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Hi, I need a little help on lung biopsy information.

cinnamonsmile
Posts: 1049
Joined: Dec 2010

Hi, I am a cross over from the breast cancer discussion boards.

I have been having a cough problem since January 2013.I had influenza and I figured it settled in my chest and aggravated my asthma. I went through heck in 2007 with a cough like that. I finally got a little relief in part of April.

In late April, the cough turned to a terrible cough again, crackling when I exhale when sitting or lying down, a terrible wheeze and chest tightness. I do have asthma. 

In February 2013, I had an xray done for appenidicits. Because of mistakes made during the surgery, I got all my medical records. The left lung showed atelectasis. My doctor told me to ignore it. But put me on 14 days of Levaquin. No relief. She put me on 10 more days. I called in to say no relief and the nurse told me to go to the walk in immediately because something serious was in my lung. I argued that most of the time when I go to the walk in, they don't do anything.

Well, I went, and the doc said nothing he can do for me but send me to a pulmonologist.

I saw him. He ordered a CT Scan and some pulmonary function testing. The results came back. Yes I have asthma, but the CT Scan showed problems in the left lung and two slightly enlarged lymph nodes.

I like my pulmonologist. He says he will find out what is wrong with me.He wants a biopsy and two slightly enlarged lymph nodes removed. He did bring up cancer. He said it didn't look like cancer, but of course, can't know 100% until the biopsy. He did say it could be any number of diseases.

I was too shocked to ask how large the area is, etc. I will have a list for my appt. with the thoracic surgeon.

The lung doc said I would be in the hospital a couple of days.

I was wondering if anyone of you could share whaht the basic lung biopsy is like, and removing two lymph nodes? I would greatly appreciate any responses. What is the recovery like for those that had it?

I already have Lymphdedema on the chest and have severe pain issues from the nerves being nicked during surgery. I imagine my recovery will be a bit more painful due to the neuropathy.

Thank you.

dennycee
Posts: 685
Joined: Mar 2011

There several few ways they can do a bx and location of the nodes will dictate which type they do.  I'm sure you are familiar with the fine needle bx, it is done musically in conjunction with a ct or US.  The second is an EBUS, or endobronchial ultrasound, and finally a surgical wedge or lobectomy.  With the wedge a section of the lung is removed and the tumor tested.  Lobectomy is removal of the lobe,  both surgical options include the removal of lymph nodes for testing.   It is possible to do either by way of a video assisted thorachotomy surgery (VATS) which is minimally invasive.  

If the nodes are smaller than 10cm they are too small to bx.  When they do the bx ask them to get enough tissue for genetic mutation testing.   Have they mentioned whether or not the think this is a new primary?  Breast mets? Scheduled a PET exam or head MRI? 

I look forward to learning more.  

cinnamonsmile
Posts: 1049
Joined: Dec 2010

Hi dennycee, you gave me just the basic information I was looking for to keep my mind calm while waiting to the see the thoracic surgeon.

So far all I have had is an xray which found something in the left lung by accident back in February, and a CT Scan done on July 11th.

He gave me the regular speech that it doesn't look like cancer to him (but they said my breast cancer lump didn't FEEL like a BC lump) and that he can't be positive until the pathology report comes back. He said it could be some disease and he asked me if I had irish or german ancestry. I said lots of german ancestry and he said that there are some lung diseases that only those with German/Irish Ancestry.

I really don't know much about lung issues. That brings up an interesting issue I will ask the thoracic surgeon: Is there a genetic mutation testing for a lung disease?

I know for breast cancer, there are gene mutations that make us high risk for BC and Ovarian Cancer.

Are there genetic tests for lung cancer?

My last head MRI was back in the spring of 2012 (I have leukoairoses on the brain, its like plaque on the white matter).

My lung doctor sounds like he isn't going to guess what it is. He said it could be cancer, but probably not or some lung disease, but can't know until it comes back from pathology.

What he does know, is that he is determined to find out what is wrong with my lung.

I am assuming that since the 2 lymph nodes that need to come out will be greater than 10 cm, because the are slightly enlarged.

I really would like to thank you for your clear, well thought out words. I appreciate it so much.

I already have my list of questions going.

Of course my brain was number while talking with the lung doctor and I have so many questions forming already. Having breast cancer, I guess, prepared me on how to deal with this (not to say I am not still in a bit of shock) and figure out questions, as well as the CSN Boards.

Anyway, thank you so much.

 

dennycee
Posts: 685
Joined: Mar 2011

There are a few useful mutations in non small cell lung cancer adenocarcinoma. I am not an authority here but I will share what I do know.  The two most useful are the egfr and alk.  

The oncologists who monitor the boards at cancergrace.org are probably best to ask about mutations.  They have written a number of plain English papers discussing them.  please stay in touch.   

ToBeGolden's picture
ToBeGolden
Posts: 697
Joined: Aug 2010

I had a fine needle biopsy. Unfortunately, the lung collapsed (pneumothorax), and I got to spend a day in the hospital with a chest tube. All in all the whole procedure was virtually free of pain/discomfort. The hole in the lung wall sealed without any adverse effect. Unfortunately, the biopsy in my case came back positive for lung metastasis. Rick.

cinnamonsmile
Posts: 1049
Joined: Dec 2010

Thank you for the information. I really do appreciate it. I am interested to know if it is cancer, or what disease it could be (especially if it is a disease that follows Irish/German lineage).

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