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lung pet scan hot spots
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National Jewish -
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MedHelp Member's Question

lung pet scan hot spots

by gloria1951, Apr 17, 2006 12:00AM
I'm a healthy (cept for one basal cell skin cancer episode, fibrods, & molar pregnancy 15 yrs ago), 54 female, nonsmoker, with no respiratory symptoms (and can't recall having any such problems, like pneumonia).  As a fluke of a January stomach CT, a 2.5 cm mass was observed in my lower left lung.  This was confirmed with a March lung CT, along with other lung masses.  An April PET scan showed uptake in numerous regions including the left lung base above the diaphragm (SUV 3.5), mediastinum (6), periaoric or left hilar (6), lesion along the aorta (5.4), left suprahilar location , thoracic inlet, right paratracheal location (3).  The lung specialist is referring me to a cardiac thorastic surgeon, to perform a biopsy, starting with the top lymph node, and working down, employing VATS or through the chest wall, if that is needed to reach lower lobe mass.  I got the impression that if the top areas are cancerous, they just may quit the surgery and regroup.   I know from this excellent forum that PET positive nodules can be false positives, due to numerous other conditions.  But can PET positive lymph nodes also be false positives?  Should I be preparing myself for a cancer diagnosis?  and me, a nonsmoker!?  I would appreciate any guidance you can provide, like what questions I should be asking, what options to consider. Any hopeful comments especially! Thank you very much!  Gloria

Doctor's Answer

by National Jewish, Apr 18, 2006 12:00AM
From the information that you provided it sounds like lymph nodes as well as nodules were positive on your positron emission tomography (PET) scan.  In addition to cancer that may have spread from somewhere else, this could be lymphoma or sarcoidosis.  Please read our sarcoidosis information at http://www.nationaljewish.org/disease-info/diseases/sarcoidosis/index.aspx to learn more.
Member Comments (12)

by usnvet, Apr 17, 2006 12:00AM
gloria, i heve commented on this before.my situation was simular 3 yrs ago. one nodule in each lower lobe.had a pet scan and showed 3 hot spots in lungs and one in my neck.had neck biopsy first as it was easier and it was negative. then had lung biopsy which also came back negative. 3 years later i am still here.i have some lung problems(bronchitis shortness of breath inflammation which nothing i take seems to help. point is it may not be cancer,only tests will tell, and a biopsy is still the gold standard,that is what my doctor at sloan kettering cancer center told me. good luck and try not to worry. keith

by Grand Rapids, Apr 17, 2006 12:00AM
Gloria - I can't provide you as much information as Keith did but I recently had a PET for 2 nodules that were found on my CT.  In preparation for that, I did a fair amount of research and found that hot PETS do not always mean malignancy. Here is a list I found for false positive readings.



• Granulomatous disease

•       Infections

• Recent radiotherapy

• Inflammatory process

• Repair process

• Recent surgery

• Injection site and lymph nodes proximal to injection



I also learned that malignancy scores are more typically:



Squamous carcinomas (score 11)

Adenocarcinomas (score 9)



There is a Bronchioloalveolar Carcinoma (BAC) that shows less uptake (score 3.5), but what I found is that these generally are slow growing and appear as solitary nodules.



My PET came back cold and I am very grateful for that.  I know you must be worrying about this.  When I was waiting for test results, I spent a lot of time trying to educate myself as much as I could with all the resources the Internet has to offer.  I also changed my diet, began drinking tons of water, and taking a regimen of vitamins.  Exercise helped me keep my mind off it.  And I began praying a lot more.  I believe God answered those prayers.



I wish you all the best and I hope you keep us posted.



God bless,



Tom



by gloria1951, Apr 17, 2006 12:00AM
Tom and Keith, thank you very much for your comments!  It's information like this that gives one hope and helps get through the days before getting final word.  I guess what I'm especially confused about is lung masses/nodules versus lymph nodes.  I know that lung masses can be caused by other things - Tom gave a comprehensive list.  But can a lymph node go "bad" for these same reasons?  What I fear is that lymph node involvement means that something bad has spread into existing body parts and the fact that lymph nodes showed up on the PET scan means a higher probability of cancer.  I have a fine needle aspiration of the thyroid schedule for next Monday now- so I might hear those results before the surgeon goes on his exploration of my lung!   thanks again!  Gloria

by Grand Rapids, Apr 18, 2006 12:00AM
Gloria - I read NJC-R.N.-DC's answer to your questions and that this could be lymphoma or sarcoidosis. I suppose sarcoidosis would be good news at this point.  I think it's like Keith said, the only real way to know is through a biopsy, which you said they had scheduled for next week.  As I said before, educating yourself on these subjects will help immensely.  And keeping a positive attitude really helps.



And with all that said, miracles really do happen.  My wife was at a wedding shower just last night and there was a lady there that told her she had been diagnoised with cancer of the mouth, based on a biopsy.  It was a tumor nearly the size of a golf ball on the roof of her mouth.  After preparing herself for surgery and then chemo, the doctors told her after it's surgical removal that it was completely benign.  The doctors were shocked.  She said she had prayed for God's healing and she believed that's why she had such a wonderful outcome.



I know of other stories similar to this.



Your biopsy may come back negative and I pray that it does.  If it's positive, you can still beat it, especially with His grace.



Please keep us posted.



Tom