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What Does My CT Scan Test Report Indicate?

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Posted on Tue, 4 Aug 2015
Question: My daughter went in for her annual physical and they found a slightly relegated ANA, so they sent her to a rheumatologist. The rheumatologist had her see a dermatologist and also took an X-ray of her chest. With that they found a shadow in her tracheal area. So the dermatologist looked at her and said her skin and slight butterfly rash was not a lupus rash and she then had a ct scan to see the tracheal area better. The CT scan showed slightly enlarged lymph nodes in the tracheal area. She has had no symptoms of any kind of infection and has been in good health. She had a baby 1 year ago and all went well with that. She does have some aches, but nothing severe. Now they want her to see a polminary doctor . We are all very worried. She cannot get into see a polminary doctor till September? She is only 30 years of age and has been healthy up to this. Can you calm our fears at all?
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
Is she having any symptoms?

Detailed Answer:
Thanks for your question on Health Care Magic.
I have gone through the report you have attached.
I can understand your concern.
Her CT report is suggestive of infective etiology.
Mediastinal lymphnodes are commonly seen in infective etiology. It is also seen in malignancy, but at her age, malignancy is less likely.
So, she should definitely consult pulmonologist and get done
1. Clinical examination of respiratory system
2. Bronchoscopic evaluation and if needed fine needle aspiration cytology (FNAC) from the lymphnodes.
3. ESR and CRP levels to rule out infection.
Please let me know
1. Is she having any symptoms at present, like fever, cough, weight loss etc?
2. Is she having history of tuberculosis in the past?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wishing good health to your daughter.
Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Drkaushal85 (6 hours later)
No, just some achy joints.
doctor
Answered by Dr. Drkaushal85 (7 minutes later)
Brief Answer:
No need to worry much at present.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
Since she is asymptomatic and not having previous history of tuberculosis, no need to worry much for these findings on CT scan.
But do consult pulmonologist in September and get done investigations to rule out any infective etiology.
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your daughter. Thanks.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Drkaushal85 (1 hour later)
Thank You! I've attached a better screen shot of CT scan. I'm afraid some of it was missing. The alarming word is malignancy and the disease mentioned. Can they even know for sure before they do a biopsy? Another thing; if it is an infection shouldn't she get treated before September?
doctor
Answered by Dr. Drkaushal85 (6 hours later)
Brief Answer:
She is not having any alarming symptoms, so no need to worry.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
No need to worry for malignancy because at her age malignancy is extremely unlikely.
Words like infections and inflammation is for tuberculosis and sarcoidosis respectively.
But again she is asymptomatic, not having cough, fever, weight loss, so possibility of these diseases are loss less.
And treatment of tuberculosis is for atleast 6 months. So we need to be double sure before starting anti tb drugs. Same is true with sarcoidosis. Sarcoidosis needs long term steroid treatment. So we can not start steroid with out confirmation.
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your daughter. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15005 Questions

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What Does My CT Scan Test Report Indicate?

Brief Answer: Is she having any symptoms? Detailed Answer: Thanks for your question on Health Care Magic. I have gone through the report you have attached. I can understand your concern. Her CT report is suggestive of infective etiology. Mediastinal lymphnodes are commonly seen in infective etiology. It is also seen in malignancy, but at her age, malignancy is less likely. So, she should definitely consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Bronchoscopic evaluation and if needed fine needle aspiration cytology (FNAC) from the lymphnodes. 3. ESR and CRP levels to rule out infection. Please let me know 1. Is she having any symptoms at present, like fever, cough, weight loss etc? 2. Is she having history of tuberculosis in the past? Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your daughter. Thanks.