Postby menreeq » Sun Nov 05, 2017 8:11 pm
Thyroid:
Chest CT scans usually include only part of the thyroid. Depending on where your scan starts, it could have not been in the field of view of prior scans. Alternatively, someone could have seen it but declined to mention it because it didn't look suspicious (low density lesions in the thyroid are very common and better evaluated with ultrasound). Then, they could also have just missed it. If you're worried, ask for a thyroid ultrasound. The caveat is that lots of these thyroid lesions end up being biopsied because telling benign from malignant based on imaging is really hard.
Lung nodules:
If very small, these may not be seen from scan to scan depending on the slice thickness of the CT. It also depends on how much of a breath you take in. Some radiologists don't bother mentioning every ditzel because nodules less than 4 or 6 mm (depending on which guidelines are being followed) are "nonspecific" and could be nothing to worry about -- post infectious, post inflammatory, etc. They are too small to biopsy and too small to see on PET. Each radiologist decides how detailed to be in general.
Kidney stones:
These can definitely disappear from scan to scan (or reappear!). Drink lots of water.
As to why one radiologist does one thing and another does another. I doubt it is because one is trying to "one up" the other. Most are trying to do what is best for the patient. Some may think not mentioning every little thing will decrease patient anxiety. Others think that it is best to mention everything so that attention is paid to those things on the next scan. It is a matter of style.
CT is not the best test for most cancers of the gastrointestinal system. Endoscopy and colonoscopy are standard of care. CT colonography has yet to surpass colonoscopy as the screening test of choice.
Stage IIA rectosigmoid CC (T3N0M0)
Dx 6/5/17 @age 41ls
Workup: c-scope, EUS, rectal MRI, CT C/A/P
AdenoCA 5.5cm, WHO Grade 2, 0/22 LN, no distant mets
CEA 1.9 (6/5/17), 0.8 (2/28/18), 1.0 (9/17/18), 1.1 (4/16/19), 1.0 (9/24/19), 1.7 (7/8/20)
No lymphovasc/perineural invasion, clear margins
MSI intact, OncotypeDx RS 7
Lap sig colectomy 6/23/17, no ileo/colostomy
Genetics neg for mutations, 4 VUS
Xeloda monotherapy 8/13/17-1/22/18
PET/CT 3/21/18 NED
CT C/A/P 9/17/18 NED, 3/8/19 NED, 9/19/19 NED, 5/13/20 NED