CT and Lung Nodules
Comments
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Has a pulmonologist or interventional radiologist looked at your CT yet? Someone with that expertise would be able to decide the best way to biopsy the nodule. Hopefully your oncologist will consult with or refer your case to a doctor who does lung biopsies frequently.
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Marge, I had to look up lung anatomy on google. Both my nodes are in the apex, left & right. Which is at the very top of the lung. I see a thoracic surgeon for my treatment. Size of mine is 5 mm R & 6 mm L. The concern is the 6 mm is irregular shaped. Hoping yours is in a spot to biopsy if necessary.
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I haven’t seen a pulmonologist. My oncologist said he will order the biopsy. Still haven’t heard about it yet. Tomorrow will be a week since I seen the oncologist. As far as size can imaging be wrong I have been told it’s any where from 1.8 to 1.1 but going down so could it still be 1.8 and the imaging isn’t correct? Thanks you guys for hearing my questions.
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Hi Marge, Currently my lung CTs are read by a specialist pulmonary radiologist (in a large teaching hospital) and seem accurate to within a few millimeters. During office visits my pulmonologist pulls up the CT on a screen with a little ruler which he uses to check the measurements in the report. At my small local hospital with older equipment and a general radiologist doing the reading imaging measurements have been off, sometimes by quite a bit when compared to the large hospital imaging and post surgical pathology. It's probably pretty accurate to say the size is decreasing if it went from 1.8 to 1.1 cm on the same machine but there could be some error in the measurement. 1 cm seems to be the size for ordering a biopsy unless there is good evidence that it is probably benign or the risk of complications is high.
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Good info to know!! They were in different machines so maybe that had something to do with it!! Still waiting for them to call and get it scheduled the biospy tomorrow will be a week since I seen my dr and he order it stat. So frustrating!!
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We hope you hear soon about scheduling, @margecandoit, we know how frustrated you must feel!
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It is scheduled for next week. They called today!! They said they would sedate me and didn’t say there would a problem with it. The dr performing it looked at it already. I guess I will find out.
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Good news, Marge. They most likely would have let you know if it looked problematical. I hope the nodule is benign.
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@margecandoit Great news glad your on the schedule! Fingers crossed for benign.
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Marge, I too am hoping it is benign. HUGS
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Thanks guys!! Tomorrows the day! A little nervous!!
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Just got the update to my pet scan! What do you guys think. I am glad I am getting the biopsy tomorrow. So if know!! Not sure what to think about my breast.
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Marge, good luck tomorrow!
I have no insight on how to read the PET/CT report. But hope it’s all good.
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Marge, I’m not the expert cookie54 is but things look pretty much stable to me. I hope the biopsy goes well.
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@maggie15 Thanks for the compliment not quite the expert but a wee bit knowledgeable having worked in radiology. Kudos to you also you seem very knowledgeable in medicine by your posts.
@margecandoit Hope all goes well today and you are blessed with favorable results. Seems with comparison things have slightly improved which to me it's always good to head in a positive direction. But as I have always said to myself and many other , there is nothing like a tissue biopsy to tell the true story. For example. on point one of my PET's it showed minimal micrometastasis in one lymph node. When I got to surgery after treatment for lymph node dissection I had 5 lymph nodes with cancer out of 8 they removed. So honestly imaging is not always 100% correct especially on small changes. It's a great tool and we have had great advancements over the years but still doesn't compare to an actual tissue analysis.
Wish you well, keep us posted. Hugs
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@margecandoit We're thinking of you today, hope everything goes well!
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Thanks all!! Had the biospy yesterday and it was a little ruff!! I got there at 10 and didn’t leave till 5:30. They almost kept me overnight but I really wanted to get home and rest. They gave me a sedative and I am not sure it really did anything for me but I was still ok. Think I could have done with out it. So I was doing good till the last ct scan and then I started coughing up a lot of blood. The it was to much for the suction and was coughing into the throw up bags. Filled one and then need a second till I could use the suction. Then they had to do 2 x rays and it showed I had a small amount of air in my chest outside of me lungs but wasn’t bad enough to need a chest tube thank goodness. So after albuterol treatment cough meds and Percocet. I was able to go home. Feeling much better today only hurts a little when I breath and only cough up a little blood today. Thanks all for thinking of me.
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Hi Marge, I'm glad you didn't need a chest tube and were able to go home in the late afternoon. I hope you continue to feel better and get a benign result.
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@margecandoit Glad it's over! Sorry it was a little rough but thankfully no chest tube, they're not fun! Rest up and have a peaceful evening.
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I think I got my pathology report. Look on the patient portal. I think it’s not cancer Yay!! Here’s the report.
Lung biopsy right
CLINICAL INFORMATION:
Diagnosis/Clinical Information: Malignant neoplasm of lower outer quadrant of left female breast Procedure/Source: Lung biopsy right
GROSS EXAMINATION:
Labeled "right lung biopsy" are multiple tan, hemorrhagic soft tissue cores, 0.2 to 1.1 cm. Cold ischemic time unknown. Fixation time is more than 6 hours and less than 72 hours. 3ns
MICROSCOPIC EXAMINATION:
Microscopic examination performed.
DIAGNOSIS:
Lung, right, needle biopsy:
- Bronchial mucosa with moderate chronic inflammation.
- Lung parenchyma without pathologic diagnosis (SEE COMMENT) - No granulomas or malignancy.
COMMENT:
Clinical and radiographic correlation regarding sampling adequacy is recommended.
The only think that makes me wonder is the comment. What are they recommending? I think this is a good report.
Thanks all for listening to me during this time. I don’t want to say all this to my husband and kids!!
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@margecandoit Hope you're feeling well. Seems to me there is a question as to if the biopsy is adequate. They are recommending perhaps taking a look at it again presumably by CT to see if it looks like they got a enough tissue for pathology. This is a frequent occurrence unfortunately, sometimes it's very difficult to get enough tissue for a complete pathology report. I'm sorry, I hope I'm wrong but that is how I interpret this. Hey I'm not a doctor so you never know, obviously best to talk to your doctor on Monday and we won't jump to any conclusions on our own.
I know how hard the anxiety of waiting for pathology reports can be. I have been through it more than my ten fingers can count! Keep yourself busy and like I said you are no worse off right now, just still waiting of course.
Sending you positives vibes and a hug.
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Thanks cookie you’re the best!! I don’t see my dr for another 2 weeks. So the long wait but it’s ok cause it say it’s not malignant. So I will just rest and wait till then. I am still coughing up blood and still sore so resting is the best. I am sorry you have been through so many biopsy I guess I been through 5 not fun!! For sure!! I am 1 for 5 on them being cancer. So I guess that’s good but not as good as them all being not cancer.
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Oh wait I just reread what you said. Chemo has slowed my processing down. What your saying is that you think they didn’t get enough to say if it was a adequate sample so they might need to do it again?
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Marge, I’m hoping they don’t want to test again. HUGS
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Hi Marge, I hope they determine that the biopsy sample was adequate. I guess nobody ever promised this would be easy. Continue to rest up and feel better.
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@margecandoit Yes, that's what MAY happen. When they say clinical correlation it means a conversation needs to take place regarding your symptom's, situation, procedure etc.. Radiographic correlation I doubt a chest Xray being it's too difficult to accurately get a decent reading on nodules. Will your MO feel it should be repeated or will your MO want to repeat PET in a couple months or CT. IF this is truly inconclusive decisions need to be made as to what route to take now. It all comes back to what your MO thinks is going on? Are these inflammatory, benign ,growing, shrinking with treatment? Are you both comfortable with the wait and see approach?
Ugh I'm sorry I know all this is tiring and stressful! I don't want to stress you out but just want to share with you possibilities so your not blind sided!🤞❤️
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Thanks I appreciate it!! I like to have some type of information before going in to my oncologist so I can ask the right questions. If I get the info from him in the room I usually can’t process what he saying untill later and can’t ask the right questions.
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Well went to the Dr. yesterday and it didn’t go how I thought it would. I usually go with my husband but he couldn’t go. So I seen my breast surgeon and my medical oncologist. My med onco order a breast MRI and my breast surgeon found out and was like nope that won’t do any good. So she wants me to do a mammogram so I have to cancel that and schedule a mammogram and my medical oncologist said the lung biopsy was neg active and when I asked about the comment he said they might not have got the right spot but he didn’t think I need to do it in the first place so he didn’t want me to do it again and he will order a ct in 3 months. I just went home and cried because I don’t feel like I got any answer to put my mind to rest and that’s why I went through all of that. Thanks for listening to me. See what 3 months brings back.
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Hi @margecandoit , I'm sorry you are back where you started after going through all that trouble. Lung biopsies are notoriously difficult to perform in many circumstances which is why my pulmonologist continues surveillance until he is pretty sure there is a problem. The positive takeaway is that no malignancy was found. It's hard to continue with the uncertainty but we're here to empathize with you. My next CT is in two weeks.
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Marge, I feel bad you didn’t get any specific answers. Focus on no malignancy found. It’s always a waiting game. My next CT is in 12 days, 11/27.
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