Hi,
Both the CT scan and the PET scan show a suspicious mass in the left lung with enlarged lymph nodes showing uptake. Also it appears that the disease is confined to the left lung and hilar and mediastinal lymph nodes and there are no metastasis elsewhere. At this point, a biopsy or an FNAC from the mass is needed to confirm the diagnosis. An IHC of this biopsy material may be necessary to confirm the origin of this mass - primary lung versus metastatic colon.
If the biopsy shows cancer the treatment options include radiation therapy, chemotherapy, surgery and various combinations of these. Once the diagnosis is established, the treatment options are best discussed in a multidisciplinary team comprising of a surgical, medical and radiation oncologist. The optimal combination and sequencing of therapy can be decided based on the stage of the disease and the patient’s general condition.
Good Luck!
Here is the follow-up PET scan for my father. Opinions, please, on metastasis, possible treatment options and timeframe? Is surgery viable? VATS? He has a brain CT scan scheduled this week. Thank you very much.
FINDINGS:
Skull base and neck: No mass, adenopathy or focal abnormal FDG uptake is identified in the neck. There are moderate degenerative changes in the cervical spine.
Thorax: A central LEFT upper lobe/LEFT hilar mass is again noted, not significantly changed from the recent CT chest dated 5/1/2009. The mass shows markedly abnormal FDG uptake with maximum SUV of 19.2. This is highly suspicious for malignancy. There is a mildly enlarged LEFT hilar lymph node which shows abnormal FDG uptake likely resenting a metastasis. No other sites of abnormal FDG uptake are identified in the chest. Calcified granulomas are noted in the pretracheal and subcarinal regions and as well as the RIGHT hilum. Atherosclerotic calcifications involve the coronary arteries and aorta. There is mild adenopathy in the aortopulmonic window. Increased activity is seen within several of these lymph nodes. The lymph node with the greatest uptake in the AP window has maximum SUV of 5.3 Peripheral to the LEFT upper lobe mass is a vague reticulonodular infiltrate which shows only mildly elevated FDG uptake with SUV of 1.9. This is probably post obstructive infiltrate although lymphangitic spread of tumor is not entirely excluded.
Abdominal images show a few granulomas in the spleen. Otherwise, the liver and spleen are not remarkable. The gallbladder, pancreas, adrenal glands and kidneys are normal. No mass or adenopathy is seen. There is no intestinal distention. There is no focal abnormal FDG uptake in the abdomen or pelvis. No ascites is seen mild degenerative findings are present in the spine.
IMPRESSION: The soft tissue mass at the superior aspect of the LEFT hilum involving the LEFT upper lobe shows abnormal FDG uptake consistent with malignancy. This may represent a primary lung carcinoma. Considering the patient's history of colon carcinoma, metastatic disease is not entirely excluded. Adenopathy in the aortopulmonic window and LEFT hilum also shows increased activity and is most likely metastatic adenopathy. Peripheral LEFT upper lobe infiltrate probably is due to to postobstructive infiltrate although lymphangitic spread of the neoplasm is not entirely excluded. No metastatic disease is identified in the abdomen or pelvis.
Hi,
According to the report, the situation is worrying. There appears to be likelihood of lung cancer.
Please consult an oncologist urgently for appropriate investigation (biopsy or FNAC), staging, and treatment.
All the best, and God Bless!