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CT scan images reveal a lobulated mass in medial portion of upper lobe. What does it mean?

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May 2014
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If the Ct scan images reveal a lobulated mass measuring 13x7x5 cm in the medial portion of upper lobe what does thes means?
Posted Fri, 9 Aug 2013 in X-ray, Lab tests and Scans
 
 
Answered by Dr. Vivek Chail 1 hour later
Hi,
Thanks for writing in.

You are a 64 years old gentle man on treatment for diabetes and high blood pressure. There is a history of smoking for over 47 years.

I assume you have got a CT scan chest which shows a lobulated mass in the upper lobe of lung. This means there is some new growth in your lung which is having rounded margins perhaps. The size you have mentioned is 13 x 7 x 5 cms, almost like a pear, slightly larger.

I would be glad if you could send me complete report details for better understanding of your problem.

With this information it is difficult to assess the nature of the mass completely. It can be an inflammatory or infective, which is the most common reason for formation of such masses. Then we have to consider the possibility of tumors. Even in tumors, there are benign ones which are harmless and only grow in size slowly over long periods of time and lastly we have the malignant ones which need early diagnosis and treatment.

To call a mass infective there must be certain characteristics like sudden appearance over days with onset of fever and cough. Rarely there may be weight loss. The appearance of such masses is typical with the presence of fluid within cavities at times.

In benign masses, there is a slow growth over few months to years. Such masses produce symptoms very slowly and only when the size is significantly large. They have regular borders and margins. Some of them show presence of calcification arranged regularly and also elements like fat within.

The malignant ones are the most difficult to treat. These masses are highly irregular and double quickly over 3 to 6 months. Patient also has cough and loss of weight. Sometime fever may also be there. In many there will be lymphnode swellings seen in the armpit and neck regions.

With a mass as you have described, it is essential to do a FNAC or biopsy test under CT scan guidance and make a confirmed diagnosis at the earliest.

Hope your query is answered.
Further queries welcome.

Wishing you good health.
Dr Vivek
Above answer was peer-reviewed by
 
Follow-up: CT scan images reveal a lobulated mass in medial portion of upper lobe. What does it mean? 4 hours later
Hi. Thank you for answering my queries. Im asking these for my dad. We seen sweelings on my dad's neck and he has a hoarse voice. We hear wheezing on his chest. We havent done any biopsy yet. These were the impression: left upper lobe mass contiguous to the left subclavian artery, left main pulmonary and aorta. Nodular septal thickening with tree in bud appearance, left upper lobe, probably metastases. Two focal areas of nodular septal thickening, right upper lobe. Aortopulmonary window and pretracheal adenopathy. Atherosclerotic aorta. Spondylosis. What does these means?
 
 
Answered by Dr. Vivek Chail 28 minutes later
Hi,
Thanks for writing in again.

From your description of CT findings, it is important to get the biopsy done as early as possible. This is one single investigation that will decide the future course and treatment of your dad.

1. Left upper lobe mass contiguous to the left subclavian artery, left main pulmonary and aorta. Nodular septal thickening with tree in bud appearance, left upper lobe, probably metastases. Two focal areas of nodular septal thickening, right upper lobe:

This indicates that these is a mass in the upper part of left lung which is close to certain blood vessels (left subclavian artery, left main pulmonary artery and aorta). There is also mention of smaller lesions in both lungs, apart from the larger mass.

I have dealt with more than thousand patients with features similar to that of your dad and have done as many biopsies. A biopsy is a very safe investigation and can be done as out patient procedure. This is the only way we can rule out a malignancy.

2. Aortopulmonary window and pretracheal adenopathy: this means there are small lymphnodes in chest, this can be a sign of infection or malignancy.

3. Atherosclerotic aorta. Spondylosis: These are age related changes.

Hope your query is answered.
Further queries welcome.

Wishing your father good health.
Dr Vivek
Above answer was peer-reviewed by
 
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