September 1, 2006 - An Encouraging-Sounding Report

This afternoon I go to Atlantic Medical Imaging for more scans – CT scans of the abdomen and pelvis, to be exact. Joanne from Dr. Lerner’s office phoned me yesterday, to say the doctor wants CT scans, in addition to the PET/CT fusion. She explained that the amount of detail visible on the fusion scan is not as great as he prefers to see.

Joanne managed to get the scan scheduled for the very next day – today – and got immediate pre-certification from my medical insurance. Because I’ve just had a CT scan of the lung on Monday (along the with PET/CT fusion), I don’t need to have that one re-done. Just the abdomen and pelvis.

Today’s scans go smoothly enough – drink the contrast fluid ahead of time, get poked in the arm for the IV contrast infusion, lie down on the table with arms over my head, hold my breath when the disembodied machine-voice tells me to – the usual.

As I’m talking to Kathy, the technician, I explain about the call from Dr. Lerner’s office, and how it happens that I’ve come in so soon again. I ask her if it’s a common thing for doctors to want a CT scan in addition to the PET/CT fusion, and she says it is. Some doctors will wait to see the report from the fusion scan before deciding they want the supplementary CT scans, while others routinely order both at the same time.

Reading between the lines of my question, Kathy tells me the narrative report from Monday’s scans is in my file, and offers to make me a copy of it. Sitting in my car in the parking lot after the test is finished, I wade through the medical jargon, and come upon these words:

“There is no abnormal hypermetabolic activity in the neck, skull base, abdomen, pelvis or upper thighs.” Towards the end, in the summary, the pathologist repeats, “No hypermetabolic activity to suggest pathologic lymphadenopathy in the neck, chest, abdomen or pelvis.”

Although I’ll have to wait for Dr. Lerner to confirm this when I see him this coming Wednesday afternoon, this sounds like good news to me.

As for the spot on the lung, there’s still something there, but it appears to be a bit smaller than whatever it was that showed up in May. It also appears to be of a non-cancerous nature.

From the narrative report of this past Monday’s CT scan:

“The centimeter sized nodule of interest is seen in the right middle lobe on the prior study. On today’s study, this area has an appearance more suggestive of scarring and is not hypermetabolic. This area also appears smaller on today’s study.... There is a triangular area of interstitial disease in a small portion of the superior segment of the right lower lobe... There is an area of scarring in the right middle lung. Just posterior to this, there is a tiny, triangle-appearing nodule approximately 2 mm also likely reflecting scarring. I do not see a centimeter sized nodule as was described on the prior reports within the right middle lobe.”

From the summary: “On PET/CT scan, also performed today, there is an area of hypermetabolic activity in the superior segment of the right lower lung corresponding to an area of interstitial lung disease on the chest CT. I would favor this to reflect an inflammatory or infectious etiology...”

Bottom line? As I read the medical jargon – and, again, I’ll have to wait to hear from Dr. Lerner for the final word – it looks like the lung abnormalities are scar tissue, from some past or present lung infection of as-yet-unknown origin.

It will be a lot easier to wait for Wednesday’s appointment, having read the encouraging-sounding PET/CT fusion report.