Here is a question received from the case submission form:
Patient is a 66 years old Male, Smoker since last 30 years. Hypertensive too ( IInd class)
Presently, C/O an edpisode of Haemoptysis in June 2006. Lasted for 1 and 1/2 days.
A similar episode of Haemoptysis occured in year 2002. The HRCT report at that time indicated : Small (.8cm) pre-tracheal,Right para tracheal sub-carnial lymph node. The patient was subsequently diagonsed with RENAL Stenosis and a stunt was placed without incident.
Data: Chest xray showed a small patch of moderately dense,streaky opacity at left base with localized loss of definition of cardiac apex
MRI findings : 1. Fibre lesion in right middle lobe. 2. No evidence of pleural effusion/thickening. 3.Small sub-centrimeter, pre tracheal, right para tracheal sub carnial lymphnodes. However, no evidence of significant mediastinal lymphadenopathy.
FOB + Biopsy : Bronchial mucosa shows foci of inflammatory cells in the stroma and focal area of squamous metaplasia.
Question: Is it Lung cancer : Stage 1? If not, appreciate if you can guide us further.
Subscribe to:
Post Comments (Atom)
3 comments - CLICK HERE to read & add your own!:
I would consider that a non-diagnostic (rather than negative) bronch and would go after more tissue. What is the size of the right middle lobe lesion? A PET scan may assist in choosing the re-Bx site (mediastinoscopy vs. CT-guided FNA).
since the lesion is only 0.8cm and he only had 2 episodes of hemoptysis in 4 years...i seriously doubt this is cancer...since the nodule is only 0.8cm a pet scan might not be too effective...is his pft good enough for surgery(vats if its peripheral)..this might be a granuloma or hamartoma
The squamous metaplasia does not necessarily imply cancer; it is also in line with an inflammatory process, which was seen in the stroma of mucosal biopsy. I would consider following these findings with serial CT's (every 3 months) to assess for change in size. I would not intervene unless there is growth of these nodules.
Post a Commenttest post a comment