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Would a thymic tumor show up on a chest x-ray or any other blood test?

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Posted on Wed, 30 Jul 2014
Question: Hello again Dr,
You answered a question last week about MEN 1, an abnormal thyroid/parathyroid ultrasound. I received another blood test back for cortisol free urine-it measured 51 .Normal level is 4-50. I am really concerned that this may be a thymic tumor, since I have a pth level of 103. My CGA test came back ok, prolactin was 9 a couple of months ago, now it is 5. I had a chest x-ray, but the doctor did not request the thymus to be on that scan. Would a thymic tumor show up on a chest x-ray or any other blood test? Thanks
doctor
Answered by Dr. Binu Parameswaran Pillai (29 minutes later)
Brief Answer:
Hi

Detailed Answer:
Hello,
Good day and welcome back
Please do not worry. I can understand that you are stressed. Stress rises blood cortisol level and that may reflect in urine. Your urine free cortisol is just above normal range. In true cushing's syndrome with excess cortisol, we get urine cortisol levels 2-3 times of upper limit of normal. Please do a second screening test called " midnight salivary cortisol" or a Dexamethasone suppression test. (Just to rule out hyper cortisolism so that you may feel better).

Glad to know that, Chromogranin-A is negative. Xray chest may show widening of mediastinum in case of a thymic tumour, but it is not very specific. CT chest is the best. In your case, I wouldn't recommend that strongly considering the " radiation" exposure and the index of suspicion is low.

If you are worried, you may request your GP to get a genetic screening for MEN-1. A negative result would surely put your mind at ease.

I believe that half the symptoms of our body are created by mind ( including me) itself. Please stay relaxed

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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Would a thymic tumor show up on a chest x-ray or any other blood test?

Brief Answer: Hi Detailed Answer: Hello, Good day and welcome back Please do not worry. I can understand that you are stressed. Stress rises blood cortisol level and that may reflect in urine. Your urine free cortisol is just above normal range. In true cushing's syndrome with excess cortisol, we get urine cortisol levels 2-3 times of upper limit of normal. Please do a second screening test called " midnight salivary cortisol" or a Dexamethasone suppression test. (Just to rule out hyper cortisolism so that you may feel better). Glad to know that, Chromogranin-A is negative. Xray chest may show widening of mediastinum in case of a thymic tumour, but it is not very specific. CT chest is the best. In your case, I wouldn't recommend that strongly considering the " radiation" exposure and the index of suspicion is low. If you are worried, you may request your GP to get a genetic screening for MEN-1. A negative result would surely put your mind at ease. I believe that half the symptoms of our body are created by mind ( including me) itself. Please stay relaxed Regards Binu