HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Does The Following PET Scan Result Indicate?

default
Posted on Fri, 11 Nov 2016
Question: this is the result of my PET scan. Pulmonologist initially thought I had an old or healing infection. He wanted me to do a PET scan to see if anything lights up. I'm scared now, but Radiologist did not say it was definitely cancer yet, and if you look at my other uploads, you will see that I have indications of infection. Can a PET light up this way due to inflammation and/or infection or is this a strong indicator of lung cancer? If so, does it look like it is confined for now since nothing in my lymph nodes?

PET results:

Impression:
1. An elongated intensely hypermetabolic mass-like lesion is
seen along the superior aspect of the right major fissure
extending into the adjacent right upper lobe and superior segment
of the right lower lobe (SUV XXXXXXX 15.4). Punctate calcifications
are seen within this lesion. This lesion is nonspecific and may
be infectious/inflammatory or neoplastic/malignant. Recommend
correlation with tissue sampling.
2. A 1.7 cm nodular lesion is seen within the anterior basal
segment of the right lower lobe abutting the adjacent pleura.
Hypermetabolic activity is seen just superior to this lesion (SUV
XXXXXXX 4.4) which likely represents misregistered activity
associated with this lesion. This lesion is also nonspecific and
may be infectious, inflammatory, or possibly neoplastic.
3. A cluster of mildly hypermetabolic centrilobular nodules is
seen along the posterior aspect of the superior segment of the
right lower lobe (SUV XXXXXXX 2.2), most suggestive of
infectious/inflammatory disease. A smaller cluster of minimally
hypermetabolic centrilobular nodules is also seen along the
posterior aspect of the left lower lobe (SUV XXXXXXX 1.8), most
suggestive of infectious/inflammatory disease. An 8 mm
non-hypermetabolic nodule is also seen within the right upper
lobe which is nonspecific.
4. No hypermetabolic lymph nodes are seen. No hypermetabolic
lesions are seen outside of the thorax.
XXXXXXX CONFIDENTIAL Page 5 of 15
5. Incidental note is made of a small right adrenal adenoma.
doctor
Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer:
may be infective

Detailed Answer:
Hi
Thanks for followup.

None of the lesions mentioned in PET report are definitive for malignancy (as per the interpretation of PET specialist). So this may not be cancer.

And the presence of punctate calcification in the most avid lesion also points against cancer. But possibility of cancer remains. If it is cancer, though nodes are free, if we consider all the nodules to be resulting from cancer, then it is a bit advanced.

However, at this stage a biopsy is definitely indicated as that would exclude cancer and also give the actual diagnosis.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Indranil Ghosh (29 minutes later)
If advanced, what staging would you put it at? I have been mainly as assymptomatic except for a cough I just recently developed--tickling in throats that my pulmonologist thinks is allergies not related to what I have.
Would they do a. Reflect biopsy and do you recommend a biopsy for both the mass and nodule? Would the radiologist have said cancer or strongly points to it if he assessed it as such? My pulmonologist thought the mass (on CT) was odd and not characteristic of cancer.
If advanced, is it restricted to my right lung? I saw no lymph node involvement.?

doctor
Answered by Dr. Indranil Ghosh (46 minutes later)
Brief Answer:
Yes it is still odd

Detailed Answer:
This report is not clear cut for cancer. I think they would do biopsy of the mass first. Doing from the nodules is bit difficult.

Even if it is cancer it is still restricted to one lung and nodes are negative. But considering both upper and lower lobes involved, it becomes locally advanced. But these are all far-fetched, as we need the diagnosis first.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Indranil Ghosh (30 minutes later)
You think given my age and other factors that there is a chance it could be something infectious? I did test positive on my ANA's, anti-chromatin and SVL-70. I'm still unsure of test results of histo, blasto or cocci.
doctor
Answered by Dr. Indranil Ghosh (7 hours later)
Brief Answer:
Yes it may be infectious in you

Detailed Answer:
Definitely, considering all factors, infection till tops the list in you. Those antibodies you mentioned are not for infections, they suggest autoimmune disorders. They can also cause lung problems.

So again, the biopsy becomes paramount.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Indranil Ghosh (8 hours later)
Would they do a needle biopsy? Would they have to biopsy both the mass and the nodule?
doctor
Answered by Dr. Indranil Ghosh (11 minutes later)
Brief Answer:
I think needle biopsy

Detailed Answer:
The mass can be biopsied but the nodules are probably too small to biopsy.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Indranil Ghosh (47 minutes later)
I think I have a cold right now. Have had a cough for two and a half weeks that comes and goes and now I think it's getting into my lungs. Going to make an appt with my primary physician. Is it safe to take my flu shot or receive antibiotics if needed? Would you also recommend a pneumonia vaccine too?

One other thing--if infection--would this be considered an active infection? Would I have contracted this recently?
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Brief Answer:
yes an active infection

Detailed Answer:
This kind of active infection can be found only in active infection.

Antibiotics are fine but vaccination is usually not recommended while active infection is ongoing.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Indranil Ghosh (48 minutes later)
Dr
Could this be something like histo or blasto or sarcoidosis? Could Sjögren's syndrome cause this? Is this considered a lot of damage to my lungs?
Is my left lung probably not cancer since not indicated? Both lower lobes have tree in bud appearance.

Would I have picked up this infection within the past six months this to a year? Or could this be an older latent one? I apparently had a clear chest X-ray back in April 2014.
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Brief Answer:
May be sjogren or histoplasmosis

Detailed Answer:
yes this can be autoimmune diseases like sjogren as the autoantibodies are positive. Sarcoid bit unlikely as there are no nodes.

if infection it can be histoplasmosis or blastomycosis or tuberculosis. Infection likely to be within last 6 months to 1 year. Left lung is not much affected as per the PET. whatever damage is there can be reversed with treatment.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Indranil Ghosh (1 hour later)
Thank you. My doctor wants me to do another cocci test too--have to go in tomorrow. Does cocci do this too?
doctor
Answered by Dr. Indranil Ghosh (6 hours later)
Brief Answer:
Yes some cocci can do this

Detailed Answer:
But I would recommend a bronchoscopy and/or CT guided biopsy at the earliest.
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

premium_optimized

The User accepted the expert's answer

Share on

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

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Does The Following PET Scan Result Indicate?

Brief Answer: may be infective Detailed Answer: Hi Thanks for followup. None of the lesions mentioned in PET report are definitive for malignancy (as per the interpretation of PET specialist). So this may not be cancer. And the presence of punctate calcification in the most avid lesion also points against cancer. But possibility of cancer remains. If it is cancer, though nodes are free, if we consider all the nodules to be resulting from cancer, then it is a bit advanced. However, at this stage a biopsy is definitely indicated as that would exclude cancer and also give the actual diagnosis. Hope this helps. Regards