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Dr. Tharun
Dr. Tharun, Doctor
Category: Medical
Satisfied Customers: 3682
Experience:  MBBS
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Can a ct scan tell between a benign n malignant lesion ?

Customer Question

Can a ct scan tell between a benign n malignant lesion ?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Tharun replied 2 years ago.
Dr. Tharun :

Hi

Dr. Tharun :

What is the lesion you are talking about ?

Dr. Tharun :

Is the CT scan planned with contrast administration ?

Dr. Tharun :

Hi, Are you there ?

Dr. Tharun, Doctor
Category: Medical
Satisfied Customers: 3682
Experience: MBBS
Dr. Tharun and 2 other Medical Specialists are ready to help you
Expert:  Dr. Tharun replied 2 years ago.

HI

Please give me the necessary information, so that I can answer your question.

Dr.Tharun

Customer: replied 2 years ago.

Ct was with contrast yes.

father had colon cancer surgery in march . He was a dukes c1.

a recent ct shows a 1.5 mm lesion in liver

Expert:  Dr. Tharun replied 2 years ago.
HI Hina,

CT scan can characterize a lesion but cannot confirm its pathology. Only a biospy would shed more light on the type of lesion.

Are you sure about the size of the lesion; is it 1.5 mm or cm. If it is 1.5 mm ( which I doubt), then there is no issue in wait and watch. Just follow up with serial scans to see if the lesion is growing or not.
If it is 1.5 cm then may be CT guided biopsy would be recommended. But the possibility of it being cancer depends on the original cancer in the bowel. Early stage localized bowel cancer rarely spreads. So if the initial biopsy report after surgery was a favorable one then it can be followed up. If it was unfavorable then it has to be consdiered cancerous unless proved otherwise. So a biopsy is advised.

If you have any doubts, please let me know.

Dr.Tharun
Customer: replied 2 years ago.

He was a dukes c1. The lesion is 15 mm. But can a ct not trll if it's malignant from appearance ?

his dr said they are unsure so will do pet scan .

if thy were sure they would not do pet scan right ?

Expert:  Dr. Tharun replied 2 years ago.
Many lesions look similar on CT scan. CT scan will just tell whether it is vascular or not. But that is not enough to confirm whether it is malignant.
So the next obvious step is a PET scan.

Dr.Tharun
Customer: replied 2 years ago.

What do u mean by vascular ?

Expert:  Dr. Tharun replied 2 years ago.
Means more blood supply to the lesion. Cancerous lesions have good blood supply and so does other lesions like hemagiomas. Hence the confusion.

Dr.Tharun
Customer: replied 2 years ago.

But a hemigioma or cyst cannot just develop right especially as April scan was clear?

also he already has liver cysts from before . This was confirmed by an mri .

Expert:  Dr. Tharun replied 2 years ago.
HI

If it is a recent devleopment after the surgery, it has to be considered as metastasis unless proved otherwise. So PET would be natural choice now.
Customer: replied 2 years ago.

Is there treatment for it ?also r liver mets ususlly multiple ?

Expert:  Dr. Tharun replied 2 years ago.
Treatment depends whether it is a primary tumor or metastasis. Primary tumor should be treated depending on its merit. Metastasis warrants chemotherapy.

Metastasis are usually multiple. But if caught early it could be single.

Dr.Tharun
Customer: replied 2 years ago.

Is it better if the met is single ?

Customer: replied 2 years ago.

Would a rafiologist use the word metsases on the ct report if he thought a liver lesion was a met ?


 


he has the following wording .


 


1 new liver lesion


1 10 mm lymph node noted


appearances keeping with disease progression

Expert:  Dr. Tharun replied 2 years ago.
Hi

Radiologists usually describe the lesion rather than give a diagnosis like metastases or other malignancy.

Definitive diagnosis is only given on a histopathological report. Imaging reports are given in the form of differential diagnoses.

Dr.Tharun

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