In limbo....HELP plz - 1262764

lonnie6
Posts:7

I went in for a CT of abdomen in Dec. 2013... Which incidentally showed a small nodule on lower left lung. My Dr then ordered a full chest CT...it confirmed a nodule 1.8cm A previous CT (2 years prior) was used for comparison. In Feb 2014 I had a PET scan that now showed two adjacent nodules .8cm and 1.8 cm lobulated no calcification so seen. They did not absorb the radioactive inhibitor. My Dr. Thinks I should biopsy now...the oncologist says I should wait until end of May and then rescan for changes and then decide...I don't know what to do...anyone with some advice? I'm a female, 46, non smoker.

Forums
Full Archive

Reply # - March 14, 2014, 04:56 PM

JimC
Posts: 2753

Hi lonnie6,

Welcome to GRACE. It sounds like you have somewhat conflicting signals from your scans. The nodules did not light up on the PET, which tends to indicate it may not be cancer, although it is certainly not determinative. On the other hand you now have two nodules, although the larger of them does not seem to have increased in size since the previous scan (but it should be noted that comparisons between different types of scans are not always accurate).

As Dr. Yankelevitz described in his webinar on Evaluation and Management of Pulmonary Nodules, nodules greater than .5 cm are either watched very closely or biopsied. Your largest nodule is much larger than that, so your oncologist and doctor will likely want to biopsy it very soon, but their recommendations represent a judgment call based on full information about your situation. You can read the transcript of Dr. Yankelevitz's discussion here: http://cancergrace.org/lung/files/2011/12/dr-yankelevitz-pulm-nodules-e… and the figures from that webinar are here: http://cancergrace.org/lung/files/2011/12/dr-yankelevitz-pulm-nodules-e…

JimC
Forum moderator

Reply # - March 14, 2014, 08:14 PM

Dr West
Posts: 4735

The absence of uptake on PET is a favorable finding. I'm having trouble understanding what the prior CT scan from 2 years ago demonstrated, but it's critical to the interpretation. If these nodules were there and the same size years ago, it's extremely likely that they're benign, especially when you add the fact that these nodules were "PET-negative" -- and a biopsy wouldn't be warranted. If these were not present or were definitely smaller two years ago, it leads us to be quite a bit more suspicious and be inclined to favor a biopsy or at least close follow-up after an interval of a few months.

-Dr. West

Reply # - March 14, 2014, 08:41 PM

lonnie6
Posts: 7

Hello...and thank you for your response...the chest CT from 2 years ago had no signs of nodules...the one in Dec. showed only 1 but the CT in February now shows two...

Reply # - March 15, 2014, 08:01 AM

JimC
Posts: 2753

Since the abdominal nodes are the only things lighting up on the PET, they could represent an unrelated process, but the appearance of the lung nodules since the CT from two years ago raises suspicions that would warrant further work up such a biopsy.

JimC
Forum moderator

Reply # - April 23, 2014, 06:02 PM

lonnie6
Posts: 7

I have a scheduled appt next month to rescan my lungs as previously stated..However, I have developed some symptoms That I am not sure are related...headache, unexplained low grade temp 99-100.7 daily
for the past two weeks, cramps in my triceps and loss of strength in my arms and hands, extreme exhaustion and a pressure in my chest...like a squeezing sensation, dizziness...I have not called my Dr as of yet but I am thinking of going to the ER to get an immediate CT of my chest. Any thoughts or direction?

Reply # - April 23, 2014, 06:49 PM

Dr West
Posts: 4735

I'm sorry, but if there's one kind of question we would never be able to answer is, "should I go to the ER for something that is potentially serious?". Answering would be like advertising "please sue us".

Although we'd love to help, I can assure you that there is nothing that makes the folks here more qualified to address your concerns than your doctor.

-Dr. West

Reply # - April 23, 2014, 06:52 PM

lonnie6
Posts: 7

Sorry...I'm not asking if I should go or not...I know I need to go...but are these types of symptoms possibly related to the unknown nodules in my lungs?

Reply # - April 23, 2014, 08:33 PM

Dr West
Posts: 4735

Those symptoms are quite non-specific, and it is hard to tie them to some small lung nodules.

-Dr. West

Previous PostNext Post