#1 Persistent asymmetry of the piriform sinuses with soft tissue
density within the right piriform sinus. This demonstrates a maximum
SUV of 4.72.
#2 There is soft tissue thickening in the right piriform
sinus.
#3 Soft tissue stranding involving the subcutaneous tissues of the low
anterior neck is felt most likely represent treatment related effect.
#4 poorly differentiated laryngeal cancer
Any help in explaining any of the above would really be appreciated.
When the PET scan is done the SUV measures the uptake of the glucose which indicates the level of cellular activity, the higher the number the greater the activity. A PET SUV greater than 3.0 (I was told) indicates that there is a possibility of cancer and in this case in the right piriform sinus and it is poorly differentiated meaning the cells don't resemble normal cells. The conclusion reached in this path report is... poorly differentiated laryngeal cancer. Just my guess.
David's right - there's a mass in the larynx based on the ct - I'm not sure how they determined differentiation based on a ct... Possibly amount of uptake? Biopsy.... Ask them to do one for confirmation, and push them to speed up preparation for treatment. Hugs... And sorry
http://jnm.snmjournals.org/content/44/4/540.full.pdfA good read for those interested in how they determine cell differentiation via PET/CT. This was back in 2003 so it's a bit dated I'm sure. We all know the reliability numbers for PET's etc so I'd agree with getting a biopsy done for confirmation.
Need to edit original post, sorry for the confusion. # 1,2,and 3 are what I read on the report for the first scan after being out of treatment for 3 months. The sinus piraform makes me nervous because that originally lit up in the first scan I believe before treatment started but they biopsied that and it came back ok. I just wonder if it is still a suspicious area they are watching.
#4 is what they classified his original cancer on the vocal cord that did have surgery followed by radiation and chemo. Just wondered what the poorly differentiated meant but that is not associated with the results from the recent scan.
If the PET was done 3 months post Tx then the uptake can be the result of treatment damage and resulting healing. What did they doc that presaented these results to you advise? My first scan post Tx was 3 months and showed some "sreas of concern" but my RO said "not to worry, let's wait another 3 months and do another scan." That showed that the old areas of concern were "gone" but there were new "areas of concern" so we waited another 3 months and FINALLY I got an all clear.
poorly differentiated is a good thing and a bad thing. It's bad because it means the cells do not resemble normal cells at all.. They are in my definition spastic. This can mean its an aggressive cancer. The good thing is because they are so malformed - they die easier. So they are more responsive to chemo and rads. Push for them to do what they have to. Time is always of the essence. Hugs,
Just some added informaton. I checked the numbers and the first PET SCAN showed asymmetric soft tissue within the right piriform sinus with a maximum SUV of 2.6
This was from the scan done prior to surgery and radiaton and chemo. Now 3 months out of treatment I received the results from the scan and the number has increased. Is this something I should be worried about? Especailly since this area lit up on the first scan but after a biospy we were told it was ok. Here is the recent report. . .
Persistent asymmetry of the piriform sinuses with soft tissue
density within the right piriform sinus. This demonstrates a maximum
SUV of 4.72
Biopsies aren't always a 100%, if they only sample dysplastic tissue that's yet to turn malignant, which is an interesting topic and one that I had the pleasure of listening to a lecture by Dr. Edmund Truelove of the University of Washington on. If the exact same location is lighting up and the SUV levels are increasing I'd bet on cancer.