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Pauline
Pauline, Doctor (MD)
Category: Health
Satisfied Customers: 8631
Experience:  Medical Doctor & Registered Pharmacist. Worked as Community pharmacist for 17 years.
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Can you tell me what this means in plain english? Interval

Resolved Question:

Can you tell me what this means in plain english?
Interval increase to moderate non-FDG avid right pleural effusion.
Interval increase pleural based hypermetabolic lesion. For reference 3cm pleural based lesion in the lateral right middle with SUV of 7.1 (prior 2.5cm SUV of 4.5) Hypermetabolic right lower lobe atelectasis with SUV of 4.8.
Also can you tell me where is the iliac bone and sacrum located?
Submitted: 4 years ago.
Category: Health
Expert:  Pauline replied 4 years ago.

Pauline :

Hello, can you confirm what type of imaging you had and why you had it?

Pauline :

Iliac bone is the large bone in the pelvis, the sacrum is also in the pelvis..the 'tailbone':
Have a look at this picture: here

Pauline :

A right pleural effusion means that you have fluid in the right side of the chest between two layers that surround the lung. Usually causes shortness of breath. It can be caused by a number of problems.

Pauline :

Can you let me know what you have been told so far about your condition?

Customer:

You asked, what type of imaging you had and why you had it? This information comes from the results of my wife's whole body PET Scan with CT fusion done in late Dec 2011 for the purpose of checking the ongoing progression of her condition. She is a 49 y/o with an 11 yr history of breast cancer which has spread first to the liver and lungs, then most recently (2yrs ago) to the lymph nodes and now in the past year to the bone structures of the spine and ribs. This current scan indicates the interval increases in the uptake in the Thorax although not new. The new lesions appear in the Cervical C5,6,&7; Thoracic T2,3,4,& 5; Lumbar L3 & 5 of the spine. New lesions in the sternum and multiple right ribs. Two 1cm lesions in the right iliac bone and a new lesion at the sacrum.

Customer:

You also asked, what you have been told so far about your condition?

Customer:

My wife has been considered terminal since early 2006. The tumors in the liver and lungs are considered stable therefore we have been told that these new lesions in the bones are not to be considered serious since this spread is not in the "soft organs". Although I do not doubt the seriousness of what a spread to any "soft organ" would present, I'm not sure that I have any comfort zone with the statement that these boney spreads are not serious. This patient has become very frail in the past year loosing an estimated 50 lbs (from about 165 to 115). Her fatigue has been extreem for some time now as she sleeps anywhere around 15-20 hrs a day and eats very little. I understand that the bone spreads are very slow when compared to the soft organs, however I have a sense that the spine could be a pathway to the brain and so on. We have been dealing with this for some time now and we are big kids and only ask for straight answers (without spin). Seeing this spread in the spine and ribs over the past year concerns me even though I've been told it's not a problem. The lesions in the iliac and sacrum areas also explain much of the discomfort that my wife has been experiencing in her hips and pelvic area. These discomforts have been cast off as side effects of the chemo.

Pauline :

Thanks for the full reply. The PET jargon simply means that there are lesions in the lungs which are showing bright...that often means metastatic cancer (not always, but as there is a known diagnosis then that confirms the matter).

Pauline :

I am sorry to hear that the spread has continued. There are pain control options available and she should be under the care of a palliative relief/symptomatic control doctor as well as her oncologist.

Pauline :

Drugs such as ketamine infusion and lidocaine patches may help some of her pain, while some of the bony lesions may respond to palliative radiotherapy. These are options to discuss.

Pauline :

If she is very short of breath then the pleural effusion can be drained, although it may accumulate. In some cases we put in long stay chest drains to allow long term relief.

Customer:

Thank you for clearing up some of the 'jargon'! Sometimes these things get a bit confusing. In all honesty, I don't believe her oncologist is meaning to be tright by any means, she has become very close to my wife after treating her for going on 12 years and often I believe she is trying her best to provide hope with her assessments. However as you can see, sometimes this hope is clouded by the language of the radiology which I understand enough to be dangerous!! The oncologist has stated that there are no active lesions in the lungs, however the radiologist writing the report states under final impressions, "Minimal increased right pleural based FDG avid lesion suggestive of progression of disease".

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