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Old 08-15-2003, 05:32 PM   #1
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hilery79 HB User
Question question for projapoti

Hi,

You seem to be very knowledgable about a lot of topics. So, I thought I would ask you about this - if you don't mind. I was recently diagnosed with follicular thyroid cancer. Before I was diagnosed with this, my Dr. ordered a CT scan of my chest because I was having dyspnea and a lot of chest pressure. He told me the scan turned out fine, but noted they saw some extra tissue around my thymus area. He said this was nothing to worry about.
Anyway, I had to pick up my records today for another Dr. I will be seeing for RAI treatment. I looked over the radiology report of the CT scan and was wondering if you could give me your opinion on this.

The part I am worried about reads as follows:
"In the anterior mediastinum, there is a soft tissue mass with inhomogeneous enhancement. Differential diagnosis would center upon the thymus and various thymic neoplasms, cysts, and hyperplasia. The margin of the mass is not optimally defined. Differential diagnosis would include invasive or noninvasive thymomas at the margin with the mass, and adjacent mediastinal fat is not sharp; it could possibly be locally invasive, but there is no peripheral spread."

This sounds a little worrisome to me. My Dr. didn't seem to think it was anything to look further into.
I would really appreciate it if you could tell me what you think.

Thanks,
Hilery

 
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Old 08-15-2003, 06:52 PM   #2
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projapoti HB User
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Hey Hilery..thanks for your question.
Quote:
In the anterior mediastinum, there is a soft tissue mass with inhomogeneous enhancement. Differential diagnosis would center upon the thymus and various thymic neoplasms, cysts, and hyperplasia. The margin of the mass is not optimally defined. Differential diagnosis would include invasive or noninvasive thymomas at the margin with the mass, and adjacent mediastinal fat is not sharp; it could possibly be locally invasive, but there is no peripheral spread."
To be honest, this report sounds pretty non-descript to me..i.e. the radiologist really wasn't sure what (s)he was looking at because the mediastinal view wasn't too clear. This is by NO means anything bad; the radiologist was just commenting on the anatomy of the area. Now, he mentions "differential diagnosis"...this just means that, when looking at your x-ray, these are the following possibilities that can happen.

thymic neoplasms = a "new growth" on the thymus. It does not in any way shape or form have to be cancer..just a growth of new cells (kinda like a skin tag but made of thymic tissue)

cysts = a fluid filled sac

hyperplasia = overgrowth of the normal cells of the thymus.

The margin of the mass is not optimally defined = he can't really separate the normal tissue from the new/abnormal tissue of your thymus. At this point, this is neither good nor bad.

Differential diagnosis would include invasive or noninvasive thymomas at the margin with the mass, and adjacent mediastinal fat is not sharp; it could possibly be locally invasive, but there is no peripheral spread. = this whole thing means that it could be something that is invading the tissue of your thymus, and it COULD be cancer, but he is not sure. I must stress VERY STRONGLY to you that this report by NO MEANS says that you have cancer. All it is saying is that it is worth it to watch your thymus.

One good thing that was mentioned was that "there was no peripheral spread". This means that, whatever is going on in your thymus does not involve anything else important in the area--this is very encouraging.

My guess would be that you will either have another x-ray in a few months to compare if your thymic anatomy changes, or perhaps a biopsy depending on your symptoms.

 
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Old 08-15-2003, 08:04 PM   #3
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hilery79 HB User
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Thank you so much for your reply. I really appreciate your help.
My reg Dr. didn't seem to think it was anything that needed to be watched. I will be seeing a radiology oncologist next week for my thyroid cancer treatment. I'll see if he might be able to look further into finding out what this thymic "mass" is.

Thanks again,
Hilery

 
Old 08-15-2003, 09:45 PM   #4
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projapoti HB User
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That's good to hear...your doctor obviously knows much more about these things than I do. If (s)he didn't think that the thymic mass was much to worry about, it's probably because (s)he's seen so many of them that (s)he knows it's nothing too serious. I hope your treatment goes well!

 
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