Morgantown, WV
A 40-year-old female asked:
Ct shows slightly enlarged mediastinal node. what is best way to rule out malignancy. stage 2b bc diagnosis 4/13. calcifications on thyroid. cysts on liver?
4 doctor answers • 6 doctors weighed in
Dr. Addagada Raoanswered
General Surgery 58 years experience
Further investigatio: By pet scan if positive , mediastinoscopy and biopsy of the node.
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Dr. Reza Shirazianswered
Radiation Oncology 22 years experience
Pet/ct, biopsy: See my answer to the similar topic. You can start with a noninvasive pet/ct to see if there is any increased metabolic uptake in the lymph nodes. If by size criteria the size of the mediastinal lymph nodes are large enough and worrisome, you can get a image guided biopsy of the lymph nodes. Tumor markers may also help if you had elevated tumor markers to start off with.
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Dr. Terri Washingtonanswered
Endocrinology 18 years experience
See Endo and Oncolog: You report calcifications in the thyroid. This should be evaluated by and endocrinologist. If small (micro) calcifications it is more concerning and given h/o breast cancer should be evaluated by your oncologist to make sure not a recurrence. Imaging can help and depending on site of lymph node biopsy might be possible for more definitive answer.
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Dr. Joseph Accursoanswered
Radiology 31 years experience
Need more info: Is there an older chest ct to compare the mediastinal ln to? That node is what I am most worried about. Pet/ct may help, especially if that node is bigger than 1 cm.
Thyroid nodule should be evaluated with neck ultrasound and could be biopsied, but is not likely breast cancer metastasis.
Liver cyst, assuming correct interpretation, is a benign finding and can be followed.
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Similar questions
Morgantown, WV
A 40-year-old female asked:
Stage 2b, triple+bc, CT =cysts on liver, slightly enlarged mediastinal node& calcif on thyroid node. What order most critical to rule out malignancy?
4 doctor answers • 7 doctors weighed in
Dr. Carlos Encarnacionanswered
Medical Oncology 37 years experience
Depends: How long ago were you diagnosed? Are you on endocrine or any therapy at present? How much is "slightly enlarged"? Was this seen on a previous scan or is this your first scan? Why was the ct ordered? Is the ca 27.29 elevated? Further workup for those mediast. Nodes may be: to repeat ct in a short interval, to do a pet, or to go for a biopsy. It depends. Best 2u.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
Dr. Carlos Encarnacion commented
Medical Oncology 37 years experience
Provided original answer
Thanks for the additional info. Still important to know if the nodes are new vs old and how big they are. Go over this with your oncologist. We all follow fairly standard management guidelines and I'm sure he/she will act in your best interest. Hope it is all well with you.
Aug 18, 2013
Last updated Oct 29, 2014
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