Q. Chest X-ray showed a single nodule. Is a biopsy required to rule out cancer?

Answered by
Dr. Chandra Shekhar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 09, 2017

Hello doctor,

I am a 30-year-old female.The initial illness began early this year. The symptoms were cough, SOB, chest pain, and wheezing. I was treated for pneumonia but never got better. Repeated X-rays showed adenopathy as a possibility. So, a CT scan was done which showed hilar, mediastinal adenopathy and a single pulmonary nodule of 1.2 cm along with some hypodense lesions on the spleen. A biopsy was done on the lung tissue and on the endobronchial mass but not on the lymph nodes or nodule. There was no fungal, bacterial or viral cause isolated. I have been largely asymptomatic since then with an exception of some chest pain. I went in for a follow-up CT scan last week. There is still hilar, mediastinal adenopathy and now pre-tracheal aortopulmonary adenopathy along with the nodule. But, the size is the same. The doctor wants a CT scan in four months and thinks this could be the result of a fungal infection but he is not sure. I am wondering if a biopsy of the actual nodes or nodule would be necessary to rule out cancer. I am so concerned and the thought of waiting four months is devastating. I am a former smoker for five years. I take Lexapro, Adderall, and Microgestin.



Welcome to

I went through your history.

  • There are two clinching things. One is a pulmonary nodule and other is mediastinal adenopathy.
  1. For pulmonary nodule of 1.2 cm, it can be due to a number of reasons. But, if it is not enlarging in size it is most probably benign. Just get a simple CT guided FNAC (fine needle aspiration cytology) properly (incorrectly taken sample gives false results).
  2. If FNAC is not showing anything, then surely it is not a lung mass. Then, you can consider a fungal infection and rather than trying to diagnose it, take a course of antifungal (not everything is ideal in medical science)
  3. For hilar lymphadenopathy, you should to an EBUS (endobronchial ultrasound) and get an FNAC of the mediastinal adenopathy. It will surely tell us everything about cancer if any.
  • The probable diagnoses are sarcoidosis, fungal infection and a benign mass in the lung (at the age of 30, there is very less chance of malignancy).

For more information consult a pulmonologist online -->

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
Can fungal infection cause low grade fever?

.. a chronic fever, which is called as pyrexia of unknown origin when we are unable to ascertain a cause. As your blood tests and x-ray are normal, lung infection is ruled out. Conditions causing chronic fever are numerous. Also, certain infect...   Read full

Bladder biopsy shows eosinophilic cystitis with eosinophil infiltration. Please help.

.. through your post well. Eosinophilic cystitis has been mentioned in the case reports because of its rarety. No clinical trials have been conducted on the condition, it is treated with a course of steroids or NSAIDS and occasionally with resection ...   Read full

I have fungal infection in my ear.Is it mandatory to stay at the hospital overnight for a microsuction?

.. would like to tell you that fungal infection in ear is quite common and it may be treated by: Cleaning the ear: Cleaning may be done by suction or syringing or by cotton swab. Antifungal ear drops to be used three or four times a day. Anti-inflamm...   Read full


Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

Balantidiasis - Causes, Signs and Symptoms, Diagnosis, Treatment, and Prevention
Balantidiasis is a rare bacterial infection caused by a parasite called Balantidium coli. Read the article below to know...  Read more»
JAK Inhibitors in Treating Rheumatoid Arthritis
Doctors mainly suggest JAK or Janus kinase inhibitors for patients with rheumatoid arthritis to ease their symptoms. Rea...  Read more»
Importance of Sex Hormones - Types, Functions, Normal Ranges, and Roles
Sex hormones are steroids produced in the body that control sexual development, pregnancy, and overall health. Read belo...  Read more»

Ask your health query to a doctor online?

Ask a Pulmonologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.