Possible misdiagnosis???

jmitch512 · New User Joined: 15 Aug 2005 Posts: 1

I am a 27 year old male non-smoker who was seen in Dec 2004 in the ER with chest pain. At that time, I was told I had a nodule (1.2cm x 1.1cm) in my right upper lobe. I had a CT directed needle aspiration biopsy performed, but the results were inconclusive. That procedure was followed by a mediastinoscopy to take a sample of a lymphnode that was enlarged. The results showed no cancer in the lymphnode, but histoplasmosis was present. At that point, I was placed on medication to get rid of the fungus.

I have been rid of the fungus since April, but the nodule on my lung has continued to grow. 1.6cm x 1.2cm in May and 1.7cm x 1.3cm in August. I am no longer being treated for histoplasmosis. My doctor told me that he wants to wait three-months to see if the nodule continues to grow before performing any further tests.

My questions:
Since the nodule on my lung has never had a successful biopsy, is it possible that histoplasmosis is not the cause of the nodule (especially since the nodule continues to grow despite no histo fungus in the bloodstream)?

Is the doctor being too conservative by waiting three-months to see if the nodule continues to grow, despite the progressive increase in size over the three CT scans?

If anyone has any info that could be helpfuk, please reply.

Thanks!

mikes · Senior User Joined: 25 Jul 2005 Posts: 158

If the nodule is indeed malignant, you don't need to know it in three months, you need to know it now.

My wife also had an inconclusive needle biopsy. The problem is that this is not a trivial procedure as some believe. You may opt for sputum cytology, which will not give absolute confirmation, but may help to determine if another biopsy is indicated. The problem with all types of biopsies is that they may cause the tumor to spread when disturbed.

If the nodule is malignant, three months is enough for it to advance to the next stage. Also, if it is causing you anxiety, the stress may make things worse.

You might want to have a blood test for p53 which is not commonly done, but can give a clue as to the state of your immune sysem. P53 abnormalities exist in over 50% of most types of cancer. Here again, not an absolute indication, but rather a suggestion that a biopsy be done.

The thing that most people don't realize is that CAT scans and biopsies can cause problems in and of themselves. The radiation exposure from a CAT scan (especially the spiral type) is large.

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