Experience I'm a Doctor of Medicine. Licensed/certified physician and surgeon and specialist in Medical
Oncology and Radiation therapy in Sweden, Denmark, Finland, Iceland, Norway and the European Union. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine.
M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. Now in private practice in Stockholm, Sweden.
I also answer questions in these other categories: General History,
Military History,
Brain Tumors,
Breast Cancer,
Colon Cancer
Question QUESTION: Dear Dr. Nordquist:
I wrote to you last week regarding 3 nodules in lungs identified on a CT of the chest. The largest nodule was 13 mm. I had a PET done and only the largest nodule demonstrated an SUV of 3.2 and nothing in the other two. However, there was SUV in the range of 8 in the mesenteric area. I had a CT of the abdomen and pelvis done and the radiologist read it as "mesenteric panniculitis with associated lymphadenopathy. This can be a finding secondary to Hodgkin's lymphoma". My internist and my gastroenterologist read both reports and did thorough examinations and I have no symptoms of lymphoma and they are considering other reasons for the lymphadenopathy. I will see an ocologist later this week and possibly have a CT guided fine needle biopsy. My questions are 1)Do you think the node in the lung has anything to do with the lymphadenopathy in the abdomen or could they be unrelated?
2) Does any activity in a PET scan always mean cancer?
3) Could the lung nodule reading of 3.2 NOT mean cancer?
4) Can you give me any hope that I may not have cancer?
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ANSWER: 1. They may well be unrelated but I'm not sure. So they may also be related. 2. No, it depends to a large extent on the level of activity. Infections & inflammations also cause increased activity levels but usually (but not always) less so. But the lack of an activity increase does not guarantee the absence of a cancer. 3. It may but again it may not. This is not a very high activity. 4. Certainly, that may well be the case but I can not guarantee that it is. You should have that fine needle biopsy as soon as possible. If possible also of the large lung nodule. If possible that may tell us what it is so that would be settled.
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QUESTION: Dear Dr. Nordquist:
I just received the results of my labs. The CEA is normal. Is this test accurate to rule out lung ca or lymphoma? I am sure I will still be getting the fine needle biopsy. Thanks again.
Answer Well that is good and may be a good sign. But unfortunately CEA tests do have some uncertainties with both false negatives and false positives. They should therefore not really be used for primary diagnosis but instead only for monitoring follow ups. I therefore think you should go ahead with the biopsy. Good luck!
