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  • Paraaortic lymph node sizing

    Hey All,

    Hey had my first CT scans results looked at a few times by different professionals and the report that came back from the CT scan said they were clear. However my last visit to the oncologist where he kind of recommended surveillance he mentioned rather casually that I had a Paraaortic lymph node of 2.1cm which appeared normal but will need to keep an eye on it. He said it look normal on contrasting as well

    I'm just wondering does anyone know what a normal size is for one of these nodes? I felt 2.1cm seemed quite large to me but I can't seem to find any info on the tinernet about what is a normal size.
    Dave Hanson
    Found lump 18/02/2011
    Ultrasound confirmed mass 23/02/2011
    CT Abdomen, pelvis, chest (clear) 24/02/2011
    Left I/O 1/03/2011
    99% Seminoma <1% Unknown germ cell 10/03/2011
    Staging T1 - 1A 10/03/2011

    2 month - 27/04/2011 - All clear!
    5 month - 16/07/2011 - All clear!
    9 month - 22/12/2011 - All clear!
    14 month - 22/12/2011 - All clear!


    Yesterday was history, tommorrow a mystery, but today is a gift. That's why it's called the "present"

  • #2
    That is larger than normal. I think anything over 1 cm is considered abnormal.

    Comment


    • #3
      As BB says > 1cm is where they start taking an interest. For my relapse, mine was shown to be 1.8cm (and then when I started chemo it was 2.2cm). I don't know enough about tumours & lymph nodes, but I'd be concerned with the statement that it looked "normal" because from what I understand 2.2 isn't normal...

      Do you have any other information to hand (blood markers...) because if I were you I'd take a pro-active approach about this issue.

      Good luck

      Feb 2009: RHS (Seminoma) & RT
      Mar 2010: LHS (Embryonal Carcinoma)
      Sep 2010: Relapse & 3 x BEP
      Mar 2014: Four years a eunuch!
      http://doublezeroami.blogspot.com

      Comment


      • #4
        Since the ct scan and after my IO my blood markers have normalized. Apparently 7 pathologists, 4 urologists and 4 oncologist covered my case at their quarterly review the day after he told me this. When I met him a week later it wasn't mentioned so really didn't think it was too much to worry about.

        See urologist on Thursday again so will follow up with him. If I could just find some facts and figures online that would help.
        Dave Hanson
        Found lump 18/02/2011
        Ultrasound confirmed mass 23/02/2011
        CT Abdomen, pelvis, chest (clear) 24/02/2011
        Left I/O 1/03/2011
        99% Seminoma <1% Unknown germ cell 10/03/2011
        Staging T1 - 1A 10/03/2011

        2 month - 27/04/2011 - All clear!
        5 month - 16/07/2011 - All clear!
        9 month - 22/12/2011 - All clear!
        14 month - 22/12/2011 - All clear!


        Yesterday was history, tommorrow a mystery, but today is a gift. That's why it's called the "present"

        Comment


        • #5
          I had chemo because not only the lymph nodes but my blood numbers were headed back up as well.

          Comment


          • #6
            I think they look for more than just the size. But 2.1cm does sound large...

            The acid test will be whether it has changed on your next scan. It is reassuring that a large group of experts have reviewed your scans, and they are not concerned.

            Let us know how you get on.

            Best wishes.
            A
            July 2010 Stage one seminoma, 4.8cm. Rete testis invasion. HCG 28.
            Sept 2010 Single dose carboplatin (AUC x 7)
            Dec 2010 Tumour markers normal.
            Mar 2011 Follow-up CT scan - clear.
            Sept 2011 CT and CXR - clear.

            Comment


            • #7
              Usually around 1 cm is the normal size but I think my husband had some in his axillary area, if I remember right, that were a little bigger but they called them reactive (as in infection or inflamation) and not related to cancer. His abd lymph nodes are also upper limits of normal but they were that way a year ago when he had a CT looking for a kidney stone so we are thinking that is normal for him. That will be the main thing we are looking at on his follow up CT. If the nodes shrunk after treatment, it would indicate he did have active disease and they would order a 3rd round of chemo. If they stay the same we are good to go. I would say if all these experts aren't worried, just keep an eye on it and make sure it doesn't get any bigger. I would think your checkups will be frequent enough to catch anything right away. I know it's hard not to stress though. When hubby was getting ready for his CT this time, I looked at last year's report and saw the larger lymph nodes and was in a panic that he had had this for all that time and we would find him full of cancer. The mind can be a terrible thing. Luckily that was not the case
              Tina, wife to Gene
              Right I/O 2/21/11
              60% embryonal carcinoma- 40% seminoma with L/V invasion, Stage 1B, Cat Scan- clear
              HCG- 1.2, AFP-1.5, LDH-normal
              BEP X 2 started 3-7-11
              Bleo canceled for 2nd round, lung issues
              EP 3-28-11 X 5 days, finished chemo 4-1-11
              F/U cat scan 4/14/11 - Stable
              3rd round EP as precaution because Bleo was cancelled, start 4-25, finished chemo 4-29-11, pneumonia 5-6-11
              6-1-11, 8-3-11, 9-7-11, 10-19-11, 11-16-11, 12-18-11, 1-18-12, 5-8-12 Clear

              Comment


              • #8
                MrsB you can read ct scans! Lucky MrB. I'm amazed anyone can make sense of them. They should use software to identify organs and nodes etc and then colour code them. :-)
                Dave Hanson
                Found lump 18/02/2011
                Ultrasound confirmed mass 23/02/2011
                CT Abdomen, pelvis, chest (clear) 24/02/2011
                Left I/O 1/03/2011
                99% Seminoma <1% Unknown germ cell 10/03/2011
                Staging T1 - 1A 10/03/2011

                2 month - 27/04/2011 - All clear!
                5 month - 16/07/2011 - All clear!
                9 month - 22/12/2011 - All clear!
                14 month - 22/12/2011 - All clear!


                Yesterday was history, tommorrow a mystery, but today is a gift. That's why it's called the "present"

                Comment


                • #9
                  I am a radiologic technologist and my main job is diagnostic radiology and cat scan. We take the pictures and the radiologist reads them. I admit that I am not nearly as knowledgeable as the radiologists but hey, they go to school an additional 4 years after medical school to learn to read those things. I can usually find the big stuff and figure out what the reports say And I agree, color coding and diagrams would be really nice, LOL
                  Tina, wife to Gene
                  Right I/O 2/21/11
                  60% embryonal carcinoma- 40% seminoma with L/V invasion, Stage 1B, Cat Scan- clear
                  HCG- 1.2, AFP-1.5, LDH-normal
                  BEP X 2 started 3-7-11
                  Bleo canceled for 2nd round, lung issues
                  EP 3-28-11 X 5 days, finished chemo 4-1-11
                  F/U cat scan 4/14/11 - Stable
                  3rd round EP as precaution because Bleo was cancelled, start 4-25, finished chemo 4-29-11, pneumonia 5-6-11
                  6-1-11, 8-3-11, 9-7-11, 10-19-11, 11-16-11, 12-18-11, 1-18-12, 5-8-12 Clear

                  Comment


                  • #10
                    OK,

                    So went to see my urologist today and discussed a range of things. One of them being this lymph node which he was surprised about. He hadn't received the report from the oncologist. I gave him a copy to read and then he looked through the CT scans again. He could not see the node and was a little confused. Also the CT scan report also had no mention of it.

                    He did say that the lymph node is right on the point where it may need a treatment approach. He said that the CT scans can be 10%-20% inaccurate at times which would mean that it may just fall into a watch category.

                    Overall I am a little confused now. Not sure what I should do. I have my CT scan in 2 weeks so maybe that will answer some questions. I am thinking that surveillance is going to be tough going.
                    Dave Hanson
                    Found lump 18/02/2011
                    Ultrasound confirmed mass 23/02/2011
                    CT Abdomen, pelvis, chest (clear) 24/02/2011
                    Left I/O 1/03/2011
                    99% Seminoma <1% Unknown germ cell 10/03/2011
                    Staging T1 - 1A 10/03/2011

                    2 month - 27/04/2011 - All clear!
                    5 month - 16/07/2011 - All clear!
                    9 month - 22/12/2011 - All clear!
                    14 month - 22/12/2011 - All clear!


                    Yesterday was history, tommorrow a mystery, but today is a gift. That's why it's called the "present"

                    Comment


                    • #11
                      Since you have another CT in two weeks, I would wait and see how the two scans compare then go from there. They will look at it to see if it has changed any. I'm sure this is hard for you, not knowing for sure. Try not to worry in the meantime I was reviewing lymph node stuff in my CT book today and it said lymph nodes are normal up to 1 cm, borderline up to 1.5 cm and enlarged over that. Don't know if this helps or not : Are they going to check your tumor markers again at the same time? What I find confusing is that they are talking about this lymph node but it's not on the report? If not, where is this coming from?
                      Last edited by MrsB; 04-06-11, 10:46 PM.
                      Tina, wife to Gene
                      Right I/O 2/21/11
                      60% embryonal carcinoma- 40% seminoma with L/V invasion, Stage 1B, Cat Scan- clear
                      HCG- 1.2, AFP-1.5, LDH-normal
                      BEP X 2 started 3-7-11
                      Bleo canceled for 2nd round, lung issues
                      EP 3-28-11 X 5 days, finished chemo 4-1-11
                      F/U cat scan 4/14/11 - Stable
                      3rd round EP as precaution because Bleo was cancelled, start 4-25, finished chemo 4-29-11, pneumonia 5-6-11
                      6-1-11, 8-3-11, 9-7-11, 10-19-11, 11-16-11, 12-18-11, 1-18-12, 5-8-12 Clear

                      Comment


                      • #12
                        The lymph node sizing and identification came from the oncologist. I was surprised the urologist couldn't see it. The only mention to the lymph node is from the oncologist letter to my urologist. The actual CT scan report says all clear.

                        Alas I think I will have to wait until the next CT which I will have some answers.
                        Dave Hanson
                        Found lump 18/02/2011
                        Ultrasound confirmed mass 23/02/2011
                        CT Abdomen, pelvis, chest (clear) 24/02/2011
                        Left I/O 1/03/2011
                        99% Seminoma <1% Unknown germ cell 10/03/2011
                        Staging T1 - 1A 10/03/2011

                        2 month - 27/04/2011 - All clear!
                        5 month - 16/07/2011 - All clear!
                        9 month - 22/12/2011 - All clear!
                        14 month - 22/12/2011 - All clear!


                        Yesterday was history, tommorrow a mystery, but today is a gift. That's why it's called the "present"

                        Comment


                        • #13
                          Did your urologist call either your oncologist or the radiologist to ask where the lymph node is? Why the CT says clear? Surveillance is not tough (only before and after scans) but it does become a challenging mental game when you have anomalies like this to deal with.
                          Best,

                          Zsolt


                          Friendship is born at that moment when one person says to another; "What! You too? I thought I was the only one." - C.S Lewis

                          “Experience: that most brutal of teachers. But you learn, my God do you learn.” - C.S. Lewis


                          Mass found 11/20/08
                          Left I/O 11/25/08
                          Pathology: Seminoma, Stage 1
                          Surveillance: All Clear since

                          Comment


                          • #14
                            Well, that is just crazy, if they didn't see it on the cat scan, where did the oncologist get it from? Something is screwy here but hopefully it will get cleared up on the next scan! Maybe he has you confused with someone else, LOL
                            Tina, wife to Gene
                            Right I/O 2/21/11
                            60% embryonal carcinoma- 40% seminoma with L/V invasion, Stage 1B, Cat Scan- clear
                            HCG- 1.2, AFP-1.5, LDH-normal
                            BEP X 2 started 3-7-11
                            Bleo canceled for 2nd round, lung issues
                            EP 3-28-11 X 5 days, finished chemo 4-1-11
                            F/U cat scan 4/14/11 - Stable
                            3rd round EP as precaution because Bleo was cancelled, start 4-25, finished chemo 4-29-11, pneumonia 5-6-11
                            6-1-11, 8-3-11, 9-7-11, 10-19-11, 11-16-11, 12-18-11, 1-18-12, 5-8-12 Clear

                            Comment


                            • #15
                              Well I was there when the oncologist noticed it. He basically took the CT scans from me and popped them up on the display board thing they have. He looked at them for about 5 mins and it was after this that he said that the lymph node was enlarged but not something to worry about just yet.

                              I will post back to this thread after the next CT scan.
                              Dave Hanson
                              Found lump 18/02/2011
                              Ultrasound confirmed mass 23/02/2011
                              CT Abdomen, pelvis, chest (clear) 24/02/2011
                              Left I/O 1/03/2011
                              99% Seminoma <1% Unknown germ cell 10/03/2011
                              Staging T1 - 1A 10/03/2011

                              2 month - 27/04/2011 - All clear!
                              5 month - 16/07/2011 - All clear!
                              9 month - 22/12/2011 - All clear!
                              14 month - 22/12/2011 - All clear!


                              Yesterday was history, tommorrow a mystery, but today is a gift. That's why it's called the "present"

                              Comment

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