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CT Scan Showed 3 X 2mm Nodules In Lung, Arterialised Liver Lesion And A Bulky Uterus. Worrisome

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Posted on Mon, 19 Nov 2012
Question: hi dr, i am a little concerned as my results from a ct scan showed 3 x 2mm nodules in my left lung, arterialised liver lesion and a bulky uterus. I had the scan because of stomach problems i was having they thought it was a gastric hernia, although that was all clear. I have acid reflux, hypothoroid and asthma, vitamin d deficiency. i am 46 and slightly over weight, i dont smoke or drink very often. I had a scan last year which showed a slight fatty liver and my cholestral was slightly raised but i believe that is of now, just had a whole lot of blood tests yesterday too.
doctor
Answered by Dr. Michelle Gibson James (3 hours later)
Hi, thanks for using healthcare magic

I understand the you would be concerned, most persons would be and in some cases may think that it means that they have a cancerous lesion. There are, however, other reason for lung nodules.
The majority (about 60%) are not cancerous and are found in 1 in 100 CT scans of the chest.
Factors that may increase the risk of it being cancerous include:(1) the size of the lesion- the larger sizes are more likely to be XXXXXXX The size you reported would be considered small
(2) history of smoking which you do not have
(3)previous history of cancer increases the chances of it being a malignancy- again this was not mentioned in the history provided
(4)your occupation- some persons who may work with XXXXXXX chemicals have an increased risk of developing cancer.Some of these chemicals include diesel fumes, asbestos, silica, benzene, toulene, second hand smoke, radon
(5)the shape of the lesions-smooth round lesions are more likely to be non cancerous
(6)rapid growth- if the doctor monitors the lesion, if it is thought to be growing rapidly then the likelihood of cancer increases
(7)the presence of calcification or deposits within the lesion.If this was not specifically mentioned in the report then it was not seen

In terms of potential non cancerous causes:
(1) hamartomas, bronchial adenomas- benign lung growths
(2) as a result of infection- some infections can result in nodules in the lung eg tuberculosis, conditions called histoplasmosis, cysts,cryptococcosis
(3)inflammatory conditions such as rheumatoid arthritis, sacoidosis or wegener's granulomatosis,
(4) it could also be a pulmonary infarct (lung tissue with inadequate blood supply), mucoid impaction,

Your doctor may consider biopsy and removal of the area and the treatment would depend on the cause.Tests such as tuberculin skin test (to check for tuberculosis infection), sputum to check for any bacteria, full blood count (check general health), bloods to assess kidney and liver function may also be done, if they have not already been done yesterday.

In terms of the lesion detected in the liver: 70 to 75% of the lesions that are investigated in the liver are benign.The possiblities would be hepatocellular adenoma (benign tumor of the liver) ,a referred lesion, hepatocellular carcinoma (cancer of the liver.
In addition to the blood tests mentioned previously, other tests such as alpha feto-protein which may be elevated in persons with carcinoma, may be suggested.

I hope this answers your question, wish you the best , feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (3 hours later)
Hi Dr Gibson, thank you for that quick responce, which was very detailed. I do have the exact summary from the radiologist which i thought might help with a better insight into what there looking at and maybe you could shed some more light on it for me. 2mm nodule at the right lung base and two further nodules measure 2mm, also seen in the right lung base, although these latter nodules are more intimately related with adjacent vascular strucures. small hypervascular 1.2 cm nodule just lateral to the falciform ligament. multipal tiny liver cysts no other lesions. everything else normal but the cervix is a little bulky and hypervascular. please could you tell me what this all means thankyou. XXXXXXX
doctor
Answered by Dr. Michelle Gibson James (6 hours later)
Hi,

The causes mentioned above regarding the lung nodules would apply to multiple nodules as well, in addition, unfortunately, another possible cause is metastatic disease.
The report mentions liver cysts which are classified as simple (non cancerous), cysts that occur in the liver in persons who have abscess which is a collection of pus.
From the report it seems unlikely to be hepatic abscess or hydatid cysts.Investigations of the cysts involve liver function tests, imaging and in some cases removal of a cysts for analysis in the lab.Treatment varies with the cause but in general there is no medical therapy at present that reduces the size of the simple cysts and in polycystic kidney disease- no treatment is given for the liver cysts.

In terms of the cervix, the causes of a bulky and hypervascular cervix would be cervicitis (inflammation/infection of the cervix), cervical cancer (usually however there would be more significant enlargement)

The blood tests that you had done yesterday will likely shed light on exactly what is going on at present.
If anything remains unclear, feel free to ask additional questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (9 hours later)
Hi thank you for your answer, it gives me things to think about. I think the long and the short of it is, is there any chance that any of this could be cancer. I do have a persistent cough dry with occassional cataar, although it is possible i was told this is connected to my asthma or acid reflux and i have had a lot of aches and pains, particularly in the chest and middle back. Pressure pain in chest going through to back, shoulder blades and side of ribs. I have also had shortness of breath particularly around my abdomen, which sometimes feels like a band is tightning around it, it feels different to the asthma, as this is more on the chest and wheezy. I am being seen by the cardiologist friday, for possible angina. I wouldnt be so worried if i didnt have symptoms. I just need to be mentally prepared for whatever they tell me good or bad.
thanks
doctor
Answered by Dr. Michelle Gibson James (3 hours later)
HI,

Unfortunately, yes the findings on the imaging could possibly be related to cancer but remember in 60% of cases where a nodule is seen in the lung on imaging, it is not cancerous.However this means that in 4 out of 10 people with nodules, it is cancerous.
It is quite possible that you will be in the 60% but this will be determined by further testing by your doctors.
Angina normally presents with symptoms on activity which are relieved by rest, if the disease progresses then the symptoms will occur at rest.The pain is described as heavy or tight pressure sensation in the centerr of the chest.It may be associated with shortness of breath, palpitations, excess sweating.
The persistant dry cough can be associated with asthma and reflux, as you mentioned, in addition,if you have a post nasal drip this may contribute to coughing as well.
Actually untreated post nasal drip is the most common cause for chronic or persistant cough.

I really do hope that everything works out well for you, God bless,
Feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

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CT Scan Showed 3 X 2mm Nodules In Lung, Arterialised Liver Lesion And A Bulky Uterus. Worrisome

Hi, thanks for using healthcare magic

I understand the you would be concerned, most persons would be and in some cases may think that it means that they have a cancerous lesion. There are, however, other reason for lung nodules.
The majority (about 60%) are not cancerous and are found in 1 in 100 CT scans of the chest.
Factors that may increase the risk of it being cancerous include:(1) the size of the lesion- the larger sizes are more likely to be XXXXXXX The size you reported would be considered small
(2) history of smoking which you do not have
(3)previous history of cancer increases the chances of it being a malignancy- again this was not mentioned in the history provided
(4)your occupation- some persons who may work with XXXXXXX chemicals have an increased risk of developing cancer.Some of these chemicals include diesel fumes, asbestos, silica, benzene, toulene, second hand smoke, radon
(5)the shape of the lesions-smooth round lesions are more likely to be non cancerous
(6)rapid growth- if the doctor monitors the lesion, if it is thought to be growing rapidly then the likelihood of cancer increases
(7)the presence of calcification or deposits within the lesion.If this was not specifically mentioned in the report then it was not seen

In terms of potential non cancerous causes:
(1) hamartomas, bronchial adenomas- benign lung growths
(2) as a result of infection- some infections can result in nodules in the lung eg tuberculosis, conditions called histoplasmosis, cysts,cryptococcosis
(3)inflammatory conditions such as rheumatoid arthritis, sacoidosis or wegener's granulomatosis,
(4) it could also be a pulmonary infarct (lung tissue with inadequate blood supply), mucoid impaction,

Your doctor may consider biopsy and removal of the area and the treatment would depend on the cause.Tests such as tuberculin skin test (to check for tuberculosis infection), sputum to check for any bacteria, full blood count (check general health), bloods to assess kidney and liver function may also be done, if they have not already been done yesterday.

In terms of the lesion detected in the liver: 70 to 75% of the lesions that are investigated in the liver are benign.The possiblities would be hepatocellular adenoma (benign tumor of the liver) ,a referred lesion, hepatocellular carcinoma (cancer of the liver.
In addition to the blood tests mentioned previously, other tests such as alpha feto-protein which may be elevated in persons with carcinoma, may be suggested.

I hope this answers your question, wish you the best , feel free to ask any other questions