People who know radiology Lung Lobe QUESTION

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mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

People who know radiology Lung Lobe QUESTION

Postby mpbser » Thu Mar 12, 2020 10:01 am

My husband has an appointment (scans and consult) at MSK next month that we do not want to go to. However, I have a concern about his recent CT (Jan 19) that I could not ask at our last consult (Jan 20) b/c I got the report afterwards. My concern is that the Jan 19 report says, "Unchanged punctate superior segment left upper lobe nodules." However, left UPPER lobe has never been mentioned in any previous scan! Only the left LOWER lobe has been reported to have nodules. Could the upper and lower lobes be easily confused for each other???
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

kandj
Posts: 314
Joined: Sun Sep 27, 2015 11:29 am

Re: People who know radiology Lung Lobe QUESTION

Postby kandj » Thu Mar 12, 2020 10:50 pm

Why don't you guys want to go to the scans? It could be an error, could be something seen and not noted in the reports. Best to send a message and ask if you are concerned.
wife to DH, dx 8/15 stage IV @36, 12+ liver Mets
HAI placed 12/15
Liver resect 5/19/2016 15-20 mets (surgeon lost count)
Liver Recurrence 7/2017-radiation
Lung met 10/18 VATS
lung/adrenal gland recurrence 11/19
Adrenal ablation 2/20 VATS 3/20
Radiation: 9/20 adrenal gland, 2/21 pancreatic node
9/2021 liver, 4/22 esophageal node
7/2023 proton therapy: liver
140+ rounds of chemo and counting
Chest nodes, lung nodules, and esophageal nodes currently.

User avatar
JJH
Posts: 408
Joined: Mon Apr 24, 2017 7:26 am

Re: People who know radiology Lung Lobe QUESTION

Postby JJH » Thu Mar 12, 2020 11:15 pm

kandj wrote:...It could be an error, could be something seen and not noted in the reports...

Yes, this happens sometimes. On my 6th CT scan the radiologist commented on a spot and compared it to the same spot on the previous 5 scans. However, the previous 5 scans were done by 5 different radiologists and none of those radiologists had ever decided to report on that spot. Only the most recent radiologist decided to report it. It had always been there on the scans but was so tiny and unchanging in size that most of the radiologists had decided to ignore it in their report write-ups.
"The darkest hour is just before the dawn" - Thomas Fuller (1650)
●●●

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: People who know radiology Lung Lobe QUESTION

Postby mpbser » Fri Mar 13, 2020 7:10 am

Thanks JJH.

kandj, It's not that we don't want to go in April for his next scheduled scans. We just want to avoid MSK as much as possible as an employee (at Westchester) has tested positive for COVID-19.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: People who know radiology Lung Lobe QUESTION

Postby mpbser » Fri Mar 13, 2020 8:22 am

I just got a message from Dr. Kemeny about the scan concern/question I had. She says "nothing to be concerned about." GOOD!
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

kandj
Posts: 314
Joined: Sun Sep 27, 2015 11:29 am

Re: People who know radiology Lung Lobe QUESTION

Postby kandj » Fri Mar 13, 2020 10:57 pm

mpbser wrote:I just got a message from Dr. Kemeny about the scan concern/question I had. She says "nothing to be concerned about." GOOD!


Well that must be a relief! DH has one that was mentioned over and over again as lower right lobe. Then once it said either upper or left, can’t remember. Freaked me out. Turns out it was the same nodule (which did turn out to be a met) and someone either screwed up reading it or reporting it. Wasn’t really an issue till they saw growth after a chemo break.

Sorry about the person testing positive. We left NYC on Tuesday and I felt like we were getting out of Dodge. But now back here in Texas there are lots of cases and apparently even more presumptive ones. Trying to hunker down with my Clorox wipes
wife to DH, dx 8/15 stage IV @36, 12+ liver Mets
HAI placed 12/15
Liver resect 5/19/2016 15-20 mets (surgeon lost count)
Liver Recurrence 7/2017-radiation
Lung met 10/18 VATS
lung/adrenal gland recurrence 11/19
Adrenal ablation 2/20 VATS 3/20
Radiation: 9/20 adrenal gland, 2/21 pancreatic node
9/2021 liver, 4/22 esophageal node
7/2023 proton therapy: liver
140+ rounds of chemo and counting
Chest nodes, lung nodules, and esophageal nodes currently.

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: People who know radiology Lung Lobe QUESTION

Postby mpbser » Sun Mar 22, 2020 1:14 pm

I haven't been to this forum in a while. Thanks so much for the comment, kandj. Glad you are out of NYC.... Mayor Bill De Blasio stated on the news today that NYC is 10 days away from running out of ventilators and protective gear. Scary times! Stay safe!
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED


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