The anticipation continues...
Had my PET/CT scan yesterday, and had to lie about drinking some water in the morning, and was asked several times if I ate or drank anything, oh well.
Picked up my written report today from the diagnostic center, couldn't wait for the disc copy, and saw there may be some concern in level III. Met with my ENT next, who can access the scan, and then said he called the radiologist, and then the pathologist to see if a FNAB can be done under sonogram guidance, being there is a small spot in level III, where cancer was previously, which can't be ascertained what it is. If it's cancer, we'll deal with it, and was caught early, if not, I just went through some extra trouble, which I agree with. I doubt it is a reactive lymph node, being I had three neck dissections in this area. and the last cancer there was roaming, free cancer or extra-capsular spread, for lack of a better description, meaning cancer was floating around. Tomorrow I'll find out when my FNAB is scheduled, probably next week sometime.
Findings: The patient is status post revision of left neck dissection and resection of a suspicious mass in the left supraclavical fossa with placement of a pectoralis major flap reconstruction. Since 2/19/13 examination, there is interval visualization of a small lymph node along the superior deep aspect of the flap, immeditately lateral to the common carotid artery on images 76-78 measuring 7x3mm in axial cross-section. It is associated with focal metabolic activity, maximum SUV range up to 4.5
Impression: Since the prior PET/CT, there is interval visuslization of a hypermetabolic left level III lymph node along the superior derp margin of the reconstruction flap, immediatly adjacent to the carotid artery. The degree of associated metabolic activity relative to the size of this lymph node may take at least noteworthy. Distinguishing between a reactive node and a possible site of a new nodal metastic disease is limited based on current imaging. Sonographic correlation is recommended as the next step in evaluation.
To be continued....
