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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does my CT scan test report indicate?

Answered by
Dr.
Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14575 Questions

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Posted on Mon, 6 Jun 2016 in Lung and Chest disorders
Question: Hello- Could you please review my chest ct's that I am attaching. I am forty and in the last 2 years my health has had a drastic change for the worse. I am sure you will see the chronic nature and the huge work-up that we are still trying to piece together. I had a documented case of anti-NMDA receptor encephalitis and now dealing with the sequelae and manage the other issues the work-up has discovered. I am concerned about lymph nodes that have developed in my neck and apparently in my chest. I have used either remicade or humira since 2003 and know the risks. I am now also dealing with severe fatigue and functional anemia which shows ferritin deficiency, zinc protoporphyrins and I have normal serum iron levels. Any advice will help. Thank you, XXXXXXX
doctor
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
No need to worry much for Right hilar lymphnode.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the reports you have attached.
You had three CT thorax with contrast done.
In may 2015, no lymphnode is seen.
In Sept 2015, nonspecific right hilar lymphnode is seen.
In October 2015, that lymphnode is almost similar in size.
So possibility of reactive lymphnode enlargement is more.. Actually 1 month duration is too short to predict any lymphnode disease.
Ideally you should get done chest CT after 6 months to compare the size of lymphnode.
There is no report attached regarding neck lymphnodes.
Please let me know
1. Why you had two consecutive CT thorax in 1 month interval? I mean what was the indication?
2. What were your symptoms in September and October 2015? What are your chest symptoms at present?
3. What about neck lymphnodes? Do you have any reports for this?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Kaushal Bhavsar 32 minutes later

1. Why you had two consecutive CT thorax in 1 month interval? I mean what was the indication?
In september 2015 something was spotted in a chest x-ray showing a new nodular shadow at the medial right base. In october 2015 I was diagnosed with anti-NMDA encephalitis, and don't remember alot from that time frame.

2. What were your symptoms in September and October 2015? What are your chest symptoms at present? Symptoms were severe fatigue, chest wall pain, new onset tachycardia with elevated bp, night sweats, flushing, expiratory wheezing, shortness of breath and then I even developed pericarditis after the second Immunoglobulin G treatment so I was started on steroids. They are always noting left sided mastoid opacification or left mastoid disease, but I've been through 3 full course of antibiotics including Bactrim, Cipro and Xifaxin (for the crohn's/gi flora normalization).

3. What about neck lymphnodes? Do you have any reports for this? Yes, I will attach them. The right side of my neck and face is noticeably puffy and swollen to the point that people make comments. I also have swelling of my hands and feet that pits on my shins.
There are so many things complicating each other, that I really don't what is what anymore. I just am trusting my gut that something is still not back to my baseline. I still have fatigue and profuse sweating with facial flushing. And they have me seeing a hematologist next week for the functional anemia with zinc protoporphyrins seen in my blood work. My Endocrine Dr keeps saying that I have porphyria and it seems accurate, but the lab specialist in XXXXXXX said that my lab numbers would have been significantly more elevated.
I am thinking I may go to the Mayo clinic, because I am better, but not back to baseline and stress or two much physical exertion causes me to be out of breath and super weak and tired. So I am not even well enough yet to go back to work but cannot afford to be off much longer :(

thank yo and i will attach what I have.
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Follow up: Dr. Kaushal Bhavsar 5 minutes later
oh, i forgot..there was a swelling in my right throat that they biopsied and it was benign. Please let me know if you would like any other reports.
doctor
Answered by Dr. Kaushal Bhavsar 16 minutes later
Brief Answer:
Yes, you should definitely consult Mayo clinic.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
You are having multisystem involvement.
There might be some syndrome (undiagnosed).
So better to consult Mayo clinic where many research work is going on.
Yes, I will wait for your neck report.
You have not attached them yet.
So please reply me with attachment.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar 15 minutes later
https://drive.google.com/open?id=00000000

great, thank you very much. I do believe this may all be autoimmune.



https://drive.google.com/open?id=M)0000000000
doctor
Answered by Dr. Kaushal Bhavsar 6 minutes later
Brief Answer:
Sorry to say but, this will not open.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Sorry to say but this file won't be open.
Better to attach in this question only.
I am also thinking towards auto immune etiology more.
Please let me know if you had ANA study or auto immune profile done or not?
I will be happy to help you further. Wish you good health.

Thanks.
Above answer was peer-reviewed by : Dr. Deepak
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