Finding out that a nodule in your lungs has spiculations is downright terrifying if you then learn that this is strongly suggestive of cancer.

“While up to two-thirds of benign nodules can have spiculations (lung masses that have linear strands extending into the lung but not the pleura), spiculations are seen in at least 90% of cancers,” says Alex Little, MD, a thoracic surgeon with a special interest in esophageal and lung cancer, and clinical professor at the University of Arizona.

“So spiculated nodules are more likely to be malignant than benign,” continues Dr. Little.

“Of course, the identification of spiculations has to be taken in context.

“If the patient is a smoker and the nodule is larger than 10mm, the odds of cancer go up.

“And if larger that n20mm there is a 90% chance of malignancy (Radiology 2005;235:259).”

So in summary, it’s possible for a lung nodule with spiculations to be benign, even if the patient is a smoker. But it’s not something you should place any bets on.

Dr. Little trained in general and thoracic surgery at the Johns Hopkins University School of Medicine; has been active in national thoracic surgical societies as a speaker and participant, and served as president of the American College of Chest Physicians.