Hello, I recently came across my husbands first PET scan and was surprised by some information that was never relayed to us. Maybe it was ruled unimportant and not relevant. We were never given this written report but I came across it on his online chart.
.Findings:
Neck: Soft tissue attenuation is visualized filling the right piriform
sinus with maximal SUV of 2.6. Asymmetric FDG uptake is visualized in
the right vocal cord with maximal SUV uptake 4.3. Asymmetric FDG
uptake is visualized in the base of the tongue with maximal SUV uptake
5.5. 1.0 cm left level 2A lymph node with maximal SUV uptake of 2.3.
No hypermetabolic cervical chain lymph nodes are visualized.
Impression:
1. Asymmetric thickening and hypermetabolic activity of the right
vocal cord and anterior commissure consistent with laryngeal
adenocarcinoma. No hypermetabolic lymph nodes are visualized in the
neck. No evidence for disease spread in the chest, abdomen, or
pelvis.
2. Soft tissue filling the right piriform sinus with mild FDG uptake.
Asymmetric FDG uptake in the lingual tonsils on the left. Close
clinical followup is recommended.
I just think it is strange that there was a 5.5 uptake in the base of tongue and 2.3 in the lymph node and this was never mentioned to us. Also the uptake in the lingual tonsils on the left with clinical followup recommended was never mentioned. Was it possible that these areas were ruled out through the CT and Pet scan. However, there was cancer in one of the nodes in the level 2A that was detected from the neck dissection over 2 months later. Seems like it should of been done a little quicker if it looked suspicious during the scan.
Just hoping for some clarification from your view point. Thank you!!
Reply # - February 13, 2013, 05:41 AM
Reply To: Need clarificaton
dawnd,
It's impossible to say what the report means by just reading the report. However, it sounds as though though the radiologist is concerned about the head/neck region. I have a few thoughts:
*The vocal cords can often be hypermetabolic in noncancerous situations
*Adenocarcinoma of the larynx is rare. When present, I'm not aware of any PET/CT findings that distinguish it from the more common squamous cell carcinoma of the larynx.
*All the areas of concern can be easily examined by a combination of physical exam and NPL (NPL is a very thin scope; for more, see http://cancergrace.org/hnscc/2010/05/10/intro-to-scchn/ )
I suggest that you simply bring this up with your doctor. As what he/she thinks it means, and what you need to do. If you are not satisfied with the answer, the appropriate specialist is an ENT doc.
Parenthetically, this also raises one of the greatest strengths and one of the greatest weaknesses of easy online access to patient charts. Patients can better advocate for themselves and make sure nothing is missed, but the information is out of context and in doctor language.
Reply # - February 13, 2013, 06:52 PM
Reply To: Need clarificaton
Thanks for your reply and I did find it reassuring that these added areas of uptake can be visually checked with the NPL scope that that my husband has been having every month. I was just surprised that they were never mentioned, especially the 5.5 in the base of the tongue. It also surprised me with the uptake in the nodes at the 2A level that there was no rush to have the dissection with such an aggressive cancer when that is where the cancerous node was found. (I understand that it was just the adenocarcinoma component that spread to the node and not the squamous cell carcinoma.
I failed to clarify that this scan was after his confirmed diagnosis and biopsy for Adenosqamous carcinoma of the larynx. Yes, that is even more rare than Adenocarcinoma but he beat all odds and has a rare type of cancer with less than 50 cases cited in history we are told.
And yes, most of the wording used by doctors is definitely in a different language!!