Adeno Lung Cancer and Actinomyces Odontolyticus - 1290053

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jenny2017
Adeno Lung Cancer and Actinomyces Odontolyticus - 1290053

Hello-Thank you for providing such a great service! So grateful to have found this site. I'm 44, former smoker, diagnosed with stage 1a adeno Feb. 2016. Presented with pain in my back, chest, feeling of lump in throat, GERD and general malaise. X-Ray showed spot, Ct scan showed 2 cm spiculated nodule URL. Pet Scan NEGATIVE. Core biopsy positive, MODERATELY DIFFERENTIATED. Went to large cancer institute for 2nd option. They reviewed slides and said yes it's cancer and you need lobectomy. Path came back WELL DIFFERENTIATED. Had that done at that institute. In hospital had empyema continually on X-Rays so extended stay and chest tube. First CT July 2016, spot on LRL. CT Oct 2016 spot resolved, new one present. Dec. CT new 1.7 cm nodule. Biopsy scheduled 2 weeks out. Biopsy aborted as it shrunk so much. Surgeon thought it was an organizing pneumonitis. Have coughed up minimal blood twice, lump still in throat, GERD still present. After much research and thought I connected it to a root canal that I had years ago by a general dentist. Sure enough the restoration is leaking and needs to be removed. My understanding is Actin. Odont. can mimic lung cancer on CT and clinical presentation. So my question is, can a path report mistake lung cancer for Actin. Odont. as well? And maybe it was an infection all along?

Thank you,
Jenny

JimC
Hi Jenny,

Hi Jenny,

Welcome to GRACE. I am sorry to hear of your cancer diagnosis and the presence of Actinomyces Odontolyticus as well. It is certainly true that both diseases can coexist in the lung, But although Actinomyces Odontolyticus can be mistaken for lung cancer on scans, the proper way to correctly make the correct diagnosis is through a biopsy of the tissue, as described in this case report: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644747/ I don't see any likelihood that two cancer centers would mistake an infection for lung cancer based on a biopsy.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

jenny2017
Thank you for your quick

Thank you for your quick reply. Yes, I'm aware that occasionally you can have both. I had the biopsy at a local hospital which said it was moderately differentiated. Then looked at again at a major cancer center who performed the surgery then told me it was well differentiated. I'm just wondering if because it's so rare it could be a false positive based on it going from moderately to well differentiated and because of this publication I read. Can I have my slides transferred for a 3rd opinion to a infectious disease pathologist?

https://www.ncbi.nlm.nih.gov/pubmed/10882279

Thank you!

jenny2017
I should add I also have a

I should add I also have a rare condition called Osteogenesis imperfecta which makes me prone to respiratory problems. Thank you.

JimC
Although I think that the

Although I think that the difference between moderately and well differentiated was probably just a difference in the judgment call made by each of the pathologists, I don't think it can hurt to send the slides to another pathologist, since you certainly don't want to be treating for lung cancer if it's not necessary.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

cards7up
You had the lobe removed and

You had the lobe removed and the pathology showed cancer. Then you have a new growth in a different lobe that keeps shrinking without treatment, this is probably the AO. I would think if they suspect that's what this might be that they haven't brought in Infectious Disease yet. How are they treating it? Why not just ask your doctor to have ID to look at your path slides and see what's going on in the other lobe.
Take care, Judy
http://www.antimicrobe.org/b73.asp

jenny2017
Update: Had a Ct Scan at the

Update: Had a Ct Scan at the Oral Surgeon office because he couldn't tell anything from the Xray. The root canal is quite infected.

Judy-I'm not being treated at present. I have a PCP who is trying to defer to the Thoracic Surgeon and a Thoracic Surgeon who is trying to defer to the PCP and also recommended an ID Specialist who I can't get into for several weeks. Surgeon said otherwise, go to the ER.

cards7up
The thoracic surgeon does

The thoracic surgeon does surgery he does not diagnose and follow you only before and a follow-up after surgery. This should be followed by your medical oncologist or PCP if it's not cancer related. You've already seen the oral surgeon and now have to wait and see what ID says. Has ID checked your path slides yet?
Take care, Judy

jenny2017
Hi Judy,

Hi Judy,

Thanks for your response. This facility doesn't have the oncologist follow unless you needed chemo. They have the thoracic surgeon do all the follow up. I think that's where there's a big fragmentation. No, I haven't seen ID yet. Still waiting. Also in the process of trying to switch to a Pulmonologist for continued surveillance of 'cancer' after this ID is sorted