OpenHealth Q&A

Understanding PET CT Report Results

I am a 58-year-old male who underwent a PET CT scan due to ongoing coughing issues, and I would like to understand the implications of my results. **KEY FINDINGS:** **HEAD:** The brain ventricles and cerebrospinal fluid (CSF) spaces appear normal with no evidence of mass effect or midline displacement. **NECK:** No signs of hypermetabolic activity were detected in the neck region, and the primary vascular structures show no abnormalities. **THORAX:** In the right lung, a significant finding is an FDG-avid fibro-cavitary lesion situated in the apical and posterior segments of the upper lobe, presenting with diffuse thickening of the septa and heightened uptake of FDG. This lesion measures around 3.6 x 3.3 x 5 cm (anteroposterior x transverse x craniocaudal) with a maximum SUV of 7.2, extending towards the segmental bronchi. Additionally, multiple fibronodular lesions are identified, showing peribronchial involvement and extending to the pleura along with various nodules based around the pleura and fissures, all with increased FDG uptake. The left lung also shows multiple fibronodular formations and thickening of the pleura predominantly in the lower lobe, along with mild pleural effusion observed bilaterally. Right supraclavicular lymph nodes are metabolically active, the largest measuring 1.1 x 0.7 cm with an SUV max of 2.5. Other metabolically active lymph nodes are seen in the prevascular, precarinal, right hilar, and subcarinal areas, with the largest subcarinal node measuring 1 x 0.7 cm (SUV max 2.1). The right axillary lymph node also shows activity, measuring 9 x 7 mm (SUV max 1.2). No abnormal FDG uptake is noted in the heart. **ABDOMEN & PELVIS:** In the liver, a non-FDG avid hypodense lesion in segment V/VI measures 5 mm with an SUV max of 1.4 noted. Lymph nodes exhibiting FDG activity are present in the portacaval, aortocaval, and retrocaval areas, with the portacaval node measuring 9.5 mm (SUV max 1.8). No focal FDG-avid lesions are present in the duodenum or intestines. The spleen, pancreas, bilateral adrenal glands, kidneys, and major abdominal vessels are all observed as normal. The pelvic viscera appear normal as well, with no free fluid or air detected in the abdomen, and the anterior abdominal wall is intact. **OSSEOUS:** An FDG-avid lytic lesion is identified in the L2 vertebra with a maximum SUV of 4.04. **IMPRESSION:** The lesion in the right lung requires further investigation. A metabolically active fibro-cavitary lesion exists in the right upper lobe (apical and posterior), affecting the segmental bronchus. There are multiple nodular changes noted in the peribronchial and pleural regions, alongside fibrotic deposits in both lungs, and mild pleural effusion bilaterally. Metabolically active lymph nodes in the right supraclavicular, axillary, mediastinal, and retroperitoneal areas are also documented. Additionally, a metabolically active lytic lesion localizes to the L2 vertebra. A CT-guided biopsy of the lesion in the right lung’s upper lobe is recommended to exclude the possibility of tuberculosis (Koch's). I would appreciate any insights or clarifications regarding this report.

Answers (1)

8/10/2025, 10:10:49 PM

OpenHealth AI

Main Points: Your PET CT report shows significant findings, particularly in the right lung, where there’s a concerning lesion and multiple affected lymph nodes. It’s paramount to follow up on these findings with a CT-guided biopsy to provide more clarity.

Explanation:

1. Lung Findings: The report indicated a "fibro-cavitary lesion" in the right lung that is showing increased metabolic activity (indicated by the high SUV value). This could indicate an infection (like tuberculosis) or potentially malignancy, hence the recommendation for a biopsy.

2. Lymph Nodes: The presence of active lymph nodes in various regions (particularly in the neck and around the lungs) suggests that they are reacting to something occurring in your body, which may correlate with the pathology found in your lung.

3. Other Lesions: The report also noted a lytic lesion in your lumbar spine (L2) and several other changes in your lungs. These findings need to be interpreted carefully as they could relate to benign or malignant conditions.

Next Steps:

1. Biopsy the Lung Lesion: Schedule the advised CT-guided biopsy as soon as possible. This will help determine the nature of the lung lesion (infection or malignancy).

2. Follow-Up Imaging: Discuss with your healthcare provider the need for imaging to evaluate the lytic lesion in your spine, as it may require additional investigation.

3. Monitor Symptoms: Keep track of any worsening symptoms such as increased coughing, chest pain, or weight loss, and report these to your healthcare provider.

4. Stay Informed: Ask your healthcare provider to explain terms that are unclear, and discuss what these findings might mean for your overall health and what potential next steps could be.

5. Emotional Support: Remember, receiving such results can be overwhelming. Ensure you have support, whether through friends, family, or professionals who can help discuss your concerns as you navigate this process.

Understanding your health situation is a priority, and these steps will put you in a position to gain clarity and make informed decisions about your care.