Can someone Explain This ?

Yorkiegirl · 07-25-2007, 04:34 PM

I had a PET Scan done to check on a possible reoccurance on the scar line due to larg lump that showed up there. scan back saying no definite evidence for recurrent or metastatic breast carcinoma. This was told to me on the phone since my appt with my Onc isn't until September.

I had my 6 week port flush and asked for a copy of the report.

But my question lies in the remark in the Impression lines:

"Probable reactive right hilar adenopathy. If, clinically warranted follow-up PET in 3-6 months may be helpful to ensure against progression. "

Does anyone know how to interpurt this and what does it mean?

Thanks

Lani · 07-25-2007, 05:42 PM

Hilar refers to the "hilum" of the lung:

Hilum
From Wikipedia, the free encyclopedia
A hilum (formerly called a hilus) is a depression or pit at the part of an organ where structures such as blood vessels and nerves enter.
Medial depression for blood vessels and ureter to enter kidney chamber
The adjective form is "hilar", and the plural is "hila".
[edit]Examples

the hilum of kidney (admits the renal artery, vein, ureter, and nerves)
splenic hilum
hilum of lung

^^^
so that refers to the part/location of the lung where the blood vessels and nerves enter. In the case of your report it is the lymph nodes in that vicinity which are called "reactive" which means they look abnormal or enlarged in a way which may reflect an ongoing process to which they are reacting eg, infection, inflammation, etc--NOT NECESSARILY, in fact, often more unlikely, metastatic tumor by make "take" on the way it seems to be phrased.If the radiologist was suspicious of metastasis his wording would more likely have been something like enlarged hilar lymph nodes, metastatic vs reactive, suggest....to better delineate". I must clearly state I am not an oncologist, radiologist, or oncologic nurse and have no expertice in the area, so it is just my "take"

So your report includes the CYA ("cover your XXX") phrases:
"Probable reactive right hilar adenopathy. If, clinically warranted follow-up PET in 3-6 months may be helpful to ensure against progression. "
using the famous words "probable" and "if clinically warranted" as well as "may be helpful to ensure"

in other words if the test is repeated and it comes out the same or better
that is probably what it was, ie a nonmetastatic process.

This kind of phrasing is typical, as no scan can be read with 100% surety, and there are lots of lawyers out there looking to find fault. This way the radiologist lays the responsibility on the ordering doctor to decide if it is clinically warranted and to order the follow up scan.

If it was a PET scan only and not a PET/CT, and if your doctor repeats it (and if PET/CTs are available where you live) should something be seen, a PET/CT might be better able to plot the abnormality out in three dimensions and identify with the anatomic structure/part of anatomic structure with which it belongs( if the two are carried out simultaneously). More radiation is involved, so
again the ordering doctor get the responsibility of deciding if that is warranted as well as the extra expense. It may be that what you have had already was a PET/CT (the report should say).

Good luck.

Yorkiegirl · 07-25-2007, 06:26 PM

Lani, thank you for your reply. They do have the PET/CT here, BUT My Onc ordered only the PET to be done.

So, I guess I wait until September and see what he has to say.

Joy · 07-26-2007, 07:03 AM

that you can rest easy between scans. Lani's post makes a lot of sense as usual and my mother who was an RN for 34 years says CYA runs through all reports and even though it protects some it victemizes others. Energize that this will take care of itslef while you take good care of you and don't forget YOU can ask other docs for their interpretations if you need to.

thinking of you!

Sherryg683 · 07-27-2007, 01:28 PM

Yes, it depends on who is reading these scans also. Since I get PET/CTs so often, I have gotten use to this one guy reading my scans. He doesn't use all those alarming phrases that get you all worried. Every now and then my scans will get read by someone else and there's all this " cover your ass phrases" in there. My last scan was like that, then on reading it further, it said there was no changes from previous scan. ...sherry