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How to determine right size of retroperitoneal lymph node?

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  • How to determine right size of retroperitoneal lymph node?


    Hello All! I am 31, have been diagnosed TC and had my right orchiectomy 05/24/2016.
    Histology: unmatere Teratoma 70 %, yolk sac tumor 15 %, choriocarcinoma, 15 %, Vascular invasion is present.Stage 1-B.I chosed surveillance.
    After my IO (2 year and 2 months)my follow up in September, January was ok (CT were all clear, bloodwork ok).

    In July 2017 bloodwork ok but my CT found a 9x4.5 mm nodule in my left lung, but alternative consultation was that it isjust a scar and it is stable up to now.
    In Febriary 2018 bloodwork ok and my CT shown again 9x4.5 mm scar in my left lung,and it also shown two retroperitoneal lymph node (aortocaval) one up to 6 mm and one to 7 mm.

    And my last CT on 07/27/2018 shown again 9x4.5 mm scar in my left lung(its ok,becouse is stable),and the same two retroperitoneal lymph node (aortocaval) one up to 7 mm and one to 10 mm which was 6 before. I showed my CT films to another radiologist and his conclusion was next: two retroperitoneal lymph node (aortocaval) one is 9x8x12mm (was 7x5x12 before) and one is 8x7x13 (was 8x5x12 mm before).

    I am confused now.I dont understand how to determine right size of retroperitoneal lymph node for determining the boderline which I found here: https://pubs.rsna.org/doi/10.1148/ra..._pub%3Dpubmed&

  • #2
    For example: if the boderline for portacaval space is 10 mm than what size from sizes of LN (9x8x12mm) I need to use?9 mm,8 mm or 12 mm?
    Are sizes of my LN normal?Is that a relapse?

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    • #3
      hope some can help
      Son Grant
      dx 12/21/16 at age 17

      BEP x3
      Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
      2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
      Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

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      • #4
        Does smb can help?

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        • #5
          Most commonly I have seen 1 cm at the largest dimension as an indicator of being a concern for metastasis. The 1 cm is not perfect. If you suspected smaller nodes, say 0.5 cm for example, then you would catch more of the ones with cancer but you are also catching more that are not (false positives). Given the right-sided testicular cancer I would assume that your doctor would consider the interaortocaval area as a primary landing zone and with node at 1 or 1.2 cm, then I am assuming that they are suspicious that they may be something to be concerned about. I suppose I would ask that if the nodes appear to be slow growing what the risk vs. benefit is of continuing to monitor them to make sure that treatments are needed vs. starting treatments now.

          Mike
          Oct. 2005 felt lump but waited over 7 months.
          06.15.06 "You have Cancer"
          06.26.06 Left I/O
          06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
          06.30.06 It's Official - Stage I Seminoma
          Surveillance...
          Founded the Testicular Cancer Society
          6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

          For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

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