Solitary Pulmonary Nodule

[Margaret Smith]

I just had a CT that revealed I have a 1 cenimeter lung nodule. What I have read thus far is that is more than likely not a concern. However, the one difference from all I have read thus far is that I do have pain. It is not 100% constant, yet it is there and I can feel it about 75-80% of the time. I did have pneumonia earlier this year.

I distinctly remember in February when I first felt the pain in my upper back on the right side. What of course complicates matters is I do have a 3 mm kidney stone. I passed two stones already one in August, one in September. I did tell my doctor that the pain feels higher than my kidney. Also an urologist told me repeatedly that unless the stone is blocking the flow of urine it is not causing pain.

What I would like to know is, what is causing the pain? Should I be concerned that this nodule is giving me pain? The location of the pain feels far too high to be coming from my kidney.

Can the scarring from pneumonia cause pain? Does anyone know? Thanks for your help.

[UroDoc]

In my experience lung nodules, structurally, by themselves do not cause pain. Good luck

[Margaret Smith]

Thank you for your reply. I keep wondering why there is pain if a nodule in and of itself does not cause pain. Would you know if it is possible that two bouts of pneumonia, one in February, and one in May, could have left scarring that would explain the residual pain? As I said it is not harsh pain, more of a dull ache. I have noticed it is more frequent/consistent than it used to be.

Also, are there any further tests you would recommend? I would surely like to avoid having biopsy as that appears to be fairly invasive. The CT was read by a radiologist, this may be off the wall, yet, would it be a good idea to have any other doctor/specialist look at the CT? Are there other actions you would recommend? Part of me is concerned mainly because there is pain associated with this nodule... and I can't help wondering what could be the source of pain? Again, thank you for your help.

[Alicia_Azu]

Hi, this is my first visit. I hope I am doing this right. Here goes, I went to the ER in July, with
excruciating pain in my upper right side. They did a CT with Contrast. Tests results reveal:
Large Hiatal Hernia
Fatty Infiltration of the Liver
2 5mm Subpleural nodule in the rt lower lobe of the Lung
The pain lasted for well over a month, 24/7. It has eased up, but now it is wanting to
start again. I ask my doctor if the nodules could be causing the pain, and he said no.
He also said that unless the Liver was enlarged, I should not be having pain.
Well, I'm not crazy, and although the nodules are 5mm, when I lay on my back
I feel like something is poking me. I have one more test to see if it is a Kidney Stone.
I have had Kidney Stones before, but they never lasted a month.
The pain feels like I have pneumonia, but I don't.

[Davy9]

The sensation of internal pain can be referred meaning that the source of the pain can be remote from where it is perceived. In regards to the lungs the pleural lining of the lungs (the visceral pleura) is not innervated but the pleural lining of the inner chest wall (the parietal pleura) is innervated. Vascular events in the lungs can also be a direct source of lung pain.

Thoracic pain is not easy to pinpoint because the lungs themselves do not convey pain and many surrounding and intrinsic structures will convey pain. They will assess all the symptoms including the pain and work towards diagnosis and treatment from there. You are correctly helping this process by your accurate description of the pain, when and how it occurs and its relative intensity.