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CT scan showed nonspecific non calcified nodular pleural plaques in both lung. Cancer?

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Pulmonologist
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ct scan showed nonspecific noncalcified nodular pleural palques in both lungs 8cm on upper left lining small amount of second hand asbestos exposure. Pet scan next week very nervours.

are most cancerous or not have no real systoms except a dry cough but also have allergies.
Posted Wed, 27 Feb 2013 in X-ray, Lab tests and Scans
 
 
Answered by Dr. Gyanshankar Mishra 48 minutes later
Hi,
Thanks for posting the query on XXXXXXX After going through your query, I would like to comment the following:

1. You seem to be suffering from asbestos associated pleural plaques. Most of the times these are benign(non cancerous).

2. PET scan will help in detecting its etiology and spread elsewhere in the body if any.

3. Considering your symptoms of cough and allergies, you also need to get them evaluated. Investigation that may be required is pulmonary function tests. Since HRCT thorax does not show any other lung parenchymal lesion there is no need to worry much.

4. You need to visit a Pulmonologist and get yourself evaluated in detail.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed nonspecific non calcified nodular pleural plaques in both lung. Cancer? 19 minutes later
the doc said it was unusual because the 8cm is on the upper lining of the lung and not the lower if it was cancer would I have some systoms?
 
 
Answered by Dr. Gyanshankar Mishra 6 hours later
Hi,
Thanks for the follow up query. After going through the follow up query, I would like to comment the following:

1. Such large plaques are normally not found, but then the CT did not report any signs of any other disease like malignancy.

2. Mediastinal lymph nodes seem to be normal as no abnormality has been reported in them.

3. PET scan will definitely pick up any other lesion elsewhere in the body.

4. Invasive investigations like bronchoscopy and biopsy may be required after a detailed clinical evaluation. Thoracoscopic biopsy from the pleural nodule or a radiological guided biopsy may be an option .

5. I suppose you never had any significant past history of any major respiratory illness. Also current symptoms need to be there like chest pain due to the chest wall spread if any but such symptoms have not been reported by you hence malignancy not a great possibility but will need investigations to rule it out.

6. Just pleural plaques presenting as malignancy is not very common.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed nonspecific non calcified nodular pleural plaques in both lung. Cancer? 9 hours later
I want to write what the findings was still so nervours. Pet scan tomorrow.
multiple bilateral pleural nased nodular plaques only one has a small area of calcification, largetest area appears to be with the left upper lobe anteriorly and thus contains some calcifacation measurng 5.4 cm by 1.0cm no asbestos exposure know, a multifocal pleural neoplasm can also be considered, no non pleural based pulmonary nodule or mass is idntified, no pleural effusion.

My biggest fear is the size???5.4cm by 1.0cm
 
 
Answered by Dr. Gyanshankar Mishra 30 minutes later
Hi,
Thanks for the follow up info. After going through the follow up info, I would like to comment the following:

1. PET scan will help us know the sites of foci in the body.

2. In your case, I suspect a pleural biopsy from the plaque via a thoracoscopy will be of help. Please discuss this with your pulmonologist. Only a biopsy can confirm or rule out malignancy with 100% reliability.

3. The good part is that your lung parenchyma is very normal. A normal lung parenchyma in a pleural malignancy is not common.

4. Also there is no effusion or lymphadenopathy or bony involvement or pain.

5. PET is not specific for malignancy and also lights up in infections.

6. Even if it turns out to be a malignancy, chemoradiotherapy option is always there.

7. Please do let me know the PET results if possible. Watch out for any spots in the mediastinal region or lung parenchyma.

8. And please do not be nervous. There's always a solution to every problem that may come.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
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