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Could A Nodule With Hazy Appearance On A Chest X-ray Be An Infection Or Inflammation?
Question: yes please. I had an xray on my chest and report read sutle density , if persostant have a CT to determine infiltrate or mass lesion. I am 54 quit smoking 20 years ago and very healthy otherwise. Had a CT scan 2 weeks later, 3 cm nodule with hazy appearance around, spiculated. So 4 days later had a PRT scan it is actually 4 cm not 3 and otherwise pet scan was negative. It did light up a bit at varying degrees. It is in the upper outer left lobe. I have made an appointment with a cardio thoracic surgeon in a week and a half. Could it still be something freaky or an infection/inflammation. Some pain associated with this. That recommended a biopsy, should I try to get one at my appointment, isn't time of the essence. I am an RN
Brief Answer:
Good news with the PET, but need to be more sure
Detailed Answer:
Hello ma'am and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help and promise to be completely honest with you. Honestly speaking ma'am, characteristic findings like the size 3 cm (or possibly more), spiculated appearance, hazy appearance; all raise doubt of malignancy (cancer). But at the same time, a PET scan used in such a situation is considered to be 97 % sensitive in finding/detecting cancer.
As the PET scan did return a negative result, it is indeed good news. But then again, I would be more comfortable if a specialist were called in to review your case and a PET scan be repeated in about a months time, just to confirm ruling out cancer.
A biopsy can be tricky business, as it should only be advised with lots of care. If this is indeed malignancy, then the biopsy (if care is not taken) can itself cause the spread of the cancer cells. Do not push for a biopsy, until a specialist or two recommend it ma'am.
In conclusion, although most of the investigations provide us with good news, I would still prefer being completely sure before ruling out such a serious diagnosis. Please do consult a cardio-thoracic surgeon and an oncologist for a confirmed diagnosis ma'am.
I hope you find my response both helpful and informative, and I wish you all the luck and more you need. I am hopeful of good news, and please do not hesitate to write to me anytime, I am always here to help.
Best wishes.
Good news with the PET, but need to be more sure
Detailed Answer:
Hello ma'am and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help and promise to be completely honest with you. Honestly speaking ma'am, characteristic findings like the size 3 cm (or possibly more), spiculated appearance, hazy appearance; all raise doubt of malignancy (cancer). But at the same time, a PET scan used in such a situation is considered to be 97 % sensitive in finding/detecting cancer.
As the PET scan did return a negative result, it is indeed good news. But then again, I would be more comfortable if a specialist were called in to review your case and a PET scan be repeated in about a months time, just to confirm ruling out cancer.
A biopsy can be tricky business, as it should only be advised with lots of care. If this is indeed malignancy, then the biopsy (if care is not taken) can itself cause the spread of the cancer cells. Do not push for a biopsy, until a specialist or two recommend it ma'am.
In conclusion, although most of the investigations provide us with good news, I would still prefer being completely sure before ruling out such a serious diagnosis. Please do consult a cardio-thoracic surgeon and an oncologist for a confirmed diagnosis ma'am.
I hope you find my response both helpful and informative, and I wish you all the luck and more you need. I am hopeful of good news, and please do not hesitate to write to me anytime, I am always here to help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
But with it lighting up could it be infection/inflammation or anything else but cancer?
Brief Answer:
Yes, but this would be a false-positive result
Detailed Answer:
Hello once again ma'am.
Actually, suspecting or detecting cancer depends on how bright the lit up part. Some times, the PET scan can light up mildly or moderately due to infections, inflammation, healing from previous infections/inflammation; but all these causes are considered to produce a false-positive result.
In cases with false-positive results, only an Oncologist would be able to differentiate and also may request for a repeat PET scan to rule out causes other than cancer. Once a region is suspected to be a tumor or cancer, depending on it location and proximity to the heart, we can opt for a biopsy to confirm/rule out the cause.
In conclusion, yes infections and inflammation can cause a false-positive result. But this would warrant getting a repeat PET scan done in a few days or weeks time.
I hope I have explained things in a manner best understood by you ma'am. Please do not hesitate to write back to me for any further clarifications, I am always here to help.
Best wishes.
Yes, but this would be a false-positive result
Detailed Answer:
Hello once again ma'am.
Actually, suspecting or detecting cancer depends on how bright the lit up part. Some times, the PET scan can light up mildly or moderately due to infections, inflammation, healing from previous infections/inflammation; but all these causes are considered to produce a false-positive result.
In cases with false-positive results, only an Oncologist would be able to differentiate and also may request for a repeat PET scan to rule out causes other than cancer. Once a region is suspected to be a tumor or cancer, depending on it location and proximity to the heart, we can opt for a biopsy to confirm/rule out the cause.
In conclusion, yes infections and inflammation can cause a false-positive result. But this would warrant getting a repeat PET scan done in a few days or weeks time.
I hope I have explained things in a manner best understood by you ma'am. Please do not hesitate to write back to me for any further clarifications, I am always here to help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You have explained things in a good manner. I just didn't know if it did light up in area at varying degrees would that be more suggestive of a certain diagnosis. since this is the only place it is is it treatable with surgery? If it is cancer. Also it is painful it feels like a knife is in my back right in the area, particularly when I breath. But I have had pain there for years, like I said my chiropractor thought there was a rib out. But if I strech or move in a certain positionir doesn't hurt at all or much. What are you thoughts? I also have TMJ and a partial frozen shoulder on that side from old injury.
I guess lighting up in varying degrees what is that indicative of?
Also I am in Florida to be with family for a week before my appointment with doctor, for strength. Can things go from bad to worse in that amount of time what about fungal infections how would they show up?
Oh and in your first response u said negative pet is good news. But I did have varying degrees of lighting up just in nodule/mass area. So when they said negative pet do they mean everywhere else in my body?
I guess lighting up in varying degrees what is that indicative of?
Also I am in Florida to be with family for a week before my appointment with doctor, for strength. Can things go from bad to worse in that amount of time what about fungal infections how would they show up?
Oh and in your first response u said negative pet is good news. But I did have varying degrees of lighting up just in nodule/mass area. So when they said negative pet do they mean everywhere else in my body?
Brief Answer:
All queries addressed ma'am
Detailed Answer:
Hello once again ma'am.
The lighting up in varying degrees is not all at once ma'am. If it light up only mildly, it is less likely to be cancer. And if it was very bright, it is more likely to be cancer, I meant it in this way.
Yes, if it is in one place, hopefully it has not spread (if at all it is indeed cancer), and this would mean it is in the early stages and would be much easier to treat.
This is a very vague description and I would either suspect a simply abnormality with the lungs, costochondritis, or a musculo-tendon issue.
As mentioned above ma'am, varying degrees of lighting up could be indicative of abnormalities like healing, infections, etc.
It is unlikely that things would get really bad in a week. Fungal infections in the lung tissue will light up only mild-moderately, but this will also be considered a false-positive.
Yes, a negative PET scan is indeed good news. The varying degrees of lighting up could have been from a previous infection, inflammation, etc; and will not be suspected for cancer in a PET scan. When they say negative PET scan, it should be an absence of cancer in all the parts of the body that were scanned, which is the entire body, yes.
Best wishes. :)
All queries addressed ma'am
Detailed Answer:
Hello once again ma'am.
The lighting up in varying degrees is not all at once ma'am. If it light up only mildly, it is less likely to be cancer. And if it was very bright, it is more likely to be cancer, I meant it in this way.
Yes, if it is in one place, hopefully it has not spread (if at all it is indeed cancer), and this would mean it is in the early stages and would be much easier to treat.
This is a very vague description and I would either suspect a simply abnormality with the lungs, costochondritis, or a musculo-tendon issue.
As mentioned above ma'am, varying degrees of lighting up could be indicative of abnormalities like healing, infections, etc.
It is unlikely that things would get really bad in a week. Fungal infections in the lung tissue will light up only mild-moderately, but this will also be considered a false-positive.
Yes, a negative PET scan is indeed good news. The varying degrees of lighting up could have been from a previous infection, inflammation, etc; and will not be suspected for cancer in a PET scan. When they say negative PET scan, it should be an absence of cancer in all the parts of the body that were scanned, which is the entire body, yes.
Best wishes. :)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry one more question. Can u have a negative pet scan but also have some lighting up in one area also? Does negative refer to entire scan?
Brief Answer:
Yes it can; and yes :)
Detailed Answer:
Hello once again.
Yes, you can have a negative PET scan although a particular area has lit up in the scan. This just means that the area that lit up did not light up enough to produce a positive result.
And yes, it does refer to the entire scan. :)
I hope this clarifies your doubts. But please do not ever hesitate to write to me about anything, you need not worry about how many questions you ask me. I am here to help, and am always willing to help clear your doubts.
Best wishes.
Yes it can; and yes :)
Detailed Answer:
Hello once again.
Yes, you can have a negative PET scan although a particular area has lit up in the scan. This just means that the area that lit up did not light up enough to produce a positive result.
And yes, it does refer to the entire scan. :)
I hope this clarifies your doubts. But please do not ever hesitate to write to me about anything, you need not worry about how many questions you ask me. I am here to help, and am always willing to help clear your doubts.
Best wishes.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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