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Diagnosis of metastatic malignancy in the lungs and tuberculosis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Lung Cancer
Answered by

General & Family Physician
Practicing since : 2009
Answered : 595 Questions
User :   hello doctor, A spot is detected in the lungs area of my mother her age is 55 years We have gone through various phase of tests, that are 1) X-Ray 2) CT -Scan Impression:CECT chest reveals hetrogenously enhancing mass lesion involving right lowe lobe with subcentimeter mediastinal lymphadenopathy possible mitotic in nature. 3)Bronchoscopy:Test is negative Now the doctor is suggesting for the CT guided biopsy Also We have gone through the MRI of head and the report is like this: Oblong ring enhancing lesion in the right fronto-parietal region associated with perilesional edema. the etiology is likely to be neoplastic and represent metastatis. But still the doctors are not able to conclude, what the exact problem is, they are now suggesting for biopsy can u suggest what the exact problem is? weather we should go for biopsy or not? Is there is some better test which better then biopsy? Eagerly awaiting for your response Thanks
Doctor :   Hi
User :   Hi
Doctor :   Let me read
User :   ok..
Doctor :   Let me explain.
User :   ok.. please do
Doctor :   The MRI finding clearly indicates the possibility of malignancy.
Doctor :   And since it is a metastatic lesion, primary tumour has to be localised.
Doctor :   This is important not only for the diagnosis but to decide on the treatment plan too.
Doctor :   That is possible by a biopsy and histopathological examination of the lesion alone.
Doctor :   In simple words, since bronchoscopy did not help a CT/HRCT guided biopsy is required.
Doctor :   Have you followed?
Doctor :   Other tests include blood tests for tumour marker, however these tests are not conclusive and are indirect evidence aiding in diagnosis.
Doctor :   They do not help in deciding the treatment though.
Doctor :   hence a biopsy is essential
Doctor :   Have you followed?
User :   ya we are planning to go for biopsy next week
Doctor :   Do you have any other query?
User :   does the biopsy gives us the exact reson of the problem
Doctor :   This is a highly sensitive and specific test, and hence this is the best test.
Doctor :   It should give the results.
Doctor :   Do you have any other query?
User :   ya few more
User :   what do u mean by malignancy
Doctor :   malignancy mean cancer.
User :   oh..
Doctor :   Do you have any other query?
User :   by localised tumor do u mean that it is not spreading
Doctor :   A metastatic tumour refers to tumour that has already spread.
User :   Also doctor is suggesting to take TB mediciences
Doctor :   The other possible diagnosis is definitely tuberculosis.
User :   so it could be tuberculosis or cancer .. is that right
Doctor :   If the TB medications are able to cure the lesion that is seen on the MRI, then the cause for the lesion is tuberculosis.
Doctor :   Yes, they are the most common causes.
Doctor :   The other possibilities include
User :   ok
Doctor :   fungal infections.
User :   is there any risk in biopsy
Doctor :   But they are rare in the absence of immunocompromisation.
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