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What Does A Lymph Node Showing Up On A PET Scan Indicate?
Question: My dad has 1 aortocaval
Lymph node light up on pet scan . It is 10mm in size . What can be done re this and is this serious issue ?
He had colon cancer surgery this year and the bowel tumor
Was removed and he was a dukes c1.
Lymph node light up on pet scan . It is 10mm in size . What can be done re this and is this serious issue ?
He had colon cancer surgery this year and the bowel tumor
Was removed and he was a dukes c1.
Brief Answer:
Need to wait and watch
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.
Based on your query, my opinion is as follows:
1. PET scan is known to give false positives due to infection or inflammation.
2. Previous stage C-1 suggests lymphnode involvement locally. During surgery, I assume, all lymphnodes enlarged were removed. I think, chemotherapy was also given.
3. As this was not present at that time, nothing further was possibly suspected. A histopathology would confirm the diagnosis. However, the location being deep, surgery could be complicated. If that lymphnode is positive for tumor, then other lymphnodes at different locations could be involved. This will change the stage and make the prognosis poor.
4. Repeat PET scan after sometime, if still enlarged needs to go for biopsy.
5. Difficult to say not a serious issue, however PET scan can give false positives.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Need to wait and watch
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.
Based on your query, my opinion is as follows:
1. PET scan is known to give false positives due to infection or inflammation.
2. Previous stage C-1 suggests lymphnode involvement locally. During surgery, I assume, all lymphnodes enlarged were removed. I think, chemotherapy was also given.
3. As this was not present at that time, nothing further was possibly suspected. A histopathology would confirm the diagnosis. However, the location being deep, surgery could be complicated. If that lymphnode is positive for tumor, then other lymphnodes at different locations could be involved. This will change the stage and make the prognosis poor.
4. Repeat PET scan after sometime, if still enlarged needs to go for biopsy.
5. Difficult to say not a serious issue, however PET scan can give false positives.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Raju A.T
Is 10 mm large ?
Yea surgery removed the affected local nodes .
He started xeloda pills but after 11 weeks as he was no sure re having chemo .
But 4th cycle was stopped as scans were
Done as cea was creeping up.
There is 1 liver met (on edge) which is 16 mm and has uptake of 5.2 and 1 other lesion with no uptake .
Could this other lesion be a killed met ?
Yea surgery removed the affected local nodes .
He started xeloda pills but after 11 weeks as he was no sure re having chemo .
But 4th cycle was stopped as scans were
Done as cea was creeping up.
There is 1 liver met (on edge) which is 16 mm and has uptake of 5.2 and 1 other lesion with no uptake .
Could this other lesion be a killed met ?
Brief Answer:
The other lesion, could be healed lesion.
Detailed Answer:
Hi,
Thanks for asking again.
Yes, 10 mm is large. However, even 15-20 mm can be seen in inflammation. However, due to the presence of liver metastasis, the enlargement could be more due to metastasis possibly.
The other lesion with no uptake could be an healed lesion. It could be an area of fibrosis. Difficult to say a killed met, unless a previously positive uptake scan followed by another, which showed no uptake. It is an healed lesion, cause difficult to identify now.
A creeping up CEA indicates a possible recurrence of tumor, possibly in form of metastases.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
The other lesion, could be healed lesion.
Detailed Answer:
Hi,
Thanks for asking again.
Yes, 10 mm is large. However, even 15-20 mm can be seen in inflammation. However, due to the presence of liver metastasis, the enlargement could be more due to metastasis possibly.
The other lesion with no uptake could be an healed lesion. It could be an area of fibrosis. Difficult to say a killed met, unless a previously positive uptake scan followed by another, which showed no uptake. It is an healed lesion, cause difficult to identify now.
A creeping up CEA indicates a possible recurrence of tumor, possibly in form of metastases.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What u mean by healed lesion ?
Does the liver met and 1 node mean the xeloda did not work ?
What best treatment ?
Does the liver met and 1 node mean the xeloda did not work ?
What best treatment ?
Brief Answer:
Xeloda reduces tumor completely in few cases.
Detailed Answer:
Hi,
Thanks for asking again.
Without looking at the tissue, I cannot confirm it was a killed met. As there was no uptake, I am assuming it to be a cold lesion or a healed lesion (a possible injury to any other cause)
Xeloda cannot completely stop recurrence. It can only delay and prolong the cancer symptoms free survival period. Only few cases would have complete reduction of cancer.
If the liver is a mets and also the new aortacaval lymph node is a mets, then it is possible Xeloda did not work. As Xeloda was stopped after 4 weeks, it could not possibly completely work and it was also started late.
At present, a confirmation through ultrasound or CT guided biopsy of the liver/aortacaval lymph node met to confirm the presence of metastatic tumor/ other inflammatory lesion is necessary. If its a tumor, restarting Xeloda might be necessary.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Xeloda reduces tumor completely in few cases.
Detailed Answer:
Hi,
Thanks for asking again.
Without looking at the tissue, I cannot confirm it was a killed met. As there was no uptake, I am assuming it to be a cold lesion or a healed lesion (a possible injury to any other cause)
Xeloda cannot completely stop recurrence. It can only delay and prolong the cancer symptoms free survival period. Only few cases would have complete reduction of cancer.
If the liver is a mets and also the new aortacaval lymph node is a mets, then it is possible Xeloda did not work. As Xeloda was stopped after 4 weeks, it could not possibly completely work and it was also started late.
At present, a confirmation through ultrasound or CT guided biopsy of the liver/aortacaval lymph node met to confirm the presence of metastatic tumor/ other inflammatory lesion is necessary. If its a tumor, restarting Xeloda might be necessary.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
No xeloda was for 4 months .
Is best way chemo
Here or ablation / surgery first ?
Is best way chemo
Here or ablation / surgery first ?
Brief Answer:
Chemo. Ablation/surgery - difficult due to age.
Detailed Answer:
Hi,
Thanks for asking.
Sorry.
I wanted to say 4 cycles, instead said 4 weeks.
Ablation/surgery first would be the choice, if it were to be localized tumor.
Once metastasis occurs, chemo would be a better choice to kill the cells anywhere in the body. If the metastasis is causing local problems like compression of vessel, nerve or bone and leading to complications, then only I would think of ablation/surgery first.
Not sure, how much invasive surgery/ablation, he can take due to his age and other co-morbidity, if any. Any single cell, if it has metastasized before, can become large again. Chemotherapy, if it works, will reduce any tumor size - primary or metastasis. Smaller lesion, easy to excise and other much small metastatic lesions might be killed.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Chemo. Ablation/surgery - difficult due to age.
Detailed Answer:
Hi,
Thanks for asking.
Sorry.
I wanted to say 4 cycles, instead said 4 weeks.
Ablation/surgery first would be the choice, if it were to be localized tumor.
Once metastasis occurs, chemo would be a better choice to kill the cells anywhere in the body. If the metastasis is causing local problems like compression of vessel, nerve or bone and leading to complications, then only I would think of ablation/surgery first.
Not sure, how much invasive surgery/ablation, he can take due to his age and other co-morbidity, if any. Any single cell, if it has metastasized before, can become large again. Chemotherapy, if it works, will reduce any tumor size - primary or metastasis. Smaller lesion, easy to excise and other much small metastatic lesions might be killed.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I see so chemo best at present ?
WhT it chemo does not work ? They want to start folfori and scan in 8 weeks
What is survival length like for this situation with a small
Liver met and small
Node ?
WhT it chemo does not work ? They want to start folfori and scan in 8 weeks
What is survival length like for this situation with a small
Liver met and small
Node ?
Brief Answer:
Yes, Chemo best at present
Detailed Answer:
Hi,
Thanks for asking again.
Folfori is very helpful in metastasis and is known to work in many cases and should be given.
A followup scan will helpful in confirming its active role in killing the metastases.
Survival length is very well prolonged with treatment. However, based on liver metastasis and lymphnode involvement, studies say 5 year survival of around 40% with treatment. If Folfori works, it could well add a few more years.
Hope for the best.
Folfori will definitely work in most of the cases. Be positive.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Yes, Chemo best at present
Detailed Answer:
Hi,
Thanks for asking again.
Folfori is very helpful in metastasis and is known to work in many cases and should be given.
A followup scan will helpful in confirming its active role in killing the metastases.
Survival length is very well prolonged with treatment. However, based on liver metastasis and lymphnode involvement, studies say 5 year survival of around 40% with treatment. If Folfori works, it could well add a few more years.
Hope for the best.
Folfori will definitely work in most of the cases. Be positive.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Shanthi.E
I was just very worried thinking with a liver and node it's somethjng like 12-18 months .
But in the plus side I suppose it's a small
Liver met at present , 16 mm and 1 node . Hoping that more don't appear right .
But in the plus side I suppose it's a small
Liver met at present , 16 mm and 1 node . Hoping that more don't appear right .
Brief Answer:
Improve immunity, stay positive. Continue therapy
Detailed Answer:
Hi,
Thanks for asking again.
Smaller size, means surgery necessity will be low and possibly it can be reduced faster. If Folfori works in reducing metastasis nodes or liver lesions, it will be really good.
Continue therapy and stay positive.
Ya, hope more mets dont appear.
Try to keep his immunity good through good protein and Vitamin diet (specifically Vit E, Vit C, Vit B-complex), moderate exercises and good sleep. A good immunity can slow down most cancers.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Improve immunity, stay positive. Continue therapy
Detailed Answer:
Hi,
Thanks for asking again.
Smaller size, means surgery necessity will be low and possibly it can be reduced faster. If Folfori works in reducing metastasis nodes or liver lesions, it will be really good.
Continue therapy and stay positive.
Ya, hope more mets dont appear.
Try to keep his immunity good through good protein and Vitamin diet (specifically Vit E, Vit C, Vit B-complex), moderate exercises and good sleep. A good immunity can slow down most cancers.
Hope it helps.
Any further queries, will be here to help again.
Dr. Jyothi BL
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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