Head /Neck 8mm right inferior level 3 lymph node slightly hypermetabolic (max SUV 2.) 7mm left level 4 lymph node mildly hypermetabolic (suv 2.2) CHEST: confluent opacity left upperlobe 1.9x 1.9 cm hypermetabolic (suv 5.8) enlarged in one dimension from previous exam. Tiny posterior right upper lobe opacity measures 2.2 x 0.9 cm hypermetabolic SUV 4.1 and is enlarged from previous. Medial right upper lobe opacity 1.7 x1.4 cm fairly FDG avid not significantly changed from previous.
Superior mediastinal lumph nodes are insinuated between the proximal left subclavian and common carotid arterier measuring 1 cm and tetween the brachiocephalic artery and SVC and hypermetabolic but not changed in size
A Hypermetabolic 13 mm rigbht paratracheal lymph node (max SUV 4.6) numerous aortapulmonary window, paratracheal, hilar and subcarinal lymph nodes are unchanged in size. Some show increased FDG uptake SUV up to 4.7 as 1.4 cm left paratracheal mode on image 43 series 2
Impression: Bilateral upper lobe opacities are slightly enlarged compared to prior exams and are FDG avid (the left upper lobe opacity is enlared compared to 2007 and the right upper lobe opacity is only slightly enlarged and compared to 2007. and definitely enlarged to more remote exams) Adenopathy in the hilum, mediastimum, and right neck are hypermetabolic as well. These findings may simply represent the given diagnosos of pneumoconosis. Given the increase in size of 2 of the lung opacities however neoplasitc involvement cannot be completely exlcuded. Further workup is recommended.
The doctor is scheduling a needle biopsy now.
Opinions on what it could be. Lung cancer, I'm worried about lymphoma as well.
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