Lung Cancer

My mother is 56.  She has lost alot of weight in the last few months.  She  had a chest CT Scan done this week.  Here are the findings.There too numerous to count bilateral small (3 to 5mm) pulmonary nodules involving all lobes, but with an upper lobe predominance.  There is a 1.5 cm region of ground glass opacification in the medial left  upper lobe. a 7 mm AP window lymph node, a 9mm precarinal lymph node and bilateral 9mm hilar lymph nodes all measured in the short axis.  She has smoked for most of her life.  Any question that it may be lung cancer?

[DrBhumikaMD]

Hello,
The most likely condition in this case seems to be interstitial lung disease, especially those associated with smoking; it could also be sarcoidosis or tuberculosis. Lung cancer as a possibilty seems rare. Though lung cancer usually presents as a mass lesion or lymph node enlargement it still needs to kept as a differential diagnosis. What are the clinical features that she is having? Has the doctor suggested a bronchoscopy or a FNAC or biopsy? This will make the diagnosis clear. Goodluck.

[jeni757]

The only thing that is wrong with her is the extreme weight loss without known causes in a very short time frame.  Her PCP is running numerous test and that was just one of the test. Can you explain what interstitial lung disease is?  Is is like COPD?

[DrBhumikaMD]

Hi,
Well interstitial lung diseases are a group of lung diseases different from COPD and involve pulmonary fibrosis and distortion of the parenchymal architecture to a certain extent. They are restrictive in nature, unlike COPD which is an obstructive lung disease. Check out the link below, you will be able to understand better -

http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35436

In case of any doubts, please feel free to ask. What do the results of the tests done suggest?  Goodluck.

[jeni757]

The radiologist findings are muliple pulmonary nodules with associated mediastinal and hilar lymph node enlargement.  This could represent neoplastic versus inflammatory process.  Thank you for all your information.  It is deeply appreiciated.

[DrBhumikaMD]

Hi
A bronchoscopic biopsy or CT guided FNAC would have to be the most logical next step now. This would help get some cells / tissue from the site for lab examination. This is the only way to get a confirmed diagnosis and differentiate between whether it is an inflammatory lesion or a neoplastic one.Discuss this with your treating physician in detail. Goodluck.