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What Does This CT Scan Of Lungs Indicate?
Question: Hello. Please help me understand the CT scan results.
Indication: neuro-endocrine carcinoma. 63 M with a newly diagnosed high grade stage IV neuro endocrine tumor
Results:
Lungs and pleura: the trachea appears patent and devoid of endobronchial lesion. There is an approx 30x29 mm mass which occluded the origin of the posterior segmental bronchus of the right upper lobe. Post obstructive atelectasis/pneumonia is noted distal to the mass in the upper right lobe. Multiple calcified granulomata are present in both lungs. There is no pleural effusion or pneumothorax.
Neck base: there is heterogeneous attenuation of the right thyroid lobe, most commonly secondary to a goiter.
Thoracic lymph nodes: there is right paratracheal and suspected right hilar lymphadenopathy. There are a few calcified mediastinal and bilateral hilar lymph nodes, consistent with remote granulomatous disease.
Bones and soft tissue: there are degenerative changes in he thoracic spine. No lytic or destructive osseous lesion is seen. There is fatty replacement of the para spinous musculature, left worse than right
Upper abdomen: visualized portions of the upper abdomen disclose multiple hetergeneously attenuating soft tissue masses scattered throughout the liver, suggestive of metastic neoplastic process. There is a 10mm indeterminate nodule in the left retroperitoneum, possibly originating from the adrenal gland.
Indication: neuro-endocrine carcinoma. 63 M with a newly diagnosed high grade stage IV neuro endocrine tumor
Results:
Lungs and pleura: the trachea appears patent and devoid of endobronchial lesion. There is an approx 30x29 mm mass which occluded the origin of the posterior segmental bronchus of the right upper lobe. Post obstructive atelectasis/pneumonia is noted distal to the mass in the upper right lobe. Multiple calcified granulomata are present in both lungs. There is no pleural effusion or pneumothorax.
Neck base: there is heterogeneous attenuation of the right thyroid lobe, most commonly secondary to a goiter.
Thoracic lymph nodes: there is right paratracheal and suspected right hilar lymphadenopathy. There are a few calcified mediastinal and bilateral hilar lymph nodes, consistent with remote granulomatous disease.
Bones and soft tissue: there are degenerative changes in he thoracic spine. No lytic or destructive osseous lesion is seen. There is fatty replacement of the para spinous musculature, left worse than right
Upper abdomen: visualized portions of the upper abdomen disclose multiple hetergeneously attenuating soft tissue masses scattered throughout the liver, suggestive of metastic neoplastic process. There is a 10mm indeterminate nodule in the left retroperitoneum, possibly originating from the adrenal gland.
Brief Answer:
Tumor noted in right lung upper lobe with spread to liver and left adrenal
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Lungs
There is a 30 x 29 mm tumor which is blocking the airway to right lung upper lobe posterior segment. Since the airway is obstructed, therefore there is pneumonia or collapse beyond the tumor.
Both the lungs show multiple small calcifications from old infection.
2. Neck base
The right lobe of thyroid shows mixed density that is most probably due to goitre.
3. Thoracic lymphnodes
Small lymphnodes are present along the right side of trachea and also at the point where the place where the lung is attached to the trachea (hilum). This might be because of the tumor.
Other calcified lymphnodes are also there and these are probably due to an old infection.
4. The bones are showing age related degenerative changes. The muscles along the spine are also having a higher fat content. This is not a suignificant finding.
5. The liver shows multiple round areas which are probably due to spread of tumor in lung to the liver. There is also a 10 mm nodule in the area of left adrenal gland, suggests a disease spread.
In conclusion, there is a tumor in the right lung upper lobe posterior segment airway. The tumor is also causing small lymphnode enlargement along right side of trachea and where the right lung is attached to the trachea.
The findings suggest disease spread to the liver and left adrenal gland.
Neuroendocrine tumor is an aggressive cancer and present scan should be compared with earlier scan to know the response to treatment.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Tumor noted in right lung upper lobe with spread to liver and left adrenal
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Lungs
There is a 30 x 29 mm tumor which is blocking the airway to right lung upper lobe posterior segment. Since the airway is obstructed, therefore there is pneumonia or collapse beyond the tumor.
Both the lungs show multiple small calcifications from old infection.
2. Neck base
The right lobe of thyroid shows mixed density that is most probably due to goitre.
3. Thoracic lymphnodes
Small lymphnodes are present along the right side of trachea and also at the point where the place where the lung is attached to the trachea (hilum). This might be because of the tumor.
Other calcified lymphnodes are also there and these are probably due to an old infection.
4. The bones are showing age related degenerative changes. The muscles along the spine are also having a higher fat content. This is not a suignificant finding.
5. The liver shows multiple round areas which are probably due to spread of tumor in lung to the liver. There is also a 10 mm nodule in the area of left adrenal gland, suggests a disease spread.
In conclusion, there is a tumor in the right lung upper lobe posterior segment airway. The tumor is also causing small lymphnode enlargement along right side of trachea and where the right lung is attached to the trachea.
The findings suggest disease spread to the liver and left adrenal gland.
Neuroendocrine tumor is an aggressive cancer and present scan should be compared with earlier scan to know the response to treatment.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Begin second round chemo next week and another CT scan scheduled in two XXXXXXX a half weeks from now.
So, we were told its aggressive and trying to fight it.
Q1... So, has it spread to lymph nodes?
Q2...has it spread close to the spine where it will go to brain?
Q3...in neck, would the goiter be cancer?
Q4...let's say chemo is working, how fast do you believe cancer could come back?
Q5...do you believe life expectancy is one year?
Also, bones are weakening due to age or cancer?
So, we were told its aggressive and trying to fight it.
Q1... So, has it spread to lymph nodes?
Q2...has it spread close to the spine where it will go to brain?
Q3...in neck, would the goiter be cancer?
Q4...let's say chemo is working, how fast do you believe cancer could come back?
Q5...do you believe life expectancy is one year?
Also, bones are weakening due to age or cancer?
Brief Answer:
There is stage 4 cancer and chemotherapy might control disease progression
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. It is confirmed that disease has spread to right paratracheal and right hilar lymphnodes.
2. The spread brain is not always related to involvement of spine. In this case, the cancer is not close to the spine but the spread to brain cannot be predicted. It might spread through the blood circulation.
3. The neck is unlikely to be cancer as described in the report.
4. Such cancer has 50 percent recurrence after treatment in those who are in early stages. In this case, there is stage 4 cancer and it is not possible to reach the cancer free stage. I mean to say that the cancer has spread to the lymphnodes, liver and left adrenal and primary tumor is there in the right lung upper lobe. Therefore the cancer is likely to persist and the disease progress can be controlled by chemotherapy.
5. Life expectancy might be approximately 1 to 2 years and few might get lucky to survive longer. It depends on disease progress, disease stabilization, disease control rate and general health condition of the patient after chemotherapy. A research conducted on stage 4 neuroendocrine cancer lung patients at Memorial XXXXXXX Kettering Cancer Center, New York, NY showed a median survival of 11.6 months from the time of detection.
6. Bones are showing aging changes.
7. The second CT scan findings are important to know the disease control rate.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
There is stage 4 cancer and chemotherapy might control disease progression
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. It is confirmed that disease has spread to right paratracheal and right hilar lymphnodes.
2. The spread brain is not always related to involvement of spine. In this case, the cancer is not close to the spine but the spread to brain cannot be predicted. It might spread through the blood circulation.
3. The neck is unlikely to be cancer as described in the report.
4. Such cancer has 50 percent recurrence after treatment in those who are in early stages. In this case, there is stage 4 cancer and it is not possible to reach the cancer free stage. I mean to say that the cancer has spread to the lymphnodes, liver and left adrenal and primary tumor is there in the right lung upper lobe. Therefore the cancer is likely to persist and the disease progress can be controlled by chemotherapy.
5. Life expectancy might be approximately 1 to 2 years and few might get lucky to survive longer. It depends on disease progress, disease stabilization, disease control rate and general health condition of the patient after chemotherapy. A research conducted on stage 4 neuroendocrine cancer lung patients at Memorial XXXXXXX Kettering Cancer Center, New York, NY showed a median survival of 11.6 months from the time of detection.
6. Bones are showing aging changes.
7. The second CT scan findings are important to know the disease control rate.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Do you know first hand of any other treatments, conventional or non conventional, that has prolonged life to more than a year? We are trying cannabis oil.
Also, can you recommend the top people to go to for treatment? We are at XXXXXXX Clinic currently, and know they are ranked high, but I cannot find a top doctor to go to.
Also, can you recommend the top people to go to for treatment? We are at XXXXXXX Clinic currently, and know they are ranked high, but I cannot find a top doctor to go to.
Brief Answer:
Neuroendocrine cancer in advanced stage is treated with chemotherapy
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. This tumor is among the rare ones and the patient has an advanced stage of disease. Treatment at this stage involves chemotherapy with platinum based drugs and hormones in few. Patients having a strong will power usually live longer. Providing nutritional support and patient care might extend survival beyond a year.
2. The liver lesions are multiple and scattered through out making it difficult to provide a treatment that might be focused on reducing the liver metastasis.
3. Cannabis oil has not been a conventional method of treating cancer but when there are limited options, you might consider using it keeping in mind the rare possibility of it working.
4. XXXXXXX clinic has one of the best facilities in cancer treatment. However, should you look for other choices then MD XXXXXXX TX and Memorial XXXXXXX Kettering Cancer Center, NY treat agood number of cancer patients. These places might have a better experience at treating neuroendocrine tumors of lung.
5. As requested by you, please find a listing of doctors specialized in treatment of neuroendocrine tumors in the link below
http://www.carcinoid.org/patient/treatment/find-a-doctor
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Neuroendocrine cancer in advanced stage is treated with chemotherapy
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. This tumor is among the rare ones and the patient has an advanced stage of disease. Treatment at this stage involves chemotherapy with platinum based drugs and hormones in few. Patients having a strong will power usually live longer. Providing nutritional support and patient care might extend survival beyond a year.
2. The liver lesions are multiple and scattered through out making it difficult to provide a treatment that might be focused on reducing the liver metastasis.
3. Cannabis oil has not been a conventional method of treating cancer but when there are limited options, you might consider using it keeping in mind the rare possibility of it working.
4. XXXXXXX clinic has one of the best facilities in cancer treatment. However, should you look for other choices then MD XXXXXXX TX and Memorial XXXXXXX Kettering Cancer Center, NY treat agood number of cancer patients. These places might have a better experience at treating neuroendocrine tumors of lung.
5. As requested by you, please find a listing of doctors specialized in treatment of neuroendocrine tumors in the link below
http://www.carcinoid.org/patient/treatment/find-a-doctor
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Shanthi.E
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