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Suggest Tests To Diagnose A Mass In Lung

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Posted on Fri, 18 Jul 2014
Question: Hi Doctor,
A blood spot was found about 1 year ago with cough and on scanning found that a mass was found near lungs(in cardio thoracic region).Through a cardio thoracic surgery the same was removed on the assumption by doctor was the same was haematoma since the biopsy result indicates that the mass found was not cancer. Again after some days some blood was found.So a rigid brochoscopy was carried out again and the results indicates that the same was Tubercluosis.On taking up medicines for TB ,tenatively after 6 months some fresh blood came(nearly 1/2 glass or 3/4 glass).On conducting brochoscopy again it was found that a mass was found at the same portion in lungs.On consuting the surgen who conducted initial surgery he told that this is a type of carcinoid and the entire one lung need to be removed and this is the only treatment and also the same is complicated.On conducting ultrasound the results indicates are normal in the abdomen.Kindly advise on how to proceed and which is the best hospital in south XXXXXXX and best doctor where this can be carried out.What about your opinion to consult RCC XXXXXXX or Vellore cmc.Which one is better?
doctor
Answered by Dr. Shailja Puri (7 hours later)
Brief Answer:
Diagnosis of lesion required, can visit any hosp.

Detailed Answer:
Hello,

Thanks for posting your query on HealthcareMagic.

One thing that is definite after investigations is that a mass is present in the lung.
Before instituting any treatment, the site of origin and nature of the mass has to be known.
A biopsy is best investigation to determine the nature of the lesion.
One of the initial biopsy failed to determine the nature of the lesion, as you have mentioned.
I would suggest you to get a biopsy from the mass again.
Aspiration from the lesion is also a good option, however, that has again to be confirmed by biopsy so it is better to go for biopsy since, substantial time has elapsed since the symptoms started.
Once the nature of lesion is known, treatment can be instituted.

As far carcinoid of lung is concerned, treatment comprises of surgical removal of entire lung.

Regarding your query of which hospital to visit, I would suggest that visit the hospital which is near to your place as multiple trips may be required.
Both the hospitals are of repute, you can choose according to your convienence.

If you have more queries, I will be glad to answer.
Dr Shailja P Wahal


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Shailja Puri (2 days later)
Yesterday we visited RCC XXXXXXX and on seeing previous reports they also told that this is not cancer.The doctor who has done the initial surgery told that if the biopsy result again shows that it is not cancer then the procedure for one lung removal will be done along with the surgery for biopsy.How far is the risk involved in this.Is there any other treatment for carcinoid.How can we make sure the same is carcinoid.Also three or four drops of blood came yesterday after long travel.
Attached the reports for your reference.
1_initial ct-Initial ct carried out when blood was found initially
2_latest_ct,3_latest_ct-Latest ct scan reports
1_surgery_for_harmatoma,2_surgery_for_harmatoma-discharge summary after the mass was removed
3_latest_detection,4_latest_detetion-Latest detection of mass
doctor
Answered by Dr. Shailja Puri (27 hours later)
Brief Answer:
Hamartoma is non-neoplastic, no surgery needed.

Detailed Answer:
Hello and welcome again,

After reviewing your history as well as report, I have come to following conclusions:
There was a mass the chest close to the right bronchus.
The mass appeared to be carcinoid radiologically.
The mass was removed surgically.
The histopathological examination revealed that the mass was a Hamartoma and not haematoma as you have mentioned previously.
Hamartoma is a non-neoplastic lesion.
It is not a malignancy or tumor.
Surgical excision is sufficient for its treatment.
Surgical removal of the lung is not required since the mass is non-neoplastic.

Thanks and tale care
Dr Shailja P Wahal
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 9705 Questions

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Suggest Tests To Diagnose A Mass In Lung

Brief Answer: Diagnosis of lesion required, can visit any hosp. Detailed Answer: Hello, Thanks for posting your query on HealthcareMagic. One thing that is definite after investigations is that a mass is present in the lung. Before instituting any treatment, the site of origin and nature of the mass has to be known. A biopsy is best investigation to determine the nature of the lesion. One of the initial biopsy failed to determine the nature of the lesion, as you have mentioned. I would suggest you to get a biopsy from the mass again. Aspiration from the lesion is also a good option, however, that has again to be confirmed by biopsy so it is better to go for biopsy since, substantial time has elapsed since the symptoms started. Once the nature of lesion is known, treatment can be instituted. As far carcinoid of lung is concerned, treatment comprises of surgical removal of entire lung. Regarding your query of which hospital to visit, I would suggest that visit the hospital which is near to your place as multiple trips may be required. Both the hospitals are of repute, you can choose according to your convienence. If you have more queries, I will be glad to answer. Dr Shailja P Wahal