Q. I have had what is diagnosed as a probable granuloma in my right lung for three years. At the urging of a surgeon who removed granuloma tumors from each thigh, I asked my physician about redoing a CT Scan, which he has ordered periodically to monitor the problem.

The result of the CT Scan indicated that the original spot may now be malignant and there is a new spot in the left lung. Most of the material I have read on this subject does not address the possibility of malignancy. Can granulomas become malignant or turn cancerous?

A. A granuloma is just a collection of cells of different types. It is a non-specific term as to the cause. It can be something harmless such as scar tissue at the site of a previous infection or injury, but the exact diagnosis would depend on a biopsy (tissue sample).

Spots seen in the lung on an x-ray are often not reachable for a biopsy, so they may be observed over time by repeat x-rays or CT scans to look for changes in size as has been done in your case.

With the current change noted, more studies are needed to clarify the situation. Your doctor will likely start with a basic physical exam and lab work, then decide on specific tests to clarify the observation on the lung condition. A specialist in pulmonology may be called upon for consultation.

http://www.cancer.org/docroot/cri/content/cri_2_4_3x_how_is_lung_cancer_diagnosed_26.asp

http://cancer.gov/cancerinfo/pdq/screening/lung/patient/

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