What Does This CT Scan Of Adrenal Gland Indicate?

Posted on Tue, 27 Jan 2015

Tue, 27 Jan 2015 Answered on

Thu, 12 Feb 2015 Last reviewed on

Question : If a old ct report states a adrenal gland nodule on left side amd new ct report says.... New left adrenal nodule,..

1. Is this the same one? ( both appear to be left side)

The one in old report was not a met we were told.

Answered by Dr. Ajish TP (2 hours later)

Brief Answer:
It could be the same nodule

Detailed Answer:
Hi XXXXXXX

Welcome back to HCM.

The new CT is showing a small adrenal nodule - old CT is also showing adrenal nodule Left adrenals. Since the measurement of adrenal nodule is not given in the report, it should be really small and could be the same adrenal nodule.

Regards

Dr Ajish TP
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (29 minutes later)

Thx . Why in any of the nodules measurements r not g iven?

Answered by Dr. Ajish TP (16 minutes later)

Brief Answer:
Probably the size is insignificant

Detailed Answer:
Hi XXXXXXX

Welcome back.

Ideally in a CT scan if there is any nodule, the measurement should be given for future comparison. But if CT scan is done in normal healthy individuals, up to 10% can show an adrenal nodule. This is called adrenal incidentaloma. This is not having any clinical significance.

Probably your radiologist is thinking in terms of adrenal incidentaloma and not a significant nodule in the context of your initial disease. He may be feeling that this is not a metastasis and is not important in the treatment aspect. That may be the reason why the measurement is not given

Regards

Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (2 hours later)

Oh i see. The first ct scan u will see did mention measurement of the liver met and node but yea the adrenal node had no measurement.

Again this time the adrenal node has no measurements, but the other nodes have no measurement too

But at the end h

Answered by Dr. Ajish TP (14 minutes later)

Brief Answer:
The report of disease progression should be based on sub pleural nodule

Detailed Answer:
Hi XXXXXXX

Good day.

Sorry to say that my comments on adrenal nodule is only based on the report the radiologist has given. He has mentioned an adrenal nodule in August 2014 scan. Again he has mentioned a small adrenal nodule in January 2015 scan - but is reported as "new". There is no mention of any other nodules in left adrenal. So we have to consider it as the only nodule and wrongly typed as new.

The "disease progression" mentioned in latest scan is based on the new sub pleural nodule in the left lower lobe, increase in the liver lesion and increase in aortocaval node size.

Hope this will clear your doubts

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (5 minutes later)

I see . It makes sense what ur saying . Again the sub pleural nodule has no measurenent too so could it be that its benign ? And the disease progression comment is based on the increase in size of the liver met n node?

Answered by Dr. Ajish TP (7 minutes later)

Brief Answer:
These needs measurements

Detailed Answer:
Hi,

All these nodules needs measurements to compare.

Probably you are doing all these investigations (imaging) in the centre where you are getting treated for the primary disease and the treating doctor has electronic access to all your images so far done. In that case he will be able to directly compare the size and character of all these lesions in his computer. So the radiologist wont bother to measure all the lesions.

The sub pleural lesion is unlikely to be benign in this setting. Unlike adrenals, sub pleural areas are not a site of benign nodules. In this context we have to consider it as metastasis. The disease progression is based on these new nodule and increase in size of previous nodules.

Regards

Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (6 minutes later)

I see . I understand now . Thank you for your help .

Answered by Dr. Ajish TP (0 minute later)

Brief Answer:
Wishing you speedy recovery

Detailed Answer:
Hi XXXXXXX

Wishing you a speedy recovery.

Regards
Dr Ajish TP

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar