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Can't figure out this medical lingo stuff!


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I got a copy of my medical records today from my onc.'s office. (pretty big file!) Anywa, the latest results of my CT scan were summed up like this: (and maybe somebody can fill me in on what some of these words are?!)

1. Increased left hilar soft tissue prominence with increased postobstructive change with a possible mass present within an area of consolidation within the left upper lobe and extending into the lingula.

2. Stable Pericardial fluid.

3. No recurrence of the left pleural effusion post pleurodesis.

4. Several tiny bilateral pulmonary nodules. (WHAT ARE NODULES, ANYWAY?)

5. Findings suspicious for lymphogenic carcinomatosis in the left upper lobe.

6. Stable liver lesions.

7. Widespread bony metastatic disease again noted.

My results from the Feb. CT said I had improvement in the left lower lobe.... does this mean I have a new mass in the upper lobe???

Thanks for any input here!


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"Nodule" is a nonspecific term for anything that looks different than the surrounding lung tissue on the radiological image. A nodule may be a calcium deposit, scar tissue, infection, tumor, almost anything. Many people have some kind of nodule - the trick is in figuring out what the cause is.

If you are interested in why screening is not considered feasible by many health care professionals, read further. (I'm saying so because the following might also make you angry.) Non-cancerous nodules are one reason that it's so difficult for medical providers to screen for lung cancer. There are many insignificant nodules, even among high-risk individuals, and a lung biopsy is far from risk-free (esp. in people with high risk for lung cancer), so biopsying every nodule carries more risk than watching and waiting. At least from a statistical standpoint, anyway. Medical professionals have not tried to assign a statistical value to the anger and betrayal felt by people whose lung cancer could have been found earlier, had they been screened & biopsied. Which is probably appropriate, IMO.

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I guess the main word is *possible* mass. I think area of consolidation means the lung's air sacs are filled with something besides air.

Several tiny bilateral pulmonary nodules means there are nodules in both sides of the lungs. This may or may not be unusual. Usually there is a single pulmonary nodule for lung cancer. If there are multiple nodules it could mean the lung is secondary. Though multiple nodules do happen after metastasis outside the lung area.

Area of consolidation on an x-ray from what I have read means the area is white or grey versus black. The lung parts that are filled with air should look black, but you see the ribs, spine, heart.

How did they diagnose Lung cancer? Did the Drs ever do a biopsy?

Another test that can be done is TTF (thyroid transcription factor)

Often Zometa or other biphosphonates are given for bone mets, has the Dr ever mentioned this.

http://www.thoracicrad.org/STR_Archive/ ... ingJH.html

Multiple pulmonary nodules or masses.

The presence of multiple nodules or masses in the lungs usually suggests metastatic disease from an extrathoracic malignancy, or less commonly benign conditions such as granulomatous infection, sarcoidosis, vasculitis, collagen vascular disease, or septic or bland emboli. However, multiple nodules or masses may also be a manifestation of primary bronchogenic carcinoma. This may occur when there are multiple primary tumors, lung-to-lung metastases, or a primary bronchogenic carcinoma that is coincidentally associated with any other cause of pulmonary nodules. In all three circumstances, the correct diagnosis may be difficult to establish. Most often, the physician's attention is diverted away from the thorax in an attempt to identify an extrathoracic primary, thus increasing the length and expense of the diagnostic workup. Furthermore, when a patient with proven bronchogenic carcinoma has one or more other pulmonary nodules or masses, it should not be assumed that the other lesions represent lung-to-lung metastases. In patients with multiple primaries of differing cell-types, this may result in incomplete therapy for some of the types of cancer present (eq. small cell carcinoma). And. benign but potentially fatal causes of some nodules may be overlooked and go untreated (eq. tuberculosis).

Multiple primaries account for 0.72% to 3.5% of cases of bronchogenic carcinoma. In one-third of cases the multiple primaries are synchronous. Since the tumors may be of different cell types, biopsy confirmation of the cell type of each tumor is mandatory for proper therapy. In two-thirds of cases the tumors are metachronous. It has been estimated that 10% to 32% of patients surviving resection of lung cancer will develop a second primary. Therefore, the demonstration of a new solitary mass in a patient with prior lung cancer may not indicate metastasis or recurrence but rather may represent a new primary tumor.

Lung-to-lung metastases occur in about 10% of cases of bronchogenic carcinoma, usually in the late stages of the disease, when metastatases to other organ systems are present. In the absence of systemic metastases, a lung-to-lung metastasis is an unlikely cause of a new mass or nodule in a patient with bronchogenic carcinoma; superimposed infection or a second primary neoplasm should then be excluded.

Again - I would call the University of Colorado Cancer Center for a 2nd opinion

http://www3.cancer.gov/cancercenters/ce ... st.html#L4

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Guest Phyllis

Boy, I am glad you asked. I have been trying to figure all of the lingo as I go along too. They really should have a section for slow learner cancer patients. I would sign up in a heart beat. I hope John answered your questions. Take care.

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As John said, consolidation is usually due to fluid; it is a common finding in pneumonia, for example. The postobstruction changes are probably due to the same thing: fluid collected in the lung that sits beyond a tumor completely or partially obstructing an airway. It sounds like the consolidation is too dense to tell whether or not there is a mass in the left upper lobe.

Joyce wrote: left hilar soft tissue prominence...

The soft tissue could be inflamed, making it appear whitish vs. black or dark gray. The hilum is in the center of the chest, where the bronchi, blood vessels & lymphatics branch off to the right and left lungs.

The lingula is part of the upper lobe of the left lung. From Dorland's Illust. Medical Dictionary: "a projection from the lower portion of the upper lobe of the left lung, just beneath the cardiac notch, between the cardiac impression and the inferior margin." Keep in mind that the upper lobe of the left lung covers most of the "front" surface of the left lung.

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