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What Does My CT Scan Report Indicate?

Posted on Fri, 17 Apr 2015

Question: Had a chest X-ray three weeks ago described as subtle density in upper outer left lobe. Stated if persostant have CT. Had CT one week ago stated 3 cm nodule with hazy unless noted, possibly spiculated. Had PET scan 3 days ago state neg PET other than a 4 cm nodule in upper lobe only. Lit up at different levels some low some alittle higher. Had an apt with a cardi thoracic surgeon in 10 days. Should I have a biopsy asap? Could this still be something freaky like an infection/inflammation. Quit smoking 20 years ago very healthy

Pet report mentioned infiltrate or mass

Answered by Dr. Dr. Rovena (2 hours later)

Brief Answer:
detailed below.

Detailed Answer:
Hello.

Welcome to Healthcare Magic.

I read carefully your query and understand your concern.

When a solitary nodule is found in a chest X-ray ,a complete evaluation is required.The aim is to exclude a possible malign cause for the nodule.
In this case a CT-scan is ordered to evaluate better the characteristics of the nodule (size,consistency,borders,calcification ,localization etc.)
The findings of chest X-ray and CT scan are really helpful to calculate the probability of the nodule to be benign or malign and if further investigations are necessary.

A solitary nodule ,over 3 cm , with irregular, lobulated, or spiculated borders in increases the suspicions for it to be a cancer.
In this case a PET scan to evaluate the metabolic activity of the cells in nodule is ordered.
Malignant cells have a very increased metabolism and the result of PET scan in this case is hypermetabolic (positive).
Benign cells have a normal metabolic activity and the result of PET scan in this case is negative.

In your case a negative result of PET scan is a very good news.In such serious diseases like lung cancer it is necessary to be reassured that the nodule is not malign.
Considering the fact that the nodule is over 3 cm,has irregular borders, you may need further investigations like biopsy to exclude 100 % the probability.
A thoracic surgeon will chose the best approach to this.

Hope this helps.
Let me know if you have any other question or doubt to clarify.I will be happy to help.

Kind regards,
Dr.Rovena Murati

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rovena (12 hours later)

How can u have a negative pet scan but have some lighting up at varying degrees in mass area? Could it be infection, fungal or some other freaky thing since infection and inflammation causes lighting up in areas also. It feels like someone is sticking a knife in my back. But I have always had a chiropractor who thought I had a rib Out in that area for years and years!!! And when he would adjust it I would feel better. My husband also said it has always feel like a bone was sticking out in that area. Could it be an inflamatory tumor? Have an appointment with a cardio thoracic surgeon in 10 days. In Florida with family for strength, can it go from bad to worse in that amount of time. My PCP said no but I feel weird knowing there is something there just sitting there.

Answered by Dr. Dr. Rovena (2 hours later)

Brief Answer:
detailed below.

Detailed Answer:
Hello again.

I am sorry you are going through this and I totally understand your concern.
Try not stress out and have faith.

Yes, it is possible that the nodule with these characteristic is due to an inflammatory process or it is a benign nodule.
The fact that PET scan was negative ,means that the cells of the nodule don't have an increased metabolic rate ,which is very specific for malign cells.
PET scan is very sensitive to evaluate the probability of a node to be malign.
A scar tissue in lungs (due to previous pulmonary infections or due to smoking ) or in areas of inflammation,infections would appear lighted in PET scan.

Now ,since lung cancer is a serious disease ,a consult with a thoracic surgeon is necessary just to be 100 % sure that the nodule is benign.

The stabbing pain in your back is less likely to be related to the nodule.Since you have had it for years it is most likely to be related to spinal problems.

You don't need to worry .Nothing would happen in 10 days.Even if it was a malign mass ,it won't get worse for 10 days.

I wish you all the best and hope everything will be just fine.

Take care,
Dr.Rovena

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rovena (29 minutes later)

I was confused because in one spot the report said negative PET and then in another spot in report said lit up at varying degrees in nodule/mass. Maybe really low light in one node but said it was negative PET

Answered by Dr. Dr. Rovena (2 hours later)

Brief Answer:
detailed below.

Detailed Answer:
Hello again,

Usually a inflamed area everywhere in the body will appear lighted in PET scan because the metabolism of the inflammatory cells is increased.
Even minor injuries can appear at some point lighted.
These areas are lighted in varying degrees compared with a malign nodule that will appear very lighted.

So if the PET scan was negative means that is less likely for the mass to be malign tumor.
Low light in one node may be due to inflammation (infection,scar ).

Take care,
Dr.Rovena

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar