Results of High-resolution CT of the lungs & protein electrophoresis blood test

[Hhedy]

chest:
Clinical information: hemoptysis

Findings:

No enlarged mediastinal or axillary lymph nodes are seen.
No pleural or pericardial effusion.
The lung parenchyma is clear of infiltrates or consolidations. Tiny nonspecific granulomas are noted in both lungs, measuring up to 3 mm in the right upper lobe.
The limited analysis of the abdomen shows a few simple biliary cysts.
The bony framework shows a 5 mm bone island at the right humeral head.

Impression:
No evidence of pulmonary infectious focus.

Protein electrophoresis test results :

Comments
Borderline polyclonal increase in gamma-globulins suggesting a chronic reactive condition.

Can someone help me interpret my Results?

[Ken_PA]

Let me talk a bit about two conditions that can cause granulomas in the lungs. I don't think you have either of these particular 2 diseases, but knowing about them might help in understanding.

Tuberculosis is caused by a bacteria. When the body is not able to kill off the bacteria, it instead surrounds them with immune cells. It's like building a wall to surround the infection. That is what granulomas are.

In Sarcoidosis, there is no bacteria (or virus or parasite or fungus). But the granulomas form anyway. No one knows why. It is a mystery immune condition.

--------------

Let's add one more example: IBS (Irritable Bowel Syndrome). It is inflammation of the digestive tract,  but no one really knows what causes it. However, people can try to detect what 'triggers' it, such as certain foods. Eliminating the foods can bring improvement. It's almost like an allergy, but different.

[Ken_PA]

"In one day"
To me, that seems less like the antibiotic effect, and more like an antihistamine effect.

This is all guesswork, but all we have at this point is trying to figure out the probabilities.


I hope you are not having too much trouble translating :)  These are complicated medical topics. Please ask for any additional explanations if it's not clear enough.

[Hhedy]

I am so thankful for what you did.

[Ken_PA]

"I am so thankful for what you did."
It's very nice of you to say that, thank you.

I also should add that although this is mysterious, it is most likely much better than having a cancer or a severe lung infection. I hope that makes you feel a little better.

[Ken_PA]

Hi, again. Are you still there? As if things weren't complicated enough already, we also have this from your CT report:
"The limited analysis of the abdomen shows a few simple biliary cysts."

This is also *rare*, maybe around 1 in 100,000 people. I think this probably gives us the cause of the abdominal pain you were having. We have to be very careful here to thoughtfully consider which type it is, so as not to rush to a surgery and not to rush to thinking it is the pre-cancerous type.

Why is it probably not-cancer?
- you are too young; the pain began when you were 30 or less, right?
- the pain stopped
- you very possibly have some unusual immune condition going on which then also probably explains the cysts

"direct correlation between the patient age and cancer risk: 0 year to 30 years (0%)"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447264/


Did you have any severe abdominal pains as a child? Can you please tell me the exact place where the severe abdominal pains occurred as an adult? Did it seem to be in the stomach, or maybe more to the right of the stomach? How high up?

[Hhedy]

No, when I was young there wasn't any pain in my stomach.
The pain is in the epigastric area below the ribcage.

[Ken_PA]

Why did you join the esophageal cancer group? Did you ever have trouble swallowing food?

[Hhedy]

I join the esophageal cancer group because the phlegm getting worse after eating or drinking.

[Ken_PA]

Since biliary cysts (also called choledochal cysts) are so rare, there is not consistency in the literature. But "Frequently, adults with choledochal cysts complain of vague epigastric... pain..."
https://emedicine.medscape.com/article/172099-clinical

Hasn't your doctor remarked on this part of the CT report?

[Hhedy]

No, my doctor did not tell me anything about this part of the report.