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Pain in chest, shoulder blade and arm. CT scan showed positive D-dimer, enlarged lymph nodes. Is it cancer or infection?

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General & Family Physician
Practicing since : 2008
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I HAVE BEEN HAVING CHEST PAIN AND SHOULDER BLADE AND ARM PAIN FOR ABOUT A MONTH NOW. RECENTLY HAD 2 SURGICAL PROCEDURES SO DR WANTED TO CHECK FOR BLOOD CLOT. D-DIMER WAS POSITIVE BUT WHEN CT SCAN WAS DONE, NO CLOT WAS FOUND BUT THEY SAID I HAD A RIGHT HILAR MASS AND ENLARGED LYMPH NODES. ALSO NOTED THAT THE LINING OF MY ESOPHAGUS WAS THICKENED. WAS TOLD IT COULD BE CANCER OR AND INFECTION. WHICH SEEMS MORE LIKELY?
Posted Sun, 6 May 2012 in Lung Cancer
 
 
Answered by Dr. Raju A.T 19 hours later
Hi,

Thanks for the query.

Please find the response by Dr XXXXXXX XXXXXXX to your query.

Hi,

I would like to know some more information before commenting on your problem , like :

1) Did you loose weight recently ?
2) Please comment on your appetite.
3) Do you have fever, cough, breathlessness , blood in sputum or any symptoms other than mentioned above ?

It would be very helpful if you can upload images of the scan or mail the images to YYYY@YYYY .

I shall after going through your answers for my above questions provide clear opinion of mine.

Anticipating your response,

Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Pain in chest, shoulder blade and arm. CT scan showed positive D-dimer, enlarged lymph nodes. Is it cancer or infection? 42 hours later
Hello,

I have lost about 20 pounds and shed the weight rather quickly but it seems to have stabilized again. At the time I had cut back on what I was eating due to the gallbladder problems. My appetite has been very good lately. I have times where I feel full right away after a couple of bites or other times I could eat as much as a horse.

I have not had a fever, cough, or blood in sputum. I have not experienced shortness of breath really but at times I feel like there is pressure on my chest and I need to take a XXXXXXX breath. I do that repeatedly throughout the day. My primary problem has been the pain that comes and goes and just the malaise that I feel. Only other thing perhaps worth mentioning was that my labwork showed a vitamin D deficiency. I do not have a copy of the image at hand right now but I will request one when I go back to the doctor today.
 
 
Answered by Dr. Raju A.T 6 hours later
Hi,

Thanks for the query.

Please find the response by Dr XXXXXXX XXXXXXX to your query.

Hi again,

Thanks for writing back.

With the info provided I would consider based on clinical grounds you may not have cancer , but most of times specially in lung cancers clinical symptoms have a wide lag.

I suggest you to go for better diagnostic tools like HR CT / MRI chest with contrast which will give better information and understanding about the mass you have .In addition to this a bronchial washings microscopy ( bonchial airways are washed with saline which is recollected back centrifuged and studies under microscope ) will be more helpful here.

Wish you good health .

regards,

Dr XXXXXXX XXXXXXX
Pulmonologist.
Above answer was peer-reviewed by
 
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