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What Does My CT Scan Report Indicate?
Question: Hello,
Experiencing discomfort and pain in upper chest and between shoulder blades when eating. Seems to be intermittent, but PPIs don't seem to be helping. Two questions:
1.) I had a thorax CT without contrast for follow up on two lung nodules that came up stable nodules and nothing remarkable about scans. Compared to CTs done 3 years ago. Chances esophageal cancer would be detected on CT?
2.) Could not chewing properly cause pain when swallowing? I have been on PPIs for two months and seems to not be helping. Could large food bolus cause this pain?
Experiencing discomfort and pain in upper chest and between shoulder blades when eating. Seems to be intermittent, but PPIs don't seem to be helping. Two questions:
1.) I had a thorax CT without contrast for follow up on two lung nodules that came up stable nodules and nothing remarkable about scans. Compared to CTs done 3 years ago. Chances esophageal cancer would be detected on CT?
2.) Could not chewing properly cause pain when swallowing? I have been on PPIs for two months and seems to not be helping. Could large food bolus cause this pain?
Brief Answer:
Endoscopy with biopsy.
Detailed Answer:
Hello,
Thanks for asking on HealthcareMagic.
I have gone very carefully through your query
Answers are-
1)CT is not a gold standard test to diagnose esophageal cancer.However it is usually used to diagnose the extent of metastasis,Lymph node involvement etc in a diagnosed case of esophageal carcinoma.As your question is specifically about esophageal cancer i would suggest you to go for endoscopic biopsy.Its gol d standard test to diagnose esophageal carcinoma.
Once daignosed CT can be done to see if lymph nodes are involved or not and to look for extent of metastasis.
2)No not in a normal person.Our esophagus is lined by mucosal layer which is usually not irritated by swallowing large bolus or spicy food.This sign is highly specific for XXXXXXX esophagus or achalasia cardia.
Tests suggested are-
High-resolution esophageal manometry. Using a catheter inserted down your esophagus, muscle contractions in your esophagus are measured when you swallow water.
Endoscopy- To visualise esophagus and stomach.
Hope i was helpful.
Regards!
Endoscopy with biopsy.
Detailed Answer:
Hello,
Thanks for asking on HealthcareMagic.
I have gone very carefully through your query
Answers are-
1)CT is not a gold standard test to diagnose esophageal cancer.However it is usually used to diagnose the extent of metastasis,Lymph node involvement etc in a diagnosed case of esophageal carcinoma.As your question is specifically about esophageal cancer i would suggest you to go for endoscopic biopsy.Its gol d standard test to diagnose esophageal carcinoma.
Once daignosed CT can be done to see if lymph nodes are involved or not and to look for extent of metastasis.
2)No not in a normal person.Our esophagus is lined by mucosal layer which is usually not irritated by swallowing large bolus or spicy food.This sign is highly specific for XXXXXXX esophagus or achalasia cardia.
Tests suggested are-
High-resolution esophageal manometry. Using a catheter inserted down your esophagus, muscle contractions in your esophagus are measured when you swallow water.
Endoscopy- To visualise esophagus and stomach.
Hope i was helpful.
Regards!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you for the answer. I understand CT is not gold standard, but does a clean CT with no esophageal abnormalities clinically significant at all? If no cancer is found on CT does that mean anything in terms of potential staging of the cancer if it is indeed present?
Brief Answer:
follow up.
Detailed Answer:
Hello dear,
Cancer starts usually as Metaplasia which means that one type of cell(normal) get converted to other type of cell.This change in nature of cells is termed as Metaplasia.This Metaplasia if not diagnosed and treated properly converts into Adenocarcinoma of esophagus in about 30% of cases.
Now problem with CT scan is that it can’t rule out metaplasia(change of one type of cell into other type).It can only rule out possibilities of a full fledged carcinoma.
For that biopsy is to be done.
Hope i was helpful.
Thanks!
follow up.
Detailed Answer:
Hello dear,
Cancer starts usually as Metaplasia which means that one type of cell(normal) get converted to other type of cell.This change in nature of cells is termed as Metaplasia.This Metaplasia if not diagnosed and treated properly converts into Adenocarcinoma of esophagus in about 30% of cases.
Now problem with CT scan is that it can’t rule out metaplasia(change of one type of cell into other type).It can only rule out possibilities of a full fledged carcinoma.
For that biopsy is to be done.
Hope i was helpful.
Thanks!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you again. So if I understand correctly a full blown carcinoma would likely show on CT but an endoscopy can tell if there are pre cancerous cells. So with a clean CT I likely do not have carcinoma but metaplasia will need to be detected for adequate monitoring. is that correct?
Brief Answer:
Yes you got it right.
Detailed Answer:
Yes my dear patient i want to explain that only.
Thanks!
Yes you got it right.
Detailed Answer:
Yes my dear patient i want to explain that only.
Thanks!
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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