dandoc
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solitary pulmonary nodule
Must rule out a possible tumor.
First step: Compare with a previous CXR (if available)---> if the nodule has not grown up or if there are no other S/S, the nodule is probably benign (a hamartoma, for eg.); if the nodule has grown up in the meantime (compared with a previous CXR) or if S/S suggesting a malignancy, that's probably cancer.
If malignancy suspected---->CT scan / MRI of the chest; also blood tests (LFTs, Ca, PO4, PAL, Na etc) to look for MTS. Next: Biopsy (CT scan / MRI guided or through Bronchoscopy)
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| fero
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THX FOR THE REPLY..but kaplan says thay...excision is preferred over biopsy...!!!!???also..management has alot to do with the age of the patient also....35yr is the cut off...> 35 yr,,more likely a malignancy..excise....,< 35 yrs,with no signs of malignancy. compare the nodule with an old xray....also wait for 3 to 6 months an repeat the xray.....
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| dandoc
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but kaplan says thay...excision is preferred over biopsy...!!!!???also..management has alot to do with the age of the patient also....35yr is the cut off...> 35 yr,,more likely a malignancy..excise....,< 35 yrs,with no signs of malignancy. compare the nodule with an old xray....also wait for 3 to 6 months an repeat the xray.....
Yes Fero, but if that's a malignancy, excision will not alter the prognosis  . Biopsy will however establish the type of tumor; once you have the histological type, proceed with an extensive workup for MTS if malignant.
35 yr age is an arbitrary point, but generally considered as the age from which you can develop lung cancer.
If you have S/S of malignancy (chest Sx, liver / brain / contralateral lung involvment), that's a malignant tumor for sure, regardless of age. However, at this point most tumors are inoperable and the prognosis is rather poor .
I don't think it's use to wait for another 3 to 6 mos if you strongly suspect a malignancy :cry: ; remember that small cell lung cancer grows up very rapidly and by the time you decide to ask for another Xray to be done, the tumor has already become inoperable .
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| fero
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thx !! dandoc.. got it now..
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| zeloc
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So let's say you find an old x-ray from 1 year back and the nodule is the same. Are you done forever or do you need to get yearly CXRs?
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