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Mediastinal lymphadenopathy

My father had a radical nephrectomy to remove a cancerous tumor (October 2008).  His Chest CT before surgery indicated mediastinal lymphadenopathy.  The doctors approach was wait and see.

So his 3 month follow-up CT Scans of lungs and kidney area were clear (Jan 2009).  However, his PET Scan indicates "several tiny bilateral subcentimeter pulmonary nodules, a few of which demonstrate FDG activity and are suspicious for metasteses."  This was quoted from the PET SCAN.

Is this indicative of lung cancer or could there be another reason for this?

1 Responses
242588 tn?1224275300
MEDICAL PROFESSIONAL
Good news that the follow-up CT scans were negative.  Multiple sub-centimeter pulmonary nodules are unlikely to be indicative of lung cancer, but more likely to be a sign of spread of your father’s kidney tumor.  However, one must be cautious in the interpretation of positive positron emission tomography (PET) scans, since there are degrees of positivity based on the standard uptake value (SUV), a cut-off point of >2.5 deemed to be significant.  An initial SUV of less than 2.5 in geographic regions with epidemic granulomatous disease such as tuberculosis (TB) or fungal infections is not useful for differentiating benign from malignant pulmonary nodules.  I am not an expert on this, so you should discuss this with the radiologist whose report stated “…suspicious for metastases”.

Good luck.
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