Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does This X-ray Report For Pain In Chest Area Indicate?
Question: having pain on right chest for last 1 month and now the pain is on right shoulder and back. consulted a doctor and took xray. it is seen white cloudy on upper right side of the chest. now doctor asked to take ct scan. what will be the disease and what all will be there?
Brief Answer:
It might be an infection, growth or a large cyst
Detailed Answer:
Hi XXXXX,
Thanks for writing in.
I have read through your query in detail.
Please find my observations below.
1. A white cloudy area on chest X ray over right upper zone might represent a consolidation with collapse or a mass. It is important to see the X ray image for accurate interpretation.
2. A consolidation is another name for severe pneumonia and is an infection. This is likely if you are having mild fever with continuous cough and discomfort. If your doctor thinks it is pneumonia then they will give you antibiotics and tell you to get another chest X ray after 10 days.
3. If not pneumonia then possibility of a growth in the lung or any adjacent structure should be considered. This can be confirmed only after doing a CT scan.
4. It is important that you get the CT scan done quickly and the diagnosis confirmed. Whether it is consolidation or a mass, early diagnosis is important to treat it.
5. Less likely it might be a large cyst or loculated fluid collection which will be confirmed on CT scan imaging. You can upload a picture of the X ray for more discussion.
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
It might be an infection, growth or a large cyst
Detailed Answer:
Hi XXXXX,
Thanks for writing in.
I have read through your query in detail.
Please find my observations below.
1. A white cloudy area on chest X ray over right upper zone might represent a consolidation with collapse or a mass. It is important to see the X ray image for accurate interpretation.
2. A consolidation is another name for severe pneumonia and is an infection. This is likely if you are having mild fever with continuous cough and discomfort. If your doctor thinks it is pneumonia then they will give you antibiotics and tell you to get another chest X ray after 10 days.
3. If not pneumonia then possibility of a growth in the lung or any adjacent structure should be considered. This can be confirmed only after doing a CT scan.
4. It is important that you get the CT scan done quickly and the diagnosis confirmed. Whether it is consolidation or a mass, early diagnosis is important to treat it.
5. Less likely it might be a large cyst or loculated fluid collection which will be confirmed on CT scan imaging. You can upload a picture of the X ray for more discussion.
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
Dear Sir,
is there any chance cancer or malignancy?
is there any chance cancer or malignancy?
Brief Answer:
Slight chance of cancer is there and therefore CT scan is important
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Though a white cloudy area over right upper lung can have many possibilities, there is a slight chance for a malignancy. However without CT scan it is difficult to tell. Please get the CT scan done quickly and please write back with the findings.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Slight chance of cancer is there and therefore CT scan is important
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Though a white cloudy area over right upper lung can have many possibilities, there is a slight chance for a malignancy. However without CT scan it is difficult to tell. Please get the CT scan done quickly and please write back with the findings.
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
Dear Sir,
I am talking on behalf of my father. In continuation of above referred discussion i may submit that we had taken the CT scan and as per the report there is a mass almost 7 cms at right apex lung and 2 or 3 lymph nodes seen enlarged. Further on biopsy its reported that it is malignant and its poorly differentiated non small cell carcinoma. On ultra sound scan everything is perfect and normal. Now we had taken a PET Scan also but report not obtained.
Now pain on his right arm also increased a lot.
We are so sad and deeply in trouble.
What to do Sir?
Is a surgery possible followed by treatment?
We are ready to go to any extent of treatment and we are financially and morally sound for that.
The important thing is that my father is a prestigious advocate having 38 years experience on taxation matters and have more than 2000 files present now. Am also an advocate junior to him . Right now we cannot think of him bedded which will affect us very badly in family as well as in profession.
I know its not curative, but frankly we need him at least 3 or 4 years more.
We are ready to see the best doctor or surgeon in this regard.
Kindly advice .
I am talking on behalf of my father. In continuation of above referred discussion i may submit that we had taken the CT scan and as per the report there is a mass almost 7 cms at right apex lung and 2 or 3 lymph nodes seen enlarged. Further on biopsy its reported that it is malignant and its poorly differentiated non small cell carcinoma. On ultra sound scan everything is perfect and normal. Now we had taken a PET Scan also but report not obtained.
Now pain on his right arm also increased a lot.
We are so sad and deeply in trouble.
What to do Sir?
Is a surgery possible followed by treatment?
We are ready to go to any extent of treatment and we are financially and morally sound for that.
The important thing is that my father is a prestigious advocate having 38 years experience on taxation matters and have more than 2000 files present now. Am also an advocate junior to him . Right now we cannot think of him bedded which will affect us very badly in family as well as in profession.
I know its not curative, but frankly we need him at least 3 or 4 years more.
We are ready to see the best doctor or surgeon in this regard.
Kindly advice .
Brief Answer:
Cancer staging with PET scan is most important now
Detailed Answer:
Hi XXXXXX,
Thanks for writing back with an update.
1. The mass in lung is not possible to be treated with surgery, though I have not seen the pictures of CT scan. It is important to obtain the PET scan report immediately. This is because if there is disease spread to any other organ then the survival is difficult for more than 2 years. If it is stage 2 or 3 then there are chances of surviving from 3 to 5 years with treatment.
2. A non small cell lung cancer measuring more than 7 cm is classified as T3. If it is less than 7 cm then it is T2b. Two nodes enlarged on the same side is N1. Guessing that there is no spread to other organs there is no metastasis. Therefore in this situation we have T2bN1M0 or T3N1M0 and the stage is IIb or IIIa. Final staging is after PET scan report.
3. If it is stage IIb and there is no significant infiltration of adjacent structures then surgery possibility has to be discussed with an experienced cancer surgeon right now. In XXXXXXX you might consult doctors at Tata cancer hospital XXXXXXX or doctors at any cancer research institute to know if surgery can be done. Clinical evaluation is important to know operability.
4. If the stage is IIIa or higher then chemotherapy and radiation therapy might be given to extend his survival. This can help to down stage a cancer and then make if possible for surgical intervention based on response to treatment.
5. There is no need to make him bed ridden and stop working. He requires attention to be given with proper nutrition and rest. Let him not be over burdened with files but he can always share his pending work with you. It is difficult but he might develop will power to fight cancer if he is busy with work.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Cancer staging with PET scan is most important now
Detailed Answer:
Hi XXXXXX,
Thanks for writing back with an update.
1. The mass in lung is not possible to be treated with surgery, though I have not seen the pictures of CT scan. It is important to obtain the PET scan report immediately. This is because if there is disease spread to any other organ then the survival is difficult for more than 2 years. If it is stage 2 or 3 then there are chances of surviving from 3 to 5 years with treatment.
2. A non small cell lung cancer measuring more than 7 cm is classified as T3. If it is less than 7 cm then it is T2b. Two nodes enlarged on the same side is N1. Guessing that there is no spread to other organs there is no metastasis. Therefore in this situation we have T2bN1M0 or T3N1M0 and the stage is IIb or IIIa. Final staging is after PET scan report.
3. If it is stage IIb and there is no significant infiltration of adjacent structures then surgery possibility has to be discussed with an experienced cancer surgeon right now. In XXXXXXX you might consult doctors at Tata cancer hospital XXXXXXX or doctors at any cancer research institute to know if surgery can be done. Clinical evaluation is important to know operability.
4. If the stage is IIIa or higher then chemotherapy and radiation therapy might be given to extend his survival. This can help to down stage a cancer and then make if possible for surgical intervention based on response to treatment.
5. There is no need to make him bed ridden and stop working. He requires attention to be given with proper nutrition and rest. Let him not be over burdened with files but he can always share his pending work with you. It is difficult but he might develop will power to fight cancer if he is busy with work.
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
Dear Sir,
We got the PET SCAN report.
The doctor said there are no other metastasis and its not spread to any other areas other than 2 nearby lymph nodes. The doctor said its the STAGE 2B and there are lot of chances for a good recovery and survival if treated now.
1 doctor said chemo-radiation is the best to start and on 2nd opinion it was said that a surgery is possible as there are no spread or other infiltration.
My dad had a angioplasty in 2010 other than that he has no other problems such as pressure, sugar, cholesterol and such other and is well engaged in all activities right now.
So what if undergo a surgery and what all are its benefits and what all if any disadvantages???
Frankly after the surgery followed by any radiation or chemo, what will be usual survival period ?
Kindly give a good suggestion, its advantages, and the cost of surgery.
Am enclosing the PET SCAN report here under:
Impression:
tn a known case of Ca. Lung for staging -
|BF-FDG Whole body PET/CT scan findings are suggestive of:
F Metabolically active primary malignant mass in right lung upper lobe as
described.
Metabolically active regional lymphnode metastasis invoMng right hilar and
lower paratracheal nodes.
Metabolically inactive left lung apical parenchymal nodule - ? Benign/ ??
Metastasis.
} No definite scan evidence of metabolically active liver/adrenal/ skeletal
metastasis.
Thank You Sir...
We got the PET SCAN report.
The doctor said there are no other metastasis and its not spread to any other areas other than 2 nearby lymph nodes. The doctor said its the STAGE 2B and there are lot of chances for a good recovery and survival if treated now.
1 doctor said chemo-radiation is the best to start and on 2nd opinion it was said that a surgery is possible as there are no spread or other infiltration.
My dad had a angioplasty in 2010 other than that he has no other problems such as pressure, sugar, cholesterol and such other and is well engaged in all activities right now.
So what if undergo a surgery and what all are its benefits and what all if any disadvantages???
Frankly after the surgery followed by any radiation or chemo, what will be usual survival period ?
Kindly give a good suggestion, its advantages, and the cost of surgery.
Am enclosing the PET SCAN report here under:
Impression:
tn a known case of Ca. Lung for staging -
|BF-FDG Whole body PET/CT scan findings are suggestive of:
F Metabolically active primary malignant mass in right lung upper lobe as
described.
Metabolically active regional lymphnode metastasis invoMng right hilar and
lower paratracheal nodes.
Metabolically inactive left lung apical parenchymal nodule - ? Benign/ ??
Metastasis.
} No definite scan evidence of metabolically active liver/adrenal/ skeletal
metastasis.
Thank You Sir...
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. Good to know that there is no disease spread and it is in stage 2b. I suggest that you get him treated at a tertiary cancer hospital where there is a team of cancer surgeons who might treat him. I have worked in a cancer institute for some years and have seen many successful cancer treatment cases if the patient receives timely treatment.
2. Cancer treatment is a team management involving surgical team who do surgery, medical oncology team who give chemotherapy and radiation oncology team who give radiation therapy.
3. Since the cancer is still operable, I suggest that surgery be done hoping that things go well. Following surgery he might still require to be treated with chemotherapy and radiation therapy. Some doctors suggest giving chemotherapy and radiation therapy before surgery to reduce the cancer volume and this decision is taken by the operating surgeon based on preferences and disease extension.
4. Cancer is said to be treated of the patient is surviving 5 years after detection of cancer. To be honest with you the 5 year survival of stage IIb non small cell lung cancer is approximately 31 percent from research literature available.
5. The PET scan report shows the cancer in the right lung and lymph nodes in the right hilar and paratracheal lymphnodes. This makes it stage IIb cancer.
6. The cost of surgery will be similar to that of a heart surgery because of the area to be operated and skill required.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. Good to know that there is no disease spread and it is in stage 2b. I suggest that you get him treated at a tertiary cancer hospital where there is a team of cancer surgeons who might treat him. I have worked in a cancer institute for some years and have seen many successful cancer treatment cases if the patient receives timely treatment.
2. Cancer treatment is a team management involving surgical team who do surgery, medical oncology team who give chemotherapy and radiation oncology team who give radiation therapy.
3. Since the cancer is still operable, I suggest that surgery be done hoping that things go well. Following surgery he might still require to be treated with chemotherapy and radiation therapy. Some doctors suggest giving chemotherapy and radiation therapy before surgery to reduce the cancer volume and this decision is taken by the operating surgeon based on preferences and disease extension.
4. Cancer is said to be treated of the patient is surviving 5 years after detection of cancer. To be honest with you the 5 year survival of stage IIb non small cell lung cancer is approximately 31 percent from research literature available.
5. The PET scan report shows the cancer in the right lung and lymph nodes in the right hilar and paratracheal lymphnodes. This makes it stage IIb cancer.
6. The cost of surgery will be similar to that of a heart surgery because of the area to be operated and skill required.
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
Dear Sir,
We had consulted and took opinion from different leading Oncologists & Thoracic Surgeons regarding the mode of treatment and procedure to be followed. All of them have reached same conclusion. They told to opt for chemo-radiation for 6 weeks (30 sittings) and after that 2 weeks rest, then again a PET Scan and after getting the response will opt surgery if the leash gets shrinked or continue with Chemo for another period. So almost a six month treatment will be needed followed by periodical chemo.
Every doctors told that since there is no spread at all from the reports other than 2 lymph nodes, its a very good sign for a curative treatment and there is more than 75% chance for a good recovery and survival at this present stage.
At present my dad does not have any other medical ailments or diseases and is perfectly fit.
So from all this we understood that now its a fit case for a curative treatment and hoping a good result as there are no other metastasis or spread.
So, dear XXXXXXX Si, what is your opinion regarding the explanation above??
an what you think of the curative treatment and survival period according to the situation?
Hope to get a clear picture from You. Its really great to share with you all these and move forward.
Thank You Sir...
We had consulted and took opinion from different leading Oncologists & Thoracic Surgeons regarding the mode of treatment and procedure to be followed. All of them have reached same conclusion. They told to opt for chemo-radiation for 6 weeks (30 sittings) and after that 2 weeks rest, then again a PET Scan and after getting the response will opt surgery if the leash gets shrinked or continue with Chemo for another period. So almost a six month treatment will be needed followed by periodical chemo.
Every doctors told that since there is no spread at all from the reports other than 2 lymph nodes, its a very good sign for a curative treatment and there is more than 75% chance for a good recovery and survival at this present stage.
At present my dad does not have any other medical ailments or diseases and is perfectly fit.
So from all this we understood that now its a fit case for a curative treatment and hoping a good result as there are no other metastasis or spread.
So, dear XXXXXXX Si, what is your opinion regarding the explanation above??
an what you think of the curative treatment and survival period according to the situation?
Hope to get a clear picture from You. Its really great to share with you all these and move forward.
Thank You Sir...
Brief Answer:
Your father has a good chance of survival
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. I hope your father has a good response to treatment for cancer. The chemoradiation and surgery at a later occasion is a recommended treatment. I hope we get the desires results.
2. Regarding survival, I will be happy if every cancer patient survives but sadly this does not happen. The survival in cancer patients depends on many other factors like the response of cancer cells to chemotherapy and radiation, will power of patient, general health of the patient and side effect of chemoradiation.
3. Most patients do not die from the cancer but because the body cannot tolerate the treatment and side effects.
4. The survival of 31 percent as mentioned earlier is for stage IIb as found in patients in cancer studies done abroad. Truly speaking, I find 75 percent curative chances slightly inflated because we really cant predict the treatment course and behaviour of the cancer. Every cancer patient is different in the way the disease spreads or is controlled. I have seen cancer patients every day for years and it is like walking on a tight rope.
5. There are certain factors which support good chances of survival for your father. He is a lawyer by profession and might have a will power to fight cancer. He has the support of you and your family and also access to good doctors and treatment. He is not having any health condition and should be able to tolerate chemotherapy and radiation therapy with minimum discomfort.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Your father has a good chance of survival
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. I hope your father has a good response to treatment for cancer. The chemoradiation and surgery at a later occasion is a recommended treatment. I hope we get the desires results.
2. Regarding survival, I will be happy if every cancer patient survives but sadly this does not happen. The survival in cancer patients depends on many other factors like the response of cancer cells to chemotherapy and radiation, will power of patient, general health of the patient and side effect of chemoradiation.
3. Most patients do not die from the cancer but because the body cannot tolerate the treatment and side effects.
4. The survival of 31 percent as mentioned earlier is for stage IIb as found in patients in cancer studies done abroad. Truly speaking, I find 75 percent curative chances slightly inflated because we really cant predict the treatment course and behaviour of the cancer. Every cancer patient is different in the way the disease spreads or is controlled. I have seen cancer patients every day for years and it is like walking on a tight rope.
5. There are certain factors which support good chances of survival for your father. He is a lawyer by profession and might have a will power to fight cancer. He has the support of you and your family and also access to good doctors and treatment. He is not having any health condition and should be able to tolerate chemotherapy and radiation therapy with minimum discomfort.
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
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
