I Am Wondering What Benefit There Is To A CT Scan After An Ultrasound Found 2 Enlarged Lymph Nodes I'm So Confused How This Is Any Benefit? Neither U.S Nor CT Can Give A Confirmation Of Any Kind Of Cancer Whether Primary Or Secondary, So I'm Very Confused Why They Would Do This As The Next Step?

Posted on Mon, 20 Feb 2023

Question: I am wondering what benefit there is to a CT scan after an Ultrasound found 2 enlarged lymph nodes. One was the right supraclavicular. Instead of a biopsy, why do a CT scan? It seems an unnecessary step? What can a CT scan show, that a Ultrasound can't. We were told by the lady doing the scan, that the request was to look at the 2 enlarged nodes. I'm so confused how this is any benefit? Neither U.S nor CT can give a confirmation of any kind of cancer whether primary or secondary, so I'm very confused why they would do this as the next step.

Answered by Dr. Monish De (1 hour later)

Brief Answer:
CT scan is more accurate in determining type and size of lymph nodes

Detailed Answer:
Hi

Yes you are right as you are having 2 enlarged lymph nodes biopsy test is the confirmatory test to rule out cancer

But in order to accurately do the biopsy CT scan is more accurate in locating the exact position and type of lymph node such as indicate lymph node is suspicious of malignant are not

Also the exact size of lymph node is more accurately indicated by CT scan rather than US and all lymph node 2 cm and more in size are suspicious of malignancy

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Monish De (48 minutes later)

Were you able to see the images I attached? Are they suspicious as suggested? Do they indicate a likely malignancy?

Answered by Dr. Monish De (1 hour later)

Brief Answer:
Unlikely malignant

Detailed Answer:
Hi

I have gone through your reports

They do not indicate to be suspicious

But for more accurate diagnosis and determining the size of lymph nodes CT scan and biopsy are necessary

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Monish De (51 minutes later)

Ok. I'm confused now. Previously you said any lymph node larger than 2cm is suspicious for malignancy. One of the images is of the right supraclavicular and is 2.68 cm x 1.64

Thanks for your help.

Answered by Dr. Monish De (12 minutes later)

Brief Answer:
Benign cyst

Detailed Answer:
Hi

An usg cannot determine whether tumour is cancerous or not

So as I told before though it is more than 2 cm it could be a benign condition like cyst.

But to determine malignant changes CT scan required
Thanks.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj