bronchi's, bronchioles, or alveoli. At 4 cm a malignant mass will have established its own blood supply and can shed into the circulatory system as well as the lymphatic system.

There are many things that can cause infiltrates including pneumonia. Please let us know what you learn.

[gumdisease in reply to Denzie]

Thank you Miss Denzie, really appreciated. The CAT Thorax, I'm guessing thorax means chest. In the scan result it only mentioned on my left lower lobe Atelectasis/pneumonia, and said No pulmonary parenchymal lung nodule or mass is identified. NEVER mention anything about Lymph nodes so I'm assuming there nothing in my lymph nodes here.

I have a question about radiation. I had 2 CT CAT scan within two days apart, should I worry about radiation? But it was needed.

I went in the ER due to severe pain on my left ribcage, first ER doctor order me an Abdominal CT scan to make sure I don't have kidney stones or something, Abdominal CT show all of my organs is fine except there is a 4cm infiltrate cannot rule out mass on my left lung lower lobe. Send me home with antibiotics think I have pneumonia.

Two days the ribcage where that left lung lobe get worst, I went back to ER, because Abdominal CT only show a the lower lobe part of my lungs, the second ER doctor ordered a Chest CT CAT scan as Chest CT show my heart and the WHOLE lungs.

This time just see my heart and lungs only, and it said where the 4cm infiltrate is now it Atelectasis/pneumonia, so where the 4cm masslike of my lower lung lobe it said it Atelectasis (partial collapse), no wonder why the pain was so much.

So I have 2 CT scan within few days time, it was needed. Should I worry about radiation?

And here my Primary care doctor want me to have a Chest X-ray (not CT but X-ray) in two weeks to see if the 4cm infiltrate has any changes, if it pneumonia or mass.

I mean it all needed, so I think I shouldn't worry about radiation at this point,

I do have appointment to see Lung specialist next week and before they decide on a biopsi they should at least get another X-ray and see if the 4cm infiltration shrink or get bigger before they decide to biopsi me right? I mean if it Atelectasis/pneumonia like what that Radiologist read it will heal eventually and scar. But if it a cancer mass the 4cm won't go away.

[gumdisease in reply to Denzie]

the Thorax CAT scan said this, and I even request a second reading because I was worry the first radiologist might left something out so the second reading was read by the Director of the Radiology department whom also is a MD radiologist.

And it said in the report:

Left lower lobe lateral basal segment costophrenic sulcus masslike infiltrate.

Opacification at the left costophrenic sulcus. Effusion and or/atelectasis.

There is an area of atelectasis/pneumonia involving the periphery of the left lower lobe of the lung.

--------

I have been coughing for one week, I can't sleep at night due to the cough, it like this tickling in my chest and trigger a cough, like violent cough episode, I even think I might have whopping cough. While waiting for the Specialist appointment next week, I think I'm going to head to the Urgent Care and see if they can do me a Phlegm test, a phlegm mucus test from my cough should at least show what bacteria that is. So I think I'm going to head to the Urgent Care, see if they give me a phlegm test.

[Denzie Moderator Volunteer in reply to gumdisease]

A phlegm test is a great idea! I think having the X-ray is a another good idea. At 4 cm an opacity like pneumonia is probably large enough to show on an X-ray and I suspect that that should be sensitive enough to tell if it has shrunk. CTs actually use X-rays so a simple chest X-ray reflects less exposure.

Take heart from the fact that both doctors saw the same thing.

I've had pneumonia and atelectasis and can confirm that this can be painful.

[Jenniferroseolson]

As difficult as it seems, try not to suffer this before you have a confirmed cancer diagnosis. You will likely need a biopsy to determine what the 4cm area actually is. Many people have nodules in lungs that are completely benign, and although I am “just” a patient and not a medical professional, I know are many things that can cause pain and can show up on imaging that are not cancerous. The waiting is absolutely awful. Once you know what you are dealing with, then you can make a plan and deal with it. Make the appointment and distract yourself with something you enjoy in the waiting period. Watch movies, or I like silly videos on social media of dogs or cats. Then, ask questions and take notes and advocate for your self for further testing. Best wishes!