Relative received the following PET Scan results and very concerned! They were referred to Oncologist and wanted some advice on what the forum thinks this could be:
IMPRESSION: There is hypermetabolic pleural parenchymal opacity at the lateral left lower lobe with a maximum SUV of 4.1. There is also hypermetabolic ill-defined 9 mm nodule at the posterior right upper lobe. There are mildly hypermetabolic reticulonodular opacities in both lungs as detailed above. The differential diagnosis includes both neoplastic and inflammatory or infectious etiologies. Please correlate clinically. No evidence of hypermetabolic nodal disease or distant metastatic disease in the abdomen or pelvis. No suspicious hypermetabolism in the bony skeleton.
So I think its showing there are issues in the lungs, but no bone cancer was found. Sorry, but I am just very concerned and appreciate any help.
Reply # - November 29, 2017, 09:35 AM
Hi Mark,
Hi Mark,
Welcome to Grace. I'm sorry your relative has received unsettling info. To begin to understand scan reports such as PET, CT and mammogram you should know who writes them and what they do and don't mean. These scans are read and reported on by radiologists. These doctors don't see patients hence the comment, "Please correlate clinically". They are highly trained and experienced in examining scans to catch and report on anything abnormal. An example is about 1 in 4 people have pulmonary nodules and the overwhelming majority of those are benign.
The report states that the nodules could be cancer, infection or inflammation. This is because the nodules are hypermetabolic /the nodules have cells that are more active than typical lung tissue suggesting one or more of the 3 differential diagnoses.
The only way to know what they represent for sure is to take a biopsy and examine the tissue under a microscope. Scans that suggest cancer by it's size, shape and metabolic activity are shown to be benign every day. So while this is unsettling and waiting is the hardest part know that it may not be cancer.
I hope your relative is and does well.
All best,
Janine
Reply # - November 29, 2017, 09:50 AM
Janine,
Janine,
Thank you so much for your reply and that makes me feel a little better. She has been experiencing pneumonia on and off for about 7 years now with a recurring fever; was diagnosed with MAC, but then corresponding lung biopsy didn't confirm or show any culture growth. There was the presence of interstitial tissue, but no malignancy was confirmed, just the presence of atypical cells. The procedure was excruciating and it seems that more of these nodules have appeared with each successive CT scan. Now she has had severe bone pain and doctor performed two kyphplasties and then did a subsequent bone biopsy in the area finding atypical cells; she has osteoporosis. This is what prompted the latest PET and CT scan. Very frustrating as it has been difficult to get anything conclusive though the presence of hypermetabolic tissue concerns me as this is usually indicative of cancer. Benign cells do not present hypermetabolism, correct?
Best,
Mark
Reply # - November 29, 2017, 12:47 PM
Hypermetabolic can also mean
Hypermetabolic can also mean infectious or inflammatory. With all that's happened previously with her lungs, I wouldn't be surprised to see some SUV uptake. Has she been on antibiotics? Benign nodules can show hypermetabolic if they're infected or inflammed. It's not just cancer that causes the SUV uptake. What has her doctor stated? Take care, Judy
Reply # - November 29, 2017, 01:18 PM
Thanks Judy,
Thanks Judy,
Appreciate the reply and certainly no conclusion yet.
She has been referred to an oncologist and has an appointment scheduled so we will learn more hopefully soon.
Best,
Mark