lung nodule or lymph node? - 1262251

graelroad
Posts:8

I had a random CT heart scan, that showed a unexpected finding of a 8.7mm noncalcified lung nodule in my mid lower left lung, so followed up with a complete chest CT, this was the only abnormal finding, So a month later had a PET/CT that show there was no uptake at all , nothing lit up. On Dec 10th had Vats surgery to remove it, ( it was to close to artery to needle biopsy) so all well and good, before surgery they did a micro coil that was CT guided to mark the nodule because of the size. They ended up taking 2 wedges , No cancer was found. I was very happy to hear this, when I returned home I requested a copy of the path report and this is where my question comes in, as it reads ( the report on gross findings) state that the first wedge 9.5x4x2 cm with the small metallic coil showed no evidence of nodularity goes on to say the specimen is fixed in formalin on 12/10/13. Further sectioning reveals a purple red soft nodule measuring 0.8 cm in diameter, this area is 0.3cm from the stapled resection margin and 0.5 cm from the nearest pleural surface. ( next wedge) is 9x2.3x1.5cm is examined ( all clear) So looks like they found it in the first wedge , So my QUESTION is on the FINAL PATHOLOGIC DIAGNOSIS it states small intraparenchymal lymph node, 0.4 cm with reactive changes , no evidence of malignancy is seen, SECOND wedge benign, ( SO ASK MY DOCTOR THE SURGEN HOW COULD A 8.7 MM NODULE BECOME A 4MM INFLAMED LUNG NODULE? HE EXPLAINED THAT DURING THE PATHOLOGIC PROCESS THER IS A HARDING EFECT AND IT DRIES OUT THE TISSUE AND THATS THE ONLY THING HE THINKS CAN EXPLAIN THE DIFFERENT SIZES..HE SAID THAT HE WOULD TALK WITH THE PATH DR, AND SEE WHY THEY ARE TWO DIFFERENT SIZES MENTIONED IN HIS REPORT AND THE REASON WHY THIS IS. I wanted this surgery so I would not need to keep scans going over the next couple of years and all the worry, I WONDER WHY also they could not tell the difference from a swollen lymph node and a SPN to begin with. CONFUSED

Forums

JimC
Posts: 2753

Hello,

Welcome to GRACE, and congratulations on the benign findings!

A CT can image a nodule, but it can be difficult to tell exactly what it is until it is removed surgically. The nodule was within the lung, near the pleura, so in this case it would be hard to tell if it's a separate nodule or what is was - an intraparenchymal (within the structure of the lung) lymph node.

The best person to respond to the question of the differing sizes would be the pathologist, so I hope you get some satisfactory answers from him.

JimC
Forum moderator