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dissecting CT

twinthings's picture
twinthings
Posts: 409
Joined: Jun 2013

Hey y'all,

I received my CT report in the mail today.  I don't go back to my oncologist for 3 months, at which time, I guess he'll discuss these findings with me.  Until then, I'm left to interprate them on my own, with the help of google, of course.  And hopefully, y'all. 

The CT Chest Impression is negative for thoracic mets.  Wonderful news!!  However, the report does make note of "A mediastinal lymph node measuring 0.9 cm is at the upper limits of normal by size".  That doesn't sound like a big deal...until I read about it.  I guess I just wouldn't have thought that 1 node on the large side of normal, would be noteworthy...unless...

The CT Abdomen Impression is negative for abdominal mets.  My lone left kidney, spleen and adrenal glands are unremarkable (no mention of pancreas).  Perfect!  However, there is a benign splenule measuring 1.5 cm.  Sounds harmless...until I read about it.  What I have learned is that, splenunculi, aka accessory spleens, are small nodules of spleen that are detached from the rest of the organ.  They are congenital and composed of normal splenic tissue.  I pretty much read the same thing on each site I searched, and that is that they are common, seen in 16% of abdonimal CT's, they are benign and asymptomatic, "their importance mainly related to the need to distinguish them from more sinister pathology".  Apparently, if during CT with contrast, the splenule does not enhance in the same fashion as the adjacent spleen, then alternative diagnoses should be entertained, most of which, start with a 'c'.  Naturally, the first thing I did was refer to my May 1st (2013) abdomen CT (it was performed at different facility).  There was no mention of a 1.5 cm anything.  Furthermore, if it's a benign splenule and they are said to be congenital, then it most certainly would have been seen before now, if it's been there since birth.  Right?   I think it begs the question, would it enhance like normal spleen tissue?  Wouldn't it be worth the small risk to my kidney to do a CT with contrast, to be sure?  I mean, if it goes from zero to 1.5 cm in 8 months, should I be waiting another 3 months for contrast?

And finally, I have a small broad-based ventral abdominal hernia containing nonobstructed bowel and fat.  Yay me!!

I think it's fair to say these things are harmless because the doctor didn't think them worthy of a phone call. 

Anyway, if any of you have had similar things show up in your post-op CT's, I'd love to know what came of them.  I'm going to do a bit more research and then I'm walking away from it.  I promised myself I would not continue to let my fear of cancer consume my thoughts and I'm going to keep that promise.  I. will. not. obsess.  I have better things to do.

Thanks for your thoughts!

Sindy 

GSRon's picture
GSRon
Posts: 1304
Joined: Jan 2013

Oh Sindy..........  sounds really good to me..!!  One thing I learned, is that different facilities sometimes read scans differently.. Heck they may even do them somewhat differently as well.  So, the first place may not of mentioned things that they think are normal.  Just like the new scan did not mention some organs.  Now to me a real thorough reading would mention everything.. but that often is not the case.   And as you likely know, that one node could be doing what it is supposed to do...  any signs of a sniffle or cough..?    For now, nothing big has shown up... so until the next scan, well.. try hard to smile and move on... 

Ron Sealed

etrainor's picture
etrainor
Posts: 8
Joined: Dec 2011

Hello Sindy,

If I were you I would contact your oncologist and ask to come in a see her/him and have them read the report with you. I don't think most physicians expect you to wait that long for CT results. That can cause a great deal of stress.

My doctor at Standford always orders my scans rigth before I'm suppose to see her, just for that reason.

Good luck,

Colleen

 

icemantoo's picture
icemantoo
Posts: 3227
Joined: Jan 2010

Sindy,

Probably nothimg. However you just saw the Oncologist and you should not be on edge for another 3 months. How about a simple call to the Oncologist--- Just saw you but I do not understand the CT report dated---Is there anything I should be concerned about the next 3 months?  Please advise either way.

 

 

Icemantoo

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

Hey Twinnie, if I have learnt anything over the last few months it is to ensure that you go over your results in depth with your Surgoen/Oncologist. It is their duty of care, you should not be left to interpret/misinterpret yourself. If you have any concerns and need clarity you would be wise to go and see them. As you say there is probably nothing of real concern in the report, but hearing that from the doctor will give you three months peace of mind.

I have discovered to my cost that it is just too easy for small anomalies to be missed. So make sure you get expert clarification!

 

Djinnie x

Srashedb
Posts: 482
Joined: Dec 2013

Sindy:

i read my husband's scans with google supplementing my education; three days later, his oncologist reviewed the scans and set us at ease.

Moral: call the onc and have him/her review them thoroughly with you. As I recall, the thumbs up came from the doc through the receptionist. Doubt that additional scans are needed but a review is.

Sarah

foxhd's picture
foxhd
Posts: 3183
Joined: Oct 2011

I think what you have is a detailed description of what the radiologist observed. Sort of like a real estate agent highlighting a property. I also think that if this wasn't your first scan interpretation from him or her, they could have used only one word. "Unremarkable."  Your scan shows several old issues you've had. I don't think there is anything of immediate concern here.

dhs1963's picture
dhs1963
Posts: 510
Joined: May 2012

The result of the CT scan should be compreshensive, and not just regarding the cancer.  They are looking at everything, not just the reason for the scan.  As an example, on May 1, 2012, the scan was to look for bowel obstructions or something.  No problem there, but they reported on a solid mass on the Kidney.

Now, I read the reports...heck, I even look at the scans.  They tell a lot about things that are a non-issue...I have the possible accessory splene too, though mine might be the result of a partial rupture when I was in my 20's.  You look for key words...enlarged lymph nodes are a concern.  But, a single enlarged node could be from an infection.  Over time, if you have enlarged nodes that are growing, that may be more of a concern. 

cubsfan9
Posts: 66
Joined: Oct 2013

Good Morning!

My husband has all of his scans done at the same place.  The difference is the radiologist who reads them.  One time we had a very detailed report that mentioned things never reported in the past...nothing was a problem, just "an observation".  Discussed this with the oncol when going over the report and he reassured us that all was well.  In October, the person who wrote the report spent 95% of his time discussing my husbands' spine!  He had back surgery 12 years ago and had some 'hardware' put in.  Well, this CT report went from vertebra to vertebra explaining the arthritis, etc.  and when it came to his lungs and pancreas (the organs of concern!) it said they were "unchanged from previous scan".  I blew a gasket!!!  The latest scans were done on Friday and we will go Monday to get the results.  I can hardly wait to see who the radiologist is this time.  I wish I could make a request and have the same person each time.  Oh well...just have to have confidence that the oncol and urologist, who also review the scans, will be alert to anything that needs attention.

Sorry for the rant, but this thread hit a nerve!!  ~Sharon

foxhd's picture
foxhd
Posts: 3183
Joined: Oct 2011

There is alot to discuss from a radiologist point of view. However, they need to concentrate on the reason why the scan is being ordered. In our case it is for metastesis or primary tumors. Other details should be addressed as such. We used to have medscan man on board and he helped interpret radiologist readings. He hasn't been around in a while.

a_oaklee
Posts: 446
Joined: Nov 2013

Your scan results sound like a good report to me, but I would still want to go over the results with the oncologist. 

When my husband has his scans, he is given the CD, but not the written report.  We get the written report at the appointment which is the following week.  I'm glad they do it that way because we would most definitely worry about what we don't understand.  Sometimes the oncologist loads up the CD and shows us the scan image.  My husband has bone mets.  One time we went to a local clinic to have the scan done.  That was a mistake.  The machine wasn't of the same quality and the report didn't have any measurements.  Our oncologist made a request for the scan to be re-read and to include measurements.  We have since made the decision to travel to the medical center to have all scans done in the same place.  The reports are detailed.

Suekub's picture
Suekub
Posts: 137
Joined: Apr 2013

hi Sindy

I can't really help with your scan report. Whenever I have a scan I do not get results until I see my doctor which is generally within 24 hours of the scan so there is no misinterpretation of the report. I know the report can sound sinister when it is not.

I would agree with the other suggestions of speaking with the oncologist.

Sue

 

twinthings's picture
twinthings
Posts: 409
Joined: Jun 2013

Thanks for all the thoughts and words of wisdom. 

I have decided I am going to put it out of my mind for now and will deal with it again in April or May (wish me luck).  If the truth be known, work has kicked in to overdrive and frankly, I am too busy to worry about it.  That's a good thing!

Because my home and my job are 1200 miles apart, I am severly limited on when I can see my oncologist.  Returning home once every 2-3 months means I have to schedule tests one visit and follow up on a subsequent visit.  So, to no fault of the doctor, it makes for long wait times.  I suppose I could call him directly but will, more likely, just wait it out. 

I hope my mind over matter approach doesn't bite me in the booty later on.

icemantoo's picture
icemantoo
Posts: 3227
Joined: Jan 2010

Sindy,

 

At least try the phone call I suggested.

 

Icemantoo

texMD
Posts: 13
Joined: Jun 2013

Your CT scan report looks great so congrats on that. I would not stress about it.  The mediastinal node and splenule should definitely be watched with repeat scans which you'll get anyway, but please don't lose sleep over it.  You should feel absolutely free to contact your doctor so he/she can take a look at with you.  At the very least, they could have a nurse call and re-assure you after they review your questions.  I'm sure they do not want you wait 3 months to have your issues addressed. As a physician, I try to make sure I review scans with my patients after the study so there are no lingering questions.  Best of luck.  

Galrim's picture
Galrim
Posts: 305
Joined: Apr 2013

Hi Sindy,

I certainly understand your thoughts and fears here, as I had more or less the same experience post-op as you. No word from my onc or surgeon regarding 90% of the observations made on the scans. Had a couple of lung nodules they wanted to watch in my follow-up scans, other than that I was "cured".

Then I got hold of my journal and started reading...

Lever cysts, a cyst on my remaining kidney, two enhanced lymph nodes neck and lower abdomen and God knows what else.

"Panic! Did they miss something? Idiots! Morans! I will sue their****** off...I will be dead from mets within a year and they didnt tell me or overlooked it. Bastards!"

I wont recap all the conversations that followed but just quote my onc: "If we have a 100% certainty that something on an ex-cancer patient scans are benign, we dont inform them about the observations as it only adds to their stress level and lower their life quality. And I didnt do it in your case either. Blame me if you want to, but I stand by that anytime."

Thats 3 years ago...and so far he has been right in all aspects.

Bottom line Sindy, I cant, no one in here can, judge whether or not the findings gives reason to be worried. If I were you I would however find some comfort in the fact they havent called you in for further testing or scans, thats normally a pretty good indication that none of the findings are causes for alarm.

/G

todd121's picture
todd121
Posts: 1425
Joined: Dec 2012

Now I usually just look at the summary. That's the important stuff.

I've looked and compared CT-to-CT a few times, and things have come and gone on the reports. When I asked about them, I was told that it's up to the radiologist to report what he sees in the detailed section, and stuff he doesn't think is important, he won't even mention those things. Whereas the next radiologist might mention them. If it's been seen before and unchanged (and not interesting to start with), they might not mention it.

I think the summary part at the end lists the important stuff, and all the stuff at the top is fluff, like in English class where you had to write a 200 word essay, and you really only had 100 words to say, so, well, you get my drift.

Do you know how much radiologists get paid? They have to write something! If they don't, they might feel bad for getting paid hundreds of dollars for spending 5 minutes looking at your scan. (Actually, does anybody know how long they actually look at it? I've only heard other docs complain how wel they get paid for spending a few minutes looking at a picture and not having to interact with a patient....) Still, thank God for them. I might not be alive if it wasn't for that CT scan 13 months ago.

I think you're fine. But do ask.

Todd

Billy's Wife's picture
Billy's Wife
Posts: 52
Joined: Jan 2014

Hi Sindy,

I agree being busy with work is a good thing and that I wish we could always get the same radiaologist to do reports.  It is so frustrating to see something on one report but then it disappears on the next and reappears later on down the road.  Patients need to be pro active but as lay people it is hard for us to read these things without getting concerned.   

 I couldn't read my husbands reports because it left me too sleepless.  I had to rely on the doctor to do so. Our family doctor sometimes went over it with me in order to tell me if there was anything else we should be concerned about.  I understand your wanting to wait but agree with those who encouraged you to talk to the oncologist and review the report to your satisfaction.  Oncologists and radiologists are people too and should understand your need for peace of mind. 

You are entitled to peace and good health.

Arleen

 

 

 

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