• question-icon

    What do my lab test reports indicate?

default
Posted on Tue, 31 May 2016 in General Health
Question: I am certain based on my symptoms I am suffering from an early onset of Pancreatic Cancer.



Questions:



1- I am wondering if I have pancreatic cancer? I am a nervous wreck and need some help. I am afraid that all of my tests have missed the cancer and I am doing these tests too early.

2- I had an Endoscopic Ultrasound done at XXXXXXX Asia Hospital XXXXXXX Is this a reputable place? 12 biopsies taken (Duodenum, Antrum, Jejunum) (See attached Report)

3- Can CT, MRCP, and Endoscopic ultrasound miss Pancreatic Cancer? How good is MRCP and Endoscopic ultrasound?

4- Can small tumours (< 2cm) cause many symptoms?

5- Should I get a PET for confirmation?

6- What does hyperechoic pancreatic duct wall but not dilated mean? Does this suggest pancreatitis or pancreatic cancer? Could you explain this in simple terms?




Had CT- Negative (John's Hopkins) -- See Discharge Report attached.
MRCP- Unremarkable
Endoscopic Ultrasound- Unremarkable (Columbia Asia Hospital Bangalore)

HEP A,B,C- Negative
Total Bilirubin- .82 AST-28 ALT- 40 ALP- 36 CA- 19.9- 9.1 T3- 1.1 T4- 7.88 TSH- 2.6
doctor
Answered by Dr. Indu Kumar 53 minutes later
Brief Answer:
Only findings is gastritis and you may need specific medicines for H.pylori

Detailed Answer:
Hello
Thanks for writing to HCM ,
I've gone through your query as well as all the reports and understand your concern.

Investigations doesn't indicate pancreatic cancer. Combined investigations must had been detected cancer if there is any(even small size may be detected by these combined tests). Combined investigations are very sensitive and it almost can't miss cancer.

Only findings is gastritis and you may need specific medicines for H.pylori infection. I'd suggest you to check with a Gastroenterologist for the therapy for H.Pylori eradication..

Gall bladder polyps is a benign condition and it may only require follow up.

So, please don't worry much.Findings are almost safe.
XXXXXXX Asia Hospital in XXXXXXX is a very reputed hospital and we can trust the findings.

I don't think you need PET scan, it is not indicated in your case.

Pancreatic duct is also normal(dilated pancreatic duct is an abnormal condition and it may indicate pathology).

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Indu Kumar 1 hour later
Hello Dr.-

Based on the imaging test, would pancreatic cancer be found? So, the fact that there is no dilated duct, does that mean no cancer?

Also, wouldn't a PET be conclusive test? Do you know if small tumors can be missed by EUS?



Hello Doctor-

Just following-up on your response.

Best-
doctor
Answered by Dr. Indu Kumar 16 hours later
Brief Answer:
EUS is not expected to miss even small pancreatic mass.

Detailed Answer:
Hello
Thanks for writing to HCM
Sorry for replying late

Dilated main pancreatic duct is usually due to chronic pancreatitis,mass etc.
It is good that pancreatic duct is normal.

EUS is not expected to miss even small pancreatic mass.
EUS is highly sensitive and specific for tumours <1.0 cm,so don't worry at all.

I don't think you will require PET scan.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
default
Follow up: Dr. Indu Kumar 20 minutes later
Thanks Dr.

I really appreciate your help and expertise. Speaking with you is definitely helping me out and I sincerely appreciate your time and effort especially on a Sunday. Your words are encouraging.

I just have a few more questions that I think if you answered could provide me with better relief as I have been provided with conflicting advice from a general surgeon.

1- The EUS report- I have one question about the report and am having trouble understanding what is meant by hyperechoic pancreatic duct wall, but not dilated? I am confused that the duct can be hyperechoic and not dilated? Does this mean it is the pre-malignncy stage of pancreatic cancer? I had a surgeon consultant tell me that this is edema and could be chronic pancreatitis, however, the gasterenterologist that performed the procedure indicated NO lesions and no Dialtion, which equates to no Chronoic Panreatitis?

2- In your years of experience, do you know if a tumor were less than 1 cm, would it cause problems like this? EUS i know is very accurate, however, do you know of how accurate it is for the diagnosis of pancreatic cancer? I know you mentioned CT scans were around 80%.

Thanks so much doctor!











doctor
Answered by Dr. Indu Kumar 15 hours later
Brief Answer:
EUS is highly sensitive,it is almost 100 % sensitive.

Detailed Answer:
Hello
Thanks for writing to HCM
Sorry for replying late

I agree with your gastroenterologist. Findings doesn't indicate chronic pancreatitis.
Edema doesn't cause hyperechoic wall.Hyperechoic wall may be due to fat deposition. It is not a premalignant finding.

EUS is highly sensitive,it is almost 100 % sensitive.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Indu Kumar 3 hours later
Thanks for your reply doctor.

Can a PET help to rule out other cancerous processes?
doctor
Answered by Dr. Indu Kumar 6 hours later
Brief Answer:
PET is helpful in diagnosing and staging many type of cancer.

Detailed Answer:
Hello
Thanks for writing to HCM

PET is helpful in diagnosing and staging many type of cancer.
PET scan alone is not primarily used for diagnosing pancreatic cancer. It is generally combined with CT scan for diagnosis.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Deepak
doctor
default
Follow up: Dr. Indu Kumar 21 hours later
Hello Thanks Doctor!

1- I have attached my MRCP and CT reports. Could you kindly have a look at let me know if there is anything of concern.

2- Have I sufficiently ruled out GI malignancy?

Thanks so much for your expertise and guidance!
doctor
Answered by Dr. Indu Kumar 16 minutes later
Brief Answer:
Findings are benign and it may only require follow up.

Detailed Answer:
Hello
Thanks for writing to HCM

I have gone through all the reports in detail.
Findings are benign and it may only require follow up.
Gall bladder polyp is a benign condition.
Diverticulosis in colon may require follow up.

Findings dont support intestinal malignancy at all. So, don't worry at all.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
default
Follow up: Dr. Indu Kumar 48 hours later
Dr-

Many thanks for all of your assistance and constant reassurance of a lack of malignancy.

My symptoms still persist, however, eus is clean. Could the symptoms not be related? I am unsure how pancreatic cancer manifests itself and perhaps you could educate me on how these symptoms present themselves.

doctor
Answered by Dr. Indu Kumar 1 hour later
Brief Answer:
Pancreatic cancer may present in various ways.

Detailed Answer:
Hello
Thanks for writing to HCM

Pancreatic cancer may present in many ways like pain abdomen,jaundice,weight loss etc.

Unexplained vague pain abdomen may be due to psychological causes.I suggest you to consult psychiatrist once,it may be helpful.I have seen many such cases which are benefited.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6727 Questions

premium_optimized

The User accepted the expert's answer

Share on

Recent questions on  Duodenum

doctor1 MD

Hi, my mother has hiatus hernia of 2 cm length present. Ircumferential ulcer present in the hiatus. She has normal funds , body and Antrum . Normal...

doctor1 MD

my little girl is 3 years old and she has had test done over the last 4 months but the doctor will not give any staight answers so I was hoping you...

doctor1 MD

Hi, Our Son, now 33 years of age was diagnosed with Neurofibromatosis type NF2, when he was 16.Since then has had several spine, and acoustic...

doctor1 MD

Hi, may I answer your health queries right now ? Please type your query here...
Hi, I got an esophagogastrduodenoscopy and the conclusion was Mild...

doctor1 MD

Hi, my father at 51 was diagnosed with cancer in his duodenum from an endoscope he died 3 years later. I'm now 50 and was wondering if I should...

doctor1 MD

I'm curious if starting probiotics can cause stool color to change. my husband started them a week ago and immediately his stool turned a very dark...

doctor1 MD

I have a diarreha condition and the stool is dark purple to black. I have had diverticulitus in the past. I am 73 male I have no pain or fever . I...

Get personalised answers from verified doctor in minutes across 80+ specialties

157 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. Indu Kumar
  • Q - Been sick. Started with fatigue and blurred vision. Have diarrhea and...

  • Q - How to get rid of constipation?

  • Q - Intense pains in legs and have a meniscus injury. Having lower body...

  • Q - Alcoholic and type two diabetic. What does the blood result indicate?

  • Q - Smell in urine. Epididymitis attack with pain at the base of penis....

  • Q - Experiencing pain in lower left abdomen. Painful to push and frequent...

  • Q - Noticed spotting after sex. Is this sign of pregnancy?

  • Q - Seem to be having gallbladder attack. Undergone gall bladder removal....

  • Q - Tightness in the testicles and pain in tip of the penis. Underlying cause?

  • Q - Taking statin. Found a small benign liver cyst in CT scan. Are they...

backtotop2