Lung lesion in right lung

[aneta0407]

My husband is 65 yo, after liver transplant 1.5 years ago. He was complaining about chest pain for some time, has cough with phlegm (clear) shoulder and back pain - his MD would always say that it is all normal, due to his transplant etc or like chest pains would treat with some medication.

But finally he had a CT done 2 weeks ago, and they found "2.6 x 2.1 cm spiculated lesion in the right lower lobe abutting the right hemidiaphragm. The morphology of the lesion is suspicious for primary lung carcinoma". This is what it is in a report.

We went to see a doctor and he gave us 3 options: 1.wait and observe, 2. biopsy, 3. remove it. We decided to have a biopsy done.
I am trying to be positive but I am not coping with this well. Could it be something from the surgery(liver transplant, 2 recent hernia surgeries) like scar tissue or fluid? Can you tell by looking at the CT? Because the doctor said that he couldn't tell. Can it be a scar tissue?

What do you think??

[stewj]

I just had a 2nd CT scan and the spot has gotten. Way bigger they yet to tell me what. It could be it's been a year apart cuz I had no health insurance I'm scared I'm 37 years old women smoked for 20 years

[Fernando Roque, MD]

Hi.  I'm happy for you regarding this recent development.  It's quite possible that the lung lesion is not actually a tumor but accumulated mucus from an infection (pneumonia) which resolved by the time the biopsy was to be done.  Anyway, I hope that things continue to turn up for the best for your husband. Good luck!

[aneta0407]

I still cannot believe what happened yesterday. I left my husband in a room to have his biopsy done. After 10-15 minutes the radiologist came out and she told that they cannot do it because........there is nothing! His lung is clear and whatever it was on CT a month ago is not here today. Two other technicians looked at the scan yesterday and confirmed that there is nothing to biopsy. They think it could have been mucus or air.

We are happy beyond believe and puzzeled because we went through a difficult month. Have you ever heard of anything like this? Is it possible?

[Fernando Roque, MD]

Hi.  Is your husband receiving pain medication? If so, what drugs has he been receiving? You should inform his doctor that his pain medication is not working, so that the dose can be increased or maybe changed to another drug.  The back/shoulder pain may be due to the lung mass, and he'll probably benefit from stronger pain medication like tramadol or morphine.  

If that mass is lung cancer, treatment might consist of initial surgery, then chemotherapy  and possibly radiation therapy afterwards.  His situation is a little delicate, because of his previous history of chronic hepatitis C and liver transplantation.  However, these conditions are not absolute contraindications to having chemotherapy.  With the proper planning, the chemotherapy can still be done safely.

[aneta0407]

Thank you for your replies.

Yes, he has Hep C and that was a reason for a transplant. He is going to have a biopsy done mid May. Meanwhile his whole back-shoulder are hurts. He says that the pain is coming from inside.
I am devastated. He has been through so much and it seems like its far from over.
If its caught early what will happen? A surgery or chemo? Can he get chemo being a transplant patient?

Tamihart, did your dad have his biopsy yet?

[Fernando Roque, MD]

Hi.  I would just like to ask: why did your husband have a liver transplant in the first place? Does he have chronic viral hepatitis?

From your description, it doesn't look to me that the right lower lobe lesion is the direct result of his liver transplant surgery.  I don't think that's a scar.  The lungs are not part of  the operative field in liver transplantation, so I don't see how a scar can get there.  I suppose your husband received drugs to suppress his immune system after the transplantation, to lessen the possibility that his body will reject the transplanted organ.  If this is the case, it is theoretically possible that such immunosuppression could promote the growth of an occult cancer in the lungs (the immune system acts not only to combat infection, but also to remove any abnormal and malignant cells).

You did the right thing in having the biopsy done, as this can provide you with definite answers.

[Tamihart]

I don't think it would be from his other surgery, and I don't know why he would have scar tissue on his lung unless he had thoracic surgery before.  Try not to be scared.  I think you made a wise choice by doing the biopsy.  If it does turn out to be lung cancer hopefully you caught it early. The biopsy will give you a definite answer.  My dad is having a biopsy soon too!  Good Luck!