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What does all this mean


      Dense airspace consolidation with possible underlying mass in the right upper lobe posterior periphery extending to the apex. A precarinal node on image 31 measures 2.4x1.3 cm.  Linear scarring in the right lung base.  The left lung is well-aerated with no definite nodule or mass.  There are mild to moderate emphysematous changes.  A left transvenous pacemaker is in place.  Mutichamber cardiomegaly.  
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Avatar universal
Hi,

Yes, a lot of posts are indeed seeking opinions. Its always good to keep an open mind.

However, never discount the value of the physical examination, this information is only available to the doctor examining you. Hence, at the end of the day, I hope posting here really does help, but I know nothing replaces the patient-physician encounter.
Helpful - 0
Avatar universal
      Hi,

    I will let you know how the test turn out,and how they will treat it if they show something.
    One question I see a lot of people say is always a 2nd opinion what do you think.  
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Avatar universal
Hi,

The breathing test will help establish what extent of surgery (if it would be an option) he could tolerate. Put another way - how much lung can we remove to allow adequate breathing after surgery? this would be the primary task of the lung power/capacity testing.  

The pet scan may help locate which area is more likely harboring cancer - since the previous scan simply showed - no definite nodule or mass.

There are some technical issues with trying to biopsy a precarinal node. This area is right behind the 4 largest blood vessels that are connected to the heart. It isn't a place where you can simply stick a needle into. In general, patients who undergo a biopsy of this area would do so using a tubular scope. If the PET shows no suspicious areas outside the lung, the breathing test shows a capacity that would likely tolerate removal of some lung, and the lung involvement is amenable to complete surgical excision - these are the people who usually undergo the scope- partly as diagnosis and partly to plan the extent of surgery.
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Avatar universal

    Thank you for your answer.
   I have gone to a lung surgeon and he has me going for three test next week.

  A breathing test-I guess in case they find anything
  A pet scan
  And a biopsy on the possible underlying mass and the pleural effusion
  I asked about the precarinal node and he did not seem to concerned,why would he not biopsy that.
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Avatar universal
Hi,
I am assuming that this is a chest CT scan. The description is not consistent with a suspicion of lung cancer. There should be a clear mass seen - which is absent in the description. If this is not a high-resolution scan - it may possible to resolve the area on the R lung which was read as "possible underlying mass" by performing one.

The presence of the precarinal node could possibly be attributed to malignancy - but it is not the typical picture. The precarinal node is in the middle of the chest - generally there is involvement of nodes in the lung before nodes in the midline are affected. It is possible that the precarinal node represents sequelae of initial inflammation associated with a foreign body - in this case the pacemaker.

If there are risk factors for lung cancer, your doctor would likely recommend that you undergo monitoring by doing some scans after a period of a few months.
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