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Gastroenterology (Expert Forum)
Hemangioma or malignancy
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Hemangioma or malignancy
by sunset1, Oct 01, 2005 12:00AM
Over 1 year ago had a CT scan and MRI both revealed small suspected cysts/hemangiomas. Last week had US there is 1 1CM probable hemangioma. The spot is in right lobe and has grown from approx 1MM to 1CM in a little more than a year. What follow up tests should be done to definitely conclude that mass is hemangioma and benign? Worried b/c non-stability in size - in little time. Would you recommend CT or MRI? Have read materials suggesting both have advantages but would like best at differentiating b/w benign and malignancy. Also seen in CT last year - inflammed lymph nodes in groin area. However, they were not as apparent in the MRI. A followup on the lymph nodes has not yet occurred. Which is the preferred means of detecting cancerous issues in the lymphatic system - MRI or CT. Hoping that the lymph node and liver mass may be evaluated in one test conclusively. No blood tests this year but last year all blood work fine. All of these test were performed because of pains in the right, upper and lower, abdomen.
Please advise on all issues - apologize that there are several but looking forward to another opinion. Don't mind posting again if you are unclear or need more info. Thanks so much!!
Please advise on all issues - apologize that there are several but looking forward to another opinion. Don't mind posting again if you are unclear or need more info. Thanks so much!!
Doctor's Answer
by Kevin Pho, MD, Oct 03, 2005 12:00AM
, Oct 03, 2005 12:00AM
Further evaluation can certainly be done with an MRI or CT scan (with the MRI being more accurate (sensitivity 90 percent, specificity 90-99 percent).
A more definitive evaluation can be considered by biopsying the lesion. However, this is a debatable approach since hemorrhage can happen when biopsying a hemangiomia.
Repeating an MRI serially to ensure the lesion isn't growing is a reasonable approach.
Regarding the lymph nodes - various types of genitourinary infections can lead to enlargement. If they continue to enlarge or persist, a biopsy can be considered to ensure they are not malignant.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
A more definitive evaluation can be considered by biopsying the lesion. However, this is a debatable approach since hemorrhage can happen when biopsying a hemangiomia.
Repeating an MRI serially to ensure the lesion isn't growing is a reasonable approach.
Regarding the lymph nodes - various types of genitourinary infections can lead to enlargement. If they continue to enlarge or persist, a biopsy can be considered to ensure they are not malignant.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
• Regarding differentiation between a benign and a malignant mass (cysts), an experienced radiologist’s opinion would be very helpful, but for knowing the exact/ true nature of the cyst/ hemangioma a biopsy is necessary.
• Serum alpha 1 fetoprotein levels can be of help.
• The change in size of the cyst in 1 year can occur & could be due to multifactor reasons.
• Are the inguinal lymph nodes still enlarged after 1 year, could have been enlarged from an infective cause, why do you feel that you need imaging of the lymphatic system?