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What Do My Lab Test Reports Indicate?

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Posted on Thu, 7 Sep 2017
Question: A few months ago I felt what I though to be something rib like on my upper right chest, right below my clavicle. It felt like it started at my sternum and made a slight upwards curve toward my clavicle. About 3 inches long and about an inch wide. It's not very thick, but it's palatable, hard and doesn't move. I can move my skin over it but I cannot move it, itself. It is not painful. It is not round, but more like a rib crossing perpendicular across my other ribs.

I've had an X-ray done, with no abnormalities found and I've also had an ultrasound done. The ultrasound noted a 1.5x0.5x1.5 cm solid lesion. I've attached the zip file with the images and report from my ultrasound.

Once the report came back I went for the MRI with and without contrast.

The radiologist report says no mass, but I have some images I'd like explained to me as what it is I'm looking at. I found some strange images in the exact place that I have this mass.
doctor
Answered by Dr. Dr. Gopal (20 hours later)
Brief Answer:
Images appear to be normal.

Detailed Answer:
Hi I am Dr Gopal Goel Orthopedic Surgeon.
You had hard swelling 3" x 1" between your sternum and clavicle.
I have gone through all the images and did not find anything abnormal in the images. The places marked by you are most likely to be blood vessels which are branching at that site. The overall size of the images does not show swelling in corresponding area. The swelling reported in ultrasound could be a small subcutaneous cyst which may have resolved on its own.
I do not have any clinical picture of you with the swelling or the pic of swelling itself. In this case I would like to trust the radiologist and his reports. It may not be possible to understand all images.
Thanx for the question. Please feel free to ask any other question.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Gopal (2 hours later)
Thank you. Did you review the Ultrasound image as well? The pictures I provided are in the location of the swelling, and match the size reported in the ultrasound. Although I have been told veins before, it makes me interested to know what could it be, if it werent veins? Is there any test or bloodwork i can do to further along the diagnosis? They noted several 7-10 mm lymph nodes as well, so I just want to figure out whats going on.
doctor
Answered by Dr. Dr. Gopal (8 minutes later)
Brief Answer:
Seen the images and reports.

Detailed Answer:
Hi
Going by the images in ultrasound also , I could not find any major area of damage.
Yes it is possible that you had lymph node swelling in infra clavicular region which reduced so much in size that it was not seen in MRI.
There are vessels , both veins and arterioles throughout the skin and whole body and majority of them are not large enough to be named or identified specifically. They look large in images as compares to actual size.
Thanx
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Gopal (11 minutes later)
The swelling hasn't gone down at all. It's still very much there and the swelling was present at the time of the MRI. I understand the pictures make it look bigger, and I'm not arguing that it looks like veins. However, I'm not just going to take the answer you provided, as it doesn't make sense. I have a rather large "mass" on my chest, that is immovable, palpable and not painful. The ultrasound noted a 1.5x0.5x1.5 cm solid lesion inside my chest wall when they ultrasound the swelling. Where these blood vessels are joining up, is where the mass is on my chest. Although the mass feels larger, the actual "lesion" is only a little over 1 cm long, so I understand the size in relation to what I'm looking at. My issue is that there is nothing else inside my subcutaneous tissues that even remotely resemble what I'm seeing on the images. I've looked all through the MRI and tried to compare the right as well and other images that look similar to what I'm seeing, and I don't see anything. This is abnormal, and it hasn't gone away. So my question is if it's veins, why is it swelling and hard?
doctor
Answered by Dr. Dr. Gopal (5 minutes later)
Brief Answer:
Please get a biopsy or orthopedic consultation.

Detailed Answer:
Hi
I understand your agony in not being able to identify your swelling.
As a last bit of suggestion- you could get a professional opinion by an orthopedic surgeon or if the swelling is superficial get it removed for biopsy. Biopsy is the best method to arrive at an diagnosis.
Hope to see your biopsy report soon
Thanx
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Gopal (7 minutes later)
That makes sense. Ok, I'll be chatting w/ my doctor on Thursday and see what the next steps are. He is trying to get me a PET scan, but I guess it's difficult with an HMO and the MRI results say there is "nothing." Anyway, thanks for the information, I appreciate it :)
doctor
Answered by Dr. Dr. Gopal (2 minutes later)
Brief Answer:
thanks

Detailed Answer:
Hi

Thanks and welcome.
Would like to see biopsy report.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

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

Orthopaedic Surgeon

Practicing since :1983

Answered : 1538 Questions

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What Do My Lab Test Reports Indicate?

Brief Answer: Images appear to be normal. Detailed Answer: Hi I am Dr Gopal Goel Orthopedic Surgeon. You had hard swelling 3" x 1" between your sternum and clavicle. I have gone through all the images and did not find anything abnormal in the images. The places marked by you are most likely to be blood vessels which are branching at that site. The overall size of the images does not show swelling in corresponding area. The swelling reported in ultrasound could be a small subcutaneous cyst which may have resolved on its own. I do not have any clinical picture of you with the swelling or the pic of swelling itself. In this case I would like to trust the radiologist and his reports. It may not be possible to understand all images. Thanx for the question. Please feel free to ask any other question.