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CT scan report revealed obulated mass in medial portion of upper lobe. Meaning? Therapy?

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Hi. We need second opinion from the expert. These are the result of the CT scan of my dad in the Philippines. I live here in Alaska. I was wondering what these means, the city image reveals lobulated mass measuring 13x7x5 cm in the medial portion of upper lobe. This mass is contigious to the left sub clavian artery, left main pulmonary artery and the aorta. this is the nodular septal thickening with tree in bud apppearance through out the rest of the upper left lobe including the lingula. Two focal areas of nodulal septal thickening is seen in the right upper lobe. No effusion. The trachea and main bronchi are intact. The heart is normal in size. The aorta is atherosclerotic. A few in large nodeare seen in the aorta pulmonary window and pre tracheal area. Spurs, subcondral sclerosis and disc space narrowing seen in the spine. The soft tissue of the chest wall are intact. Please explain to me all these. Do u think the tumor on the lung that size has a chance to livel longer? How long he will live. Does he have chance to undergo therapy?
Posted Sat, 15 Jun 2013 in Lung Cancer
Answered by Dr. Shashi Dangwal 1 hour later

Thanks for posting you query on XXXXXXX

The CT Scan findings of your father indicate clearly that he has a Mass Lesion in his left lung. This mass lesion now has to be studied to know it`s nature. You have not mentioned whether he suffers from any symptoms especially pertaining to his lungs and if he is or has been a smoker.

Two most common causes of this type of lesion are malignancy and infection. There are some other rarer causes. Tree in bud sign is generally used to describe infection especially tubercular infection but it may also be seen in cases of malignancy or in some congenital conditions or in interstitil lung diseases.

He needs to undergo a biopsy which can be in the form of bronchoscopic biopsy or CT guided FNAC or even an open lung biopsy after a vascular origin of the mass lesion is ruled out.

He should consult a pulmonologist at the earliest who will go into detail history, clinically examine him and will ask for relevant tests.

Only based on these, further course of action can be decided and prediction on prognosis can be made.

Take care.
Above answer was peer-reviewed by
Follow-up: CT scan report revealed obulated mass in medial portion of upper lobe. Meaning? Therapy? 19 minutes later
My dad was a smoker since he was 17 years old. He is 64 years old now. He have a growth or enlargement somewhere close to his throat and neck. His voice is hoarse and he cough now and then, the doctor said he got 3 months left and said it is too late. He havent done any biopsy yet, that what the doctor it really too late? The impression of the doctor is: the left upper lobe mass - contigiuos to the left subclavian artery, left main pulmonary artery and aorta. Nodulal septal thickening with tree in bud appearance, left upper lobe, probably metastasis, two focal areas of nodular setal thickening, right upper lobe. The aorta pulmonary window and pre tracheal adenopathy. Atherosclerotic aorta. Spondylosis. What are these words means? If thats a lung cancer and he undergo therapy how long he will live? What are chances? Considering the size of the size of the 13x7x5 cm.
Answered by Dr. Shashi Dangwal 30 minutes later

In view of the history of smoking and going by the description of the lesion given by you, your dad could be suffering from lung malignancy and it may have metastsized to distant areas. In such cases the disease is said to be of anvanced stage and the prognosis is guarded. As such prognosis in lung cancer cases is poor with survival rate varying from few months to few years depending on type(histopathological type) of malignancy. You may still consult a polmonologist and subject him to biopsy or just opt for palliative therapy to ease his discomfort. This decision you will have to take in consultation with his treating physician, pulmonologist, oncologist and your relatives.

Above answer was peer-reviewed by
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