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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Underwent multiple operations and had CAT scan of chest. Is there any metastasis in lungs?

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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6535 Questions

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Posted on Mon, 2 Dec 2013 in X-ray, Lab tests and Scans
Question: i have a new questions…do you want it... Or I see I was allowed to ask a follow up question….the file is in the scans folder and is called novscan2013
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Answered by Dr. Vivek Chail 3 hours later
Brief Answer: Please send in your query Detailed Answer: Hi XXXX, Thanks for getting back to me. Hope you are doing good. I would be glad to answer your question. Please send in your details. Waiting for your query. Regards, Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vivek Chail 19 hours later
I just had a cat scan three days ago. Can you download it from the same ftp place and compare it. It is under the name scans/novcat2013 and is of my chest and they went down to my kidneys caused I asked them too. please compare the size of the tumor in the right kidney. also let me know if there is any metastasis in my lungs or other parts of chest that may be seen. Remember I had multiple operations on my left side. there are bone and flesh changes and staples. Sincerely, XXXX They also gave me a bone scan but that's nuclear medicine…can you read a bone scan…??? XXXX I believe the last reports said 9cm or 8.7cm. If you are having problems with the .iso file then all you have to do is burn the .iso file onto a blank dvr is cd disk and then just put the disk into a pc computer and it will run automatically…not sure how you did it last time. Awaiting…thanks.. XXXXXXX
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Answered by Dr. Vivek Chail 9 hours later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXXXXX Hope you are having a good weekend. I was waiting for the shops to open since morning so that I can get a CD to burn the images before having a look at that. Having seen the images of your scan dated 11/07, I have observed the following: 1. The right kidney tumor shows largest dimensions of 91 x 69 mm. 2. Changes are seen due to the many surgeries in your left lower chest posteriorly and few post treatment changes are seen in the adjacent lung. 3. No lung or bone metastasis seen. 4. Careful observation shows a 8 x 3 mm (really small) node like structure in aorta pulmonary window (an area above the aorta where it originates from the heart) but it is most likely NOT related to your kidney tumor. It might be just another normal node which has no clinical significance. Some radiologists may stay silent and prefer not to report it. 5. The right kidney tumour is confined to the kidney capsule and DOES NOT show any local invasion to structures around the kidney. You can send me bone scan report findings for interpretation. I will also correlate them with CT scan images. Hope I have answered your query. Do write in with an update. Regards, Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vivek Chail 17 hours later
What is the kidney tumor size compared to the October cat scan of the kidney tumor. The pain has stopped and the bleeding has stopped but it seems as if you are saying that it got .3cm bigger….assuming that the last scan report of 8.7 was correct…. XXXX By the way I just won an arm Wrestling Tournament today in my weight class of 173 and then at the end they made the super heavy weight winner at 270 go against me for an overall winner and I beat him after 30 seconds of being in the losing position…i will get it on youtube and send you the link… XXXX So my operation for radical nephrectomy on Nov. 6th is being rescheduled because the bone scan wasn't done case I was late that day and the expiration timed out at 12 noon. The doc still wanted me to come in through the emergency room for the removal but I begged him to reschedule….any thoughts... What do you mean a few changes are seen in the adjacent lung…post treatment…what changes and what treatment are you referring to…by the way, I CALLED up the healthcare magic tech support and they said there was no way to give a bonus as of now. Another site I used in the past had a bonus option…none here… uploading the bone scan now…but I thought that was nuclear med….i need to know if there is some arthritis in my hips…now the pain is gone but for the last 10 years my hips hurt all the time.. Okay, the bone scan is uploaded…. XXXX Thank you so much for this...
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Answered by Dr. Vivek Chail 14 hours later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXXXXX Thanks for writing in with an update. A 0.3 cm difference in measurement is not significant and it can be subjective variation when measuring. It’s good news that bleeding and pain have stopped. Congratulations on winning the arm wrestling competition and I would surely like to watch it on you tube. Concerning the rescheduling, you still have time in your hand before proceeding with surgery because the tumor is confined to the kidney. Chances are thin that it will disappear completely, however a clean surgery is possible at the stage. The adjacent lung changes are with respect to the sarcoma surgery and treatment. It is not something to worry about right now, just that the lung margins are showing changes expected after treatment for the sarcoma. Bonus is not an issue with me so please do not worry for that. As radiologist, we also learn about bone scan but reporting is usually done by nuclear medicine specialist due to newer emerging branches in medicine. Your bone scan shows the surgical removal of left sided ribs posteriorly. Rest of the findings are unremarkable. You might have hip arthritis but it is not significant enough to cause differences in nuclear uptake which can be observed on nuclear bone scan. Hope I have answered your query. Do write in with an update. Regards, Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vivek Chail 14 hours later
WWW.WWWW.WW That was the tournament well some of the matches. There was an overall at the end where the winners from each weight class can try for the overall win. Normally the Superheavy weight wins that…I am 172 right now…….Do you think that the massive amounts of pain killers have caused this tumor to grow and at the same time inhibited my alternative medicines from working …either by suppressing the immune system or something else. I am quite sure that the 40 tylenol with codeine I was taking at 25 yrs old is what caused my renal cell. Now there is proof that tylenol causes it…Yes your answers I am quite grateful for… the .3 difference is larger right…not smaller? don't see how the bleeding stopped. Adderall would cause tons of bleeding the next day…I was playing with Cocaine to be able to wake up and do work and that caused bleeding as well that night or the next day. Although I have ignorantly been messing around with the cocaine again, the bleeding has completely stopped except for an occasional tiny spec of blood clot…tell me how stupid I am in your reply please…pain killers and cocaine…what is wrong with me….
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Answered by Dr. Vivek Chail 17 hours later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXXXXX Your video on YouTube was just amazing. I do agree that massive dose of pain killers can trigger cancerous tumours as seen in medical literature. At the sme time it must also be agreed upon that taking alternative forms of medications can slow tumor growth and this may be considered as my personal opinion. However total cure by such alternative means may not always occur and might take time. Things do get scary when there are alarming signs like Timor bleed and pain, which you have experienced sometime back. This necessitates a comprehensive surgical treatment. Talking about Aderall and cocaine, these drugs can suddenly increase the blood pressure in the body and especially important for you because the kidneys are easily affected by changes in blood pressure. Probably what had happend in you is that after taking these drugs the weak blood vessels in the Timor have started leaking. This subsequently got controlled and your bleeding stopped. Therefore I would not recommend you to do cocaine because of risk of tumour bleed in future. Hope your query is answered. Do write in wit updates. Regards, Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vivek Chail 31 hours later
was just wondering …did you say it grew some or shrunk some…assuming that the picture sliced are identical and the difference is not due to the angle….? Would you have a link by any chance to one of those studies showing massive doses of pain killers triggering cancer cells? I will close this out right after this last question..
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Answered by Dr. Vivek Chail 7 hours later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXXXXX Hope you are doing great and thanks once again or writing back. The kidney is an abdominal organ and small differences in measurement are acceptable. It can be due to the slice selection during imaging. Ths could also be due to many reasons like the slight change in position of the kidney with breathing or the amount of urine in the collecting system of the kidney at the time of scan. It neither shows Timor has grown or shrunk in a month's time. I would also like to say that the second scan images are of very good quality compared to the ones I got to see last month. However, please do not worry over 0.3 cm difference in size. The research showing association of long term intake of pain killers and risk of kidney cancer has been done at Kidney Cancer Center, Dana-Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Please find the link to the article abstract below. WWW.WWWW.WW Hope your query is answered. Wishing you good health. Regards, Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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