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This question was answered on Fri 11, Apr 2008 08:58am by Dr Heinrik M, MD

SPN follow up question - faint uptake in the nodule and more pronounced uptake in the lymph nodes


    
Asked by jkwrabbit (Male ) on Tue 08, Apr 2008 02:01pm

I have now gotten the results of the PET and met with a Pulmonologist. The PET showed faint uptake in the nodule and more pronounced uptake in the lymph nodes. The Pulmonologist agrees that with my risk factors of both parents dying of lung cancer and exposure to secondhand smoke for the first 17 years of my life that we should remove it. I have been referred to a thoracic surgeon next week. One of my questions is that they are saying they will have to do a mediastinoscopy to biopsy the lymph nodes, and then they need to take the top lobe of my right lung along with the nodule. If the biopsy is negative, isn't there a less drastic procedure to remove the nodule and not take so much of my lung? I appreciate any opinion you can give.
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Answer by Dr Heinrik M, MD  on Fri 11, Apr 2008 08:58am:

Hi, The procedure may seem that it is taking a lot indeed. There are about 3 kinds of operations, segmentectomy, lobectomy, pneumonectomy in increasing order of removing lung. The surgery requires removing a margin beyond the observed nodule, since the cancer may actually involve surrounding areas invisible to the naked eye (or to the CT or the PET). Segmentectomy has not been consistent in providing good outcome, but the second level - the lobectomy seems sufficient. The removal of lung is not arbitrary, I'd like to think of it as a balance, the Goldilock's level, not too much not too little. You would also be tested as to whether the amount of lung reduction would be tolerated, to ensure that your lung function remains adequate after the operation. Stay positive.

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