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Another bump in the road

Skittles
Posts: 17
Joined: Mar 2010

Hi, I'm 3 months post treatment, I just had my first p e t , which did not see any cancer left, but the doctors want to do a biopsy to make sure. I am fine with all of that, butI now have swollen lymph nodes in the lungs. They were going to do a needle biopsy but now want to do an open biopsy because it is not safe to do it with needle.They think it might be sarcoidosis. I asked if this was nessasary and the doctor sais yes to make sure. Cancer has not been mentioned, I had asked if any cancer showed up anywhere on pet and she said no. I am not sure what to do. I would like to have biopsy on anal area and port removed, but not sure about the lung. Any opinions?
Lisa

mp327's picture
mp327
Posts: 3120
Joined: Jan 2010

Hi Lisa--

If it were me, I would probably seek a second opinion. Sarcoidosis is a granulomatous lesion of unknown origin. Every time I have a PET scan, they note granulomas in my lungs that are calcified, calcified being the key word here. That means they are old lesions and are not growing or changing. Mine are most likely due to histoplasmosis, a disease often found in people who live in agricultural areas. I grew up in the midwest. The disease is caused by spores in the soil that are released into the air with cultivation of the soil. They are breathed in and can form lesions in the lungs. I never knew I had this until my first PET scan--no symptoms or anything. In my case, I would certainly not jump into getting an open biopsy and would want to get a second opinion if that had ever been suggested. I'm not saying that your lesions are the same thing, just ask lots of questions before having this done.

z's picture
z
Posts: 1273
Joined: May 2009

Hi Lisa,

I'm 1 year post tx and I have a nodule in my lung. As of 8-11 it is 11mmx9mm. I will be seeing a pulmonologist on the 27th, to see what his recommendations are. I will see a Thoraic surgeon on the 31st. With the nodule they will more than likely want to remove it, as it as grown. On 5-4 pet-ct it was 7mmx8. Because I was a 35 year smoker (quit 5-4-09), have had a cancer dx and am over 50, theres a greater chance that this could be a cancer, or a metasis. If I have it removed I will want them to use the VATS procedure, as it is less invasive. The only way that they know if its cancer is to confirm it under a microscope. I know I have read where chemo will cause inflammation in the lungs. I hope thats all that happening with your lungs, and it will subside with time. I wish you well, and let us know what your decision is. Lori

Skittles
Posts: 17
Joined: Mar 2010

Thanks, If it were cancer or metasis would'nt it have shown on the pet? All my onc said is that it would not be safe to do needle biopsy. What is a VATS procedure? thanks Lisa

z's picture
z
Posts: 1273
Joined: May 2009

Hi Lisa,

On my pet-ct the nodule only showed a .08 SUV uptake, whereas, normal lung tissue was an .05. Anything over a 2.5 would be considered malignant until proven otherwise. And yes, if there were a cancer or metasis it should shown up on the pet along with suv uptake. Thats probably how they see that your lymph nodes are enlarged, but the lymph nodes must not be showing any suv uptake, which could mean they are just inflamed.

VATS is video asst. thoraic surgery. This is less invasive than the standard surgery, and the recovery is between 1 and 3 days of inpatient hospital. I am not familiar with how they remove lymph nodes, but its probably different and a much simpler procedure. I know with my small nodule, the risk in doing a needle biopsy, is that they could possible cause the lung to collapse. I don't know if thats the issue with the lymph node.

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