Expert: Claes-Gustaf Nordquist, M.D. - 3/20/2006

Question
Dear Doctor ,,I am writing to you because of  your recognized expertise in Radiology. I am a 50 year old male none smoker ,no diabetes and I work out at a health club and I keep my self in good condition and health for my age. But now after a routine blood check up for my physical my Hemoglobin level showed an elevation of 16.3 and from my understanding the age reference levels should be 10.3 to 14.1,,My Hematocrit level showed 45.6...But also being a  little worried at this point in time, I had a routine chest x-ray as part of a annual physical and when the chest x-ray was looked at, my doctor told me to now go for a Cat-Scan because they noticed a Vascular Prominence on the Right Hilar region of my lung. After my Cat-Scan with IV contrast the Vascular prominence now showed a slight trans axel enlargement to the Hilar Node,,They told me its not really a problem because its so slight and its not in the Meditisium region but in 3 or 4 months to go for another Cat-Scan to see if their is any changes that could indicate an underline cause.I also feel a little point of discomfort kind of near the surface near my rib or between my rib right under my right chest muscle an I wonder if I should be checked for one of the forms Lymphomas.Also for well over 3 or 4 years I have suffered from Bowel habit changes having Watery stool Syndrom and my Gastroentorologist says it most likely IBS because I had a Colonoscopy 6 years ago and I was clean.But my suspicion leads me to think is it possible from the elevated Hemoglobin and the noticable Hilar node to be an underline Tumor or Neoplasma that I am not aware from my Abdomin?? Because other then the Hilar node in my Cat Scan my doctor said everything else looks remarkable.So at this stage should I play it safe and have now have a Cat-Scan of my Abdomin to make sure thier is no enlargement in Nodes near the  spleen and to follow through with Gastroentrologist recommedations for my second Colonoscopy?? Should I notify my physician of the spot on my right side near my rib of the slight discomfort when I lean foward or when I tighten my chest.I will await your response .


Thank You

Matthew  

Answer
The small blood lab. test changes you describe are NOT alarming in any way and can just be a slight statistical variation. The hilar X-ray changes described also seem to have been well taken care of. The CT scans done or planned I think are quite sufficient. With regards to your bowel problems a new colonoscopy should be recommended as 6 years is a rather long time since it was last performed. You should tell your dr. all your symptoms. Good luck!