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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56313
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I just went to a gastroenterologist last week for stomach pain

Resolved Question:

I just went to a gastroenterologist last week for stomach pain that I have had on and off for years. Had a CT scan today and I always assumed it was my gallbladder or pancreas, but the results say the gallbladder and pancreas are unremarkable. The impression at the end states " Mild splenomegaly. Minimally prominent lymph nodes in the right lower quadrant mesentery that are likely reactive. No visible inflamed bowel. No CT findings for an acute intra-abdominal process otherwise." My doctor is out of town until next week, which upsets me because I should have to wait, but I want to know what this means. A) There was no mass seen in my enlarged spleen, so what could cause that? B) Why would my lymph nodes be minimally prominent in lower quadrant mesentery and what does it mean that they are reactive? I am so tired of stressing over this and I would really appreciate an answer.

Thank you.
Submitted: 10 months ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 10 months ago.

Dr. Thomas, MD :

Hello from ja

Dr. Thomas, MD :

Can you enter chat and respond?

Dr. Thomas, MD :

Mild splenomegly is not specificgt

Dr. Thomas, MD :

not specific

Customer:

Hi, yes. DId you receive my questionn?

Dr. Thomas, MD :

Not very meaning ful

Dr. Thomas, MD :

Lymph nodes that are reactive means to inflammation or infection.

Dr. Thomas, MD :

Or a virus

Dr. Thomas, MD :

It is also not definitive of anything serious.

Customer:

Is that usually something to worry about?

Dr. Thomas, MD :

no

Dr. Thomas, MD :

what is your age?

Customer:

28

Dr. Thomas, MD :

OK

Dr. Thomas, MD :

Even less likely to be serious

Dr. Thomas, MD :

Alcohol history?

Customer:

I used to drink socially, but I do not drink anymore

Dr. Thomas, MD :

OK

Dr. Thomas, MD :

So far no problems here, any abnormal labs?

Dr. Thomas, MD :

CBC done

Dr. Thomas, MD :

all ok?

Customer:

Nope, had cbc and liver and pancreas tests and all normal

Dr. Thomas, MD :

OK good

Dr. Thomas, MD :

where is the pain exactly

Customer:

All blood tests have been normal

Customer:

The pain has been on and off for two years....upper right abdomen...more of a dull ache that can radiate to back at times. It is not very painful...more annoying than anything

Dr. Thomas, MD :

OK

Dr. Thomas, MD :

That can be gastritis or duodenitis

Dr. Thomas, MD :

Did the GI doctor suggest a scope?

Customer:

Yeah, I am getting I believe it is called an endoscope at end of month

Dr. Thomas, MD :

Correct

Dr. Thomas, MD :

That is the next step

Dr. Thomas, MD :

Might have an ulcer or gastritis

Dr. Thomas, MD :

you should also be checked for h pylori, the ulcer bug.

Customer:

I am just worries about these lymph nodes being "minimally prominent"....

Dr. Thomas, MD :

Would not at all worry about the CT findings at this point.

Dr. Thomas, MD :

Non specific

Customer:

Stomach does burn at times so ulcer would not be a surprise

Dr. Thomas, MD :

meaningless

Dr. Thomas, MD :

ulcer more likely

Dr. Thomas, MD :

or gastritis

Dr. Thomas, MD :

H pylori can even upset digestion.

Dr. Thomas, MD :

That is more likely

Customer:

I do not feel like I have an infection that is what bothers me about the prominent lymph nodes

Dr. Thomas, MD :

Prominent nodes [minimally prominent] are not really meaningful as I said.

Dr. Thomas, MD :

That is not pathological.

Customer:

Ok so you do not think it would be anything like lymphoma or caner

Customer:

cancer

Dr. Thomas, MD :

No

Dr. Thomas, MD :

You would have had other findings

Dr. Thomas, MD :

Not so

Dr. Thomas, MD :

don't worry about it

Customer:

Okay. Also, why would my spleen be enlarged?

Customer:

It says there is " no visible intrasplenic mass"

Dr. Thomas, MD :

Mild can be overestimated ..it can be normal for you...without liver disease or other abnormalities like anemia...no cause

Dr. Thomas, MD :

A cause would have showed up on exam and testing

Dr. Thomas, MD :

Your CT findings are not definitive

Customer:

What does not definitive mean?

Dr. Thomas, MD :

No indication of disease

Dr. Thomas, MD :

You have no other findings

Customer:

Okay, that is good.

Dr. Thomas, MD :

No illnesses that give an enlarged spleen.

Dr. Thomas, MD :

It probably means the size is over estimated.

Customer:

Okay. And I should not worry about the lymph nodes...that is just scary to read

Dr. Thomas, MD :

No

Dr. Thomas, MD :

that is why they said reactive

Dr. Thomas, MD :

not cancer

Customer:

Oh reactive means not cancer

Dr. Thomas, MD :

right

Customer:

Okay. I really appreciate it. Are you and MD that specializes in gastroenterology?

Customer:

an*

Dr. Thomas, MD :

I am a board certified internist: GI is our sub-specialty; I am also board certified in integrative medicine, with advanced training in functional GI disorders.

Dr. Thomas, MD :

Use reply to let me know if you have further questions.


Please do not forget a positive rating.

Customer:

Of course I will give positive rating...one more question

Customer:

If reactive means it is not cancer, what would it have said if possible cancer on report?

Dr. Thomas, MD :

It would have said possible malignancy and further investigation needed.

Dr. Thomas, MD :

Use reply to let me know if you have further questions.


Please do not forget a positive rating.

Customer:

Okay. Thank you. You will get a positive rating from me. So otherwise the impression you read meant that pretty much everything is okay and normal.

Customer:

Dr?

Dr. Thomas, MD :

with the lack of any other findings

Dr. Thomas, MD :

Normal

Dr. Thomas, MD :

I would pursue the scope

Customer:

Can i ask one more question please?

Dr. Thomas, MD :

sure

Customer:

This was not written in the impression, but in the findings. It says "there is a 0.2 cm non calcified nodule in the posterior left lower lobe; the Fleischner Society has not established any guidelines for follow up of nodules of this size in patients under the age of 35 as these nodules are typically post infectious/postinfammatory in nature." This kind of worries me too =(

Dr. Thomas, MD :

common finding, no significance

Dr. Thomas, MD :

that is why it was not even mentioned

Customer:

Okay. I though it was a tumor or something =(

Dr. Thomas, MD :

no

Customer:

I know you are a doctor and hear this stuff a lot, but to people like me who do not understand this stuff it is very scary and I think some doctors forget that. We do not mean to be pains in the rear, but we just do not know and we get scared with all these big words. I do appreciate your help. You have eased my mind and I will probably sleep better tonight

Dr. Thomas, MD :

you are welcome anytime

Customer:

Have a good night. I will give excellent rating

Dr. Thomas, MD :

You too

Dr. Thomas, MD :

Thanks

Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56313
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
Dr. Thomas, MD and 9 other Medical Specialists are ready to help you
Expert:  Dr. Thomas, MD replied 10 months ago.
thanks
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