患者信息: 41歲

  • 2 年
    胸悶,胸痛,有時到背痛
    醫生,您好:

    今年我CT 掃描發現左上胸邊有1.5 cm 的腫塊, 肺門附近淋巴結1.5cm腫大.我去看胸腔科醫生. 醫生說這看起來不像cancer. 但建議我手術切除,因日後有30% 機會轉化成癌細胞.他建議我先做PET/CT. 後來我做PET/CT. 報告如下:
    There are FDG-avid lymph nodes in the neck. Two are in the left and right upper posterior triangles with maximum standard uptake values of 3.2 on the left and 2.2 on the right. Two are in the anterior triangles at the level of the angle of the mandible bilaterally. Maximum SUV on the left is 4.1 and on the right is 3.1.
    Evaluation of the thorax reveals the branching lobulated left upper lobe mass with maximum SUV is 1.8. This measures 1.5 x 1.0 cm and is unchanged. There is an FDG-avid left hilar lymph node with a maximum SUV of 3.2. There is an FDG-avid mediastinal lymph node in the aortopulmonic window with a maximum SUV of 2.8.
    Impression :

    1. Left upper lobe lung mass seen on outside chest CT is unchanged in size. There is a maximum SUV of 1.8. There is a borderline uptake value. This nodule may be malignant or inflammatory.

    2. However , There is hypermetabolic activity in at least 4 lymph nodes in the neck as described above, as well as the left hilum and mediastinum. These are suspicious for metastatic disease or lymphoma. Tissue sampling is recommended.

    當我看到報告有6個亮點時.我感到很惶恐.因爲PET/CT是診斷癌症篩檢很好的利器.病理師幫我取左邊亮點最亮的淋巴結作了細針抽吸細胞學檢查( fine needle aspiration cytology). 結果沒有發現癌細胞.醫生說3個月候再作PET/CT.令我沮喪的是,PET/CT 準確性高達90%. 卻還不能做確認的診斷.而且醫生也不可能6個亮點都作細針抽吸細胞學檢查.我的朋友得子宮癌.子宮内的3個淋巴結出現亮點.切片只有一個有發現癌細胞.我想請教您的是,
    1. SUV如何解釋是否有癌症?
    2. 是否還有其他輔助性的檢查能確認我脖子上淋巴結的亮點是發炎,代謝疾病或者是癌變呢?


    謝謝您的解答。

    2009-05-13 11:27:29

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