Been a bumpy year (5 1/2 years ago R lower lobectomy stage 1 R upper lobe wedge stage 1) .....(see below for recent details) but wondering for those who had recurrences when did they occur and how were they managed? Did you have others since? My surgeon did frozen sample in OR and detected no cancer and I was elated - he said of course would send to pathology. Yesterday I found out my 6 days of joy were replaced again by fear, "it came back once, when will it come back again?". This isnt helping since I have had a PAL and had to go home on heimlich valve (surgery one week ago today) that I am concerned might not heal.
If one has a recurrence, even if 5+ years out, does that indicate this will be the case again? So difficutl to stay positive when so scared of what the future holds. I know I can get hit by a bus tomorrow and it sounds so easy to tell that to someone else but at times it is hard to stay positive and get back to living.
10/18/23 path surgery
TYPE OF NEOPLASM: Invasive adenocarcinoma, acinar predominant Other minor patterns: Acinar (60 %) Papillary (40 %) HISTOLOGIC GRADE Grade 2 (G2): Moderately differentiated V. TUMOR SIZE: The tumor?s greatest dimension is 1.7 cm VI. LYMPHO-VASCULAR INVASION: Not identified VII. BRONCHIAL MARGIN: Not applicable VIII. OTHER SURGICAL MARGINS: No tumor is identified on the surgical margin (adenocarcinoma is present at least 4 mm from the inked margin following removal of staples). PDL 1 < 1%
PET 9/23
Lungs: Status post right lower lobectomy and right upper lobe wedge resection with postoperative changes. Unchanged thickening along the right upper lobe suture line. Stable medial nodular component measuring 1.8 x 1.6 cm with low FDG-avidity (SUV max: 2.2; previously: SUV max: 2.0). No new or enlarging pulmonary nodule. Elevated right hemidiaphragm.
Bronch 6/23
DIAGNOSIS(ES): Lung, RUL, navigational cryobiopsy: Lung parenchyma with focally minimal fibrosis, no explanation for a nodule is seen, no granulomata or carcinoma seen. Awaiting 6 additional levels.
ADDENDUM Six additional levels of blocks A1 and A2 of the lung biopsy have been examined and again unremarkable fibrovascular tissue and lung parenchyma is seen. No inflammation, granulo mata or neoplasm is identified.
PET 5/23
CHEST: Lungs: Postsurgical changes status post right lower lobectomy and right upper lobe wedge resection. Thickening and nodularity along the suture line, increased since 2019, with heterogeneous mild radiotracer uptake most predominant snteromedially with SUV max 2 (3:83). Adjacent ground-glass changes are stable compared to the most recent CT(4:82). Airway: The trachea and central bronchi are patent. Mediastinum, hila and lymph nodes: No FDG avid mediastinal node.
CT 4/23
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.
CT 10/22
Subcentimeter nodular foci of right upper lobe ground-glass attenuation have been stable since 11/12/2021. Biopsy or close interval follow-up is recommended. Nodular foci of ground-glass attenuation measuring 3-4 mm adjacent to postoperative changes in the right upper lobe (3: 87, 3:92, 3:100) are unchanged compared to 11/12/2021. There is a stable, 2 mm fissural nodule or intrapulmonary lymph node (3:99). Calcified granulomas again noted.
CT 10/21
Lungs and pleura: Status post right lower lobectomy and right upper lobe wedge resection with unchanged postoperative appearance of the resection margin (4:71). No new or enlarging pulmonary nodule. There is chronic blunting of the right costophrenic angle and elevation of the right hemidiaphragm, which is likely postoperative. No pleural effusion. No pneumothorax.
