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Stressed!

LLewis
Posts: 4
Joined: Mar 2013

Stressed~a good place to start! In 2011 I was disabled with COPD (Asthma & Lupus). In January I went to the Dr with an infection or possible pneumonia.  I had been on antibiotics for 10 days, 5 days off, then another 10 days with a week off and each cycle I began to feel better until the antibiotic was finished. A stronger antibiotoc and O2 to wear at night and on exertion until cleared up, plus my Dr. sent me for a chest x-ray.  That showed that the aeration was better than seen on previous x-ray of two years prior in the lower right lung.  Hyperaeration with an increase in AP diameter with flattening of the hemidiaphragm.  Heart is not enlarged.  Questionable fullness of right hilium not previously seen.

Conclusion:  COPD but no acute pulmonary disease process.  There may be some fullness to the right hilium.  Perhaps CT Scan is indicated.

So CT Scan w/contrast on Feb 27th -  There are a number of bullae and blebs identified.  there are non-specific changes, there may be more aggressive interstitial process involving right lower lung posteriorly, no similar finding on the left.  Unfortunately no previous CT for comparison.  Density seen about the left upper lobe in midline right behind sternum measures a little over cm. There is indeed right hilar adenopathy with a pair of lymph nodes one measuring 1.6 cm and 1.3 cm.  This is probably what is behind the findings on the chest xray.  No left hilar adenopathy.  No subcarinal adenopathy.  Those lymph nodes which are visualized appear to be less than 1 cm.  Aortopulmonary windo is clear, no pleural effusion, no pericardial effusion.  Scans which incorporate upper abdomen fail to demonstrate a mass involving the liver or adrenal glands.  No definite paraaortic adenopathy no lytic or blastic lesion see involving visualized spine.  

Conclusion:  Right hilar adenopathy.  Etiology for this uncertain altho there is an interstitial process involving the right lowr lung posteriorly.  This does raise the possibility of a cancer.  Other interstitial changes very well could be chronic in nature.  Density behind sternum is of unknown etiology.  Theoretically could be a cancer as well, but no left hilar adenopathy is identified.

Onto a PET Scan 3/12/13.

Basically my understanding is so far, I know something is going on.....but not what! Does this mean it is too early for a CT scan to detect, thus onto PET Scan for biological changes?  I am so confused! This conclusion reminds me of today's weather forecasts, which cover every possibility from sunny, cloudy, rain, to snow!  When telling me he wanted a PET scan, said to rule out cancer, but other than the Lupus, I can't imagine it's anything but.  

I am going with the worse case scenario, just because it is easier to be prepared, but I just don't know.  My mind is spinning with all this information!

dennycee
Posts: 607
Joined: Mar 2011

Hi and welcome to the lung board!

each of us has been where you are at at some point or another, whether as patient or caretaker.  It is scary, we call what you are going through scanxiety.  I will try to break it down as best I can and as far as my knowledge extends. 

The ct and the pet scans measure two different activities.  The ct measures the actual size of something.  The radiologist uses it to locate points of interest and compares each new ct to previous ones to measure growth or shrinkage.  The pet scan evaluates body mechanisma in the way it uses sugars.  Cancerous cells burn sugar faster than healthy cells in a measurement called a Standard Uptake Value or SUV.  The higher the SUV number there greater the probability that a mass of cells is cancerous.  One problem with the Pet is that it cannot distinguish between infection (which will give a false positive) and a cancer.  Only a biopsy can tell them what it is for certain.  

Pulmonary fibrosis is another possibility.  

Hopefully this will help a bit and give you something to use as a basis for additional questions.  I look forward to hearing more from you.  

LLewis
Posts: 4
Joined: Mar 2013

Perfect name for it!!  Actually, it helped a lot.  Your explanations of the two were very clear and easy to understand.  Much clearer than anything else I have seen.  I'm certain once I have thought about it, I will have additional questions!  Thank you so much for the wonderful answer!! Smile  This is a confusing path!!

katenorwood
Posts: 1740
Joined: May 2012

Hello there !

Reading your post, I understand where you are coming from.  I have had asthma all my life, and have scaring in my lungs from this.  I have emphasemia (need spell check) changes, and severe COPD.  I had a scare with a new nodual of 4 cm's in my right lower lung last Dec.  I do have many nodes that are under 1 cm. in both lungs that haven't changed in the last yr.  They did a vats wedge resect, and found that the mass was not cancer, just worn out dead lung tissue.  I know with copd, our lungs are not in the best of shape.  Once the tissue is gone it's gone.  I also have issues with a head and neck cancer, that is common to spread to the lungs.  So I'm kinda in muddied waters.  The doc's are trying to figure out what's what with this mess.  A PET/CT would be a great test for your team to use.  I wish you luck, and yes please keep us posted !   Katie

LLewis
Posts: 4
Joined: Mar 2013

Thank you!  This is definitely a muddy path.  Figures....after all where I am in Maine, it is mud season!!  Well, I go Tuesday for the PET

scan.  Hopefully I will hear something relatively soon.  Between the COPD and the Lupus, I have no idea what to really expect.  Interstitial lung disease goes with Lupus as well.  So I know either way, it's going t be a challenge.  I wish you luck as well, and thank you for the warm welcome!  Linda

LLewis
Posts: 4
Joined: Mar 2013

Thank you!  This is definitely a muddy path.  Figures....after all where I am in Maine, it is mud season!!  Well, I go Tuesday for the PET

scan.  Hopefully I will hear something relatively soon.  Between the COPD and the Lupus, I have no idea what to really expect.  Interstitial lung disease goes with Lupus as well.  So I know either way, it's going t be a challenge.  I wish you luck as well, and thank you for the warm welcome!  Linda

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