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What Does My CT Scan Report Indicate?

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Posted on Mon, 9 Mar 2015
Question: A CT scan showed a 17 mm lobular mass within right lower lobe with a few tiny subscentimter satellite nodules? Also stated an 11.4 mm pleural-based nodule with left lung base. Also indicated mildy enlarged lymph nodes within the mediastinum. Another 12 x 17 mm lymph node in aortopulmonary window. Enlarged spleen
Blood tests showed platelet count 72 and low white blood count the DDimer was 414 -do you think they'll want to do biopsy to know if cancer?
doctor
Answered by Dr. S. Samanta (21 minutes later)
Brief Answer:
Yes, you need a biopsy/FNAC but possibly this is not cancer but infective

Detailed Answer:
Dear Mr. XXXX,

After going through your medical history, drug history and the CT findings and considering you age, I could summarize that you have portal hypertension secondary to liver disease; low blood counts related to (most probably) medicine intake or liver problems!

And you went for CT scan due to chest problems; possibly no sputum/BAL fluid/Mantoux test was done but the reports describe more than 3 lesions, largest one being 'a 17 mm lobular mass within right lower lobe...'

No necrotic focus or calcification reported.

Infections due to bacteria, fungus as well as bacteria are relatively common with people with history like yours. neoplastic lesions are generally one big and rest smaller/tiny nodules...! And lymph nodes are generally show their reaction to any kind of insult by enlarging in size.

therefore though I think it is kind of intercurrent infection, some early neoplastic lesion should not be missed,. So yes, I would order for a biopsy/FNAC in such case had you been my patient.

Hope you got the answer; please revert back to me if any more information is known to you or any more information is required by you.

wishing you good health

regards...
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. S. Samanta (26 minutes later)
Thank you for your help & information. Here are a few more comments from the CT scan:
Bilateral pulmonary nodules, one located in the left lung base and a nodule within the right lower lobe with surrounding satellite nodules. These are interminate. Maligancy cannot be excluded

Nonspecific to mildly enlarged lymph nodes within the chest with nonspecific to borderline enlarged lymph nodes in the upper abdomen. These could be reactive but metastitic disease cannot be excluded.

There are variable sized, nonspecific to mildly enlarged lymph nodes in the mediastrium. There is an approximately 12 x 17 mm lymph node in aortopulmonary window. 17 mm lobular mass in right lower pleural-based nodule in left lung base. Largest lymph node in gastrophepatic ligmament was 16 x 12 mm in transerve dimensions.

WBC - 3.2
Hemoglobin -12.3
Hematocrit - 35.5
Platelet - 72
DDimer -414

Thought this additional info would be helpful.
THANKS again
doctor
Answered by Dr. S. Samanta (24 minutes later)
Brief Answer:
A primary right lung tumor should be considered until proved otherwise

Detailed Answer:
Dear Mr. XXXX,

Thanks a lot for the new information that 'Largest lymph node in gastro-hepatic ligament was 16 x 12 mm in transverse dimensions...'! Therefore there are also lymph nodes in the abdomen, in addition to pulmonary/mediastinal ones.

The pleural based nodules are more cancerous, in my experience; but the sizes are usually 2-5 cm in diameter.

Low blood counts could be due to chronic ill-health, metabolic upset, infections or sometimes related to involvement of bone marrow by metastatic tumor.

Therefore a primary tumor in the right lung should be considered until unless otherwise proved by biopsy/FNAC not only for confirmation but also to determine the type, grade, stage and line of treatment!

However, PET-CT Study is another alternative; please consult an oncologist.

Wish you good health!
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. S. Samanta

Pathologist and Microbiologist

Practicing since :2004

Answered : 1107 Questions

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What Does My CT Scan Report Indicate?

Brief Answer: Yes, you need a biopsy/FNAC but possibly this is not cancer but infective Detailed Answer: Dear Mr. XXXX, After going through your medical history, drug history and the CT findings and considering you age, I could summarize that you have portal hypertension secondary to liver disease; low blood counts related to (most probably) medicine intake or liver problems! And you went for CT scan due to chest problems; possibly no sputum/BAL fluid/Mantoux test was done but the reports describe more than 3 lesions, largest one being 'a 17 mm lobular mass within right lower lobe...' No necrotic focus or calcification reported. Infections due to bacteria, fungus as well as bacteria are relatively common with people with history like yours. neoplastic lesions are generally one big and rest smaller/tiny nodules...! And lymph nodes are generally show their reaction to any kind of insult by enlarging in size. therefore though I think it is kind of intercurrent infection, some early neoplastic lesion should not be missed,. So yes, I would order for a biopsy/FNAC in such case had you been my patient. Hope you got the answer; please revert back to me if any more information is known to you or any more information is required by you. wishing you good health regards...