PET scan ordered

[kri312]

Saw my Surgeon yesterday for a routine follow up and this was the CT scan. I have just hit my 5 year mark from R UL wedge and R LL lobectomy. He said he WAS NOT WORRIED. However, needed to do a PET Scan to rule anything out due to the radiologists report. He has never done this in the past. He said he looked at it several times and didn't feel it was anything more than changes at the site. PET Scan ordered and follow up appointment ordered . I am so angry at myself for assuming the worst already. I find myself feeling the same way I did when I was initially diagnosed and it is a scary place to be, already can't eat or sleep. Will be a long 10 days of worry.

Study Result

Impression

Status post right lower lobectomy and right upper lobe postsurgical changes.

Mild increased thickening along the medial aspect of the suture line dating back to 2019, stable as compared to the 2022 exam. Mildly increased ground-glass changes adjacent to this thickening. Findings are of unclear significance. Follow-up recommended.

Narrative

EXAMINATION:

CT SCAN OF THE CHEST WITHOUT INTRAVENOUS CONTRAST

CLINICAL INFORMATION:

Pulmonary nodule.

TECHNIQUE:

Axial images were obtained and multiplanar reconstructions were made.

COMPARISON:

CT dated 11/04/2022, 11/12/2021 in 10/18/2019.

FINDINGS:

Lungs and pleura: Status post right lower lobectomy. Postsurgical changes in the right upper lobe with predominant stable thickening and nodularity along the suture line. Along the medial aspect of the suture line (4:61) there has been mild thickening dating back to 2019 but stable as compared to the most recent exam. Mildly increased ground-glass changes are noted adjacent to this thickening (4:60). No new or enlarging pulmonary nodules.

Trachea and bronchi: Central tracheobronchial tree is patent.

Mediastinum, hila and lymph nodes: Numerous subcentimeter mediastinal lymph nodes. Surgical clips in the lower neck.

Heart and pericardium: The heart is not enlarged. Pericardial effusion.

Vessels: The aorta is not enlarged. The main pulmonary artery is not enlarged.

Soft tissues: No axillary adenopathy. Focal calcification versus tissue clip in the lateral right breast.

Upper abdomen: Limited views of the upper abdomen are unremarkable.

Bones: No aggressive osseous lesions.

[Jenniferroseolson]

Dear Kri,

I am seeing this from the other side of worry—hope! This is Fantastic that your oncologist is providing careful close monitoring and followup. If the petscan shows metabolic activity that is not seen or obvious on the CT, you are finding it very early which will potentially lead to easier, earlier, or more possibly successful treatments. I do hope the petscan is clean, but if it isn’t, your prognosis is so much brighter if you and your team know what you are dealing with. Best wishes.

[JanetteR57]

This doesn't read in any alarming way to me - thickening along the scar line is normal - ground glass opacities are common but more often monitored than actioned and when things are commented that they are unremarkable, this means nothing to comment on. It seems as if they're doing a thorough follow on job so try and distract yourself with things to occupy your time and mind if constant anxiety is a thing for you.

Not eating or sleeping will not do you any good and if you were talking to a good friend, you'd be suggesting they look after themselves and take care in these circumstances so be kind, talk to yourself as if you're your best friend. Many patients are discharged at the 5 year mark so looks as if he's making doubly sure that he nor the radiologist are missing anything.

Good luck.

[kri312 in reply to JanetteR57]

Thank you for your response. It’s was my understanding that GGO are the precursor to cancer. While he did try to calm my nerves sitting with him , it’s really hard to not feel after 5 years you’re back to square. The PET scan was where things lit up first time and I’m so scared things are “ lurking “ that I’m not aware of. Yes I know if so , caught early but …. Sometimes it’s hard to think rationally - will do my best to get through the long week ahead.

[JanetteR57]

Believe me I know - having been hospitalised every year between 2015 and 2019 with one nasty chest infection after another including pneumonia, pseudomonas and RSV but they all took different tests to reach those conclusions... and over the years of annual surveillance (chest x-ray) it's easy to think that symptoms or delays in hearing back from consultant may be bad news.

Also our memories kick in - saying "I've been here before and it wasn't a good experience' adding to anxiety. I'll keep everything crossed for you that it turns out well - maybe reframe it that it's good that you're 5 years out already - that in itself will give hope to others going through it now. I never thought I'd get to 12 years out so far....

Not all ground glass opacities develop neither do lung nodules - in the same way when women go for a smear PAP test, and irregular cells are found, not all are precancerous but can be abnormal yet somehow we don't put ourselves into the same panic mode nor when our mammogram has to be redone due to something not quite being right.

good luck and hope you can build in some pampering sessions or treats for you in the coming week to make it pass more quickly.

[Denzie Moderator Volunteer]

Once you’ve had a diagnosis it’s hard not to suspect any twinge, illness, or cough isn’t a new mets or progression. Heck, there are some websites that will tell you a stubbed toe is the result of brain cancer, even when you know you kicked a brick. It’s an easy trap.

My takeaway is like the others. It’s not a bad report. My ground glass nodules have been there since my original diagnosis in 2010. Some have grown a bit. Others shrank. Please know that many things can cause them to change including exposure to household or industrial cleaning fumes, asthma, allergies, pollution, molds, woodsmoke, chest infections and many other things.

Your doctor is erring on the side of caution and should be applauded. Ask for a 3-6 month follow up CT.

In the meantime, do whatever chases those scary “what if’s “ away. Meditation is one good way. Also do a project, clean the garage, the basement or attic; take up a hobby, something you always wanted to try, you don’t have to be good at it, just a good distraction.

Please let us know what you learn.

[kri312 in reply to Denzie]

I am having a PET thrusday and will see him next Tuesday - he said that way we know one way or another! Long days for sure during times like this....

[Denzie Moderator Volunteer]

sending hope for the best possible outcome.

[Momchach]

Hope all goes well,👍🏻🙏🏻😊