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Thread: Do PEt scans light up infected sites?

  1. #1

    Do PEt scans light up infected sites?

    As some of you know, my mom was diagnosed in august with cancer in the Mediasteinium. In the past three weeks my mom as gone from being active and feeling "good" to being weak and short of breath, so much that she is unable to walk even 25 feet without sitting down to recover. About this time, an area near her biopsy site in the neck had become red, very hot. I was concerned it might be cellulitis. The area quickly bulged into a large mass, red, oozing, lymph nodes in bth sides of the neck buldged.

    We went for radiation mapping yesterday. She is all set to start radiation next week to hopefully off set some of the symptoms, the shorthness of breath, and oozing of the wound. Turn of events today

    My mother became very confused, barely had a blood pressure, oxygen levels dropped and 911 was called. She was rushed to the ER where they did an xray and blood work. She has pneumonia and is septic. White blood count was sky high. I questioned and discussed this mass on her neck/chest and how her weakness and shortness of breath got worse around the same time this area became red and enlarged (like an abcess) While they did not culture the wound she is spetic from something and I wonder if this area is really infected as I suspected all along. She is now in the hospital and wil be getting IV antibiotics. We are waiting for the blood culture finals, I am curious as to what bacteria has infected her.

    So, my HOPE is that perhaps her rapid decline has been caused by her sepsis. I HOPE that once the infection is cleared that she will breath easier and be able to walk and be strong like she was 3 weeks ago so she can continue to battle her cancer with the strength she had prior.

    I wonder, has anyone had a PET Scan that was falsely positive due to an infection process rather than cancer cells? could an infection light up on a PEt Scan the same way it lights up Cancer cells?

  2. #2
    Administrator Top User Didee's Avatar
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    Hi. I am so sorry to hear about your mother but I am so glad that she is being treated and looked after.
    Re your questions on PET scans..the answer is yes. They quite often give false positives as infection, inflammation and brown fat can all light up.
    Aussie, age 57
    1987 CIN 111. Cervix lasered, no further problems.

    Dx Peripheral T Cell Lymphoma stage 2B bulky, aggressive Dec/09.
    6 chop14 and Neulasta.
    Clean PET April/10, 18 rads 36gy mop up. All done May 2010
    Iffy scan Nov. 2011.
    Scan Feb 2012 .still in remission.
    Still NED Nov 2012. On to yearly bloods now.

    May/2012. U/sound, thyroid scan, FNB. Benign adenoma. A lump in otherwords, nodule if you wish to be specific.

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  3. #3
    One more question,
    If the PEt scans show inflammation, infection and brown fat do the colors that light up vary from the cancer colors? Could the results be mistaken for infection rather than cancer sites? I don't really understand the color part of the results.

  4. #4
    Administrator Top User Didee's Avatar
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    Neither do I. Hopefully one of the others will be able to explain more but I think it is down to how they are read by the professionals.
    Aussie, age 57
    1987 CIN 111. Cervix lasered, no further problems.

    Dx Peripheral T Cell Lymphoma stage 2B bulky, aggressive Dec/09.
    6 chop14 and Neulasta.
    Clean PET April/10, 18 rads 36gy mop up. All done May 2010
    Iffy scan Nov. 2011.
    Scan Feb 2012 .still in remission.
    Still NED Nov 2012. On to yearly bloods now.

    May/2012. U/sound, thyroid scan, FNB. Benign adenoma. A lump in otherwords, nodule if you wish to be specific.

    CancerForums User Policy

    http://www.cancerforums.net/threads/...picture-policy

    Out of all the things I have lost, I miss my mind the most.

  5. #5
    Administrator Top User pbj11's Avatar
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    They light up the same color. It's the SUV number that is important. The higher the number the more likely cancer. PET's done too soon after radiation can cause a false positive too. Infection/inflammation can cause a borderline high SUV where no determination can be made as to the specific cause.
    Husband diagnosed with NSCLC Stage IV in 3/2005. Fought & lived over 2 1/2 years with multiple lines of treatment.

    Post describing our journey: http://cancerforums.net/viewtopic.ph...er=asc&start=0

    Left my embrace to live with our Heavenly Father in October of 2007 and now breathes with ease forever. I will miss this gentle, giving soul with the easy smile for the rest of my days, but have faith we will be together again. He's just getting a little break from me!

  6. #6

    Not convinced

    I just can't shake the feeling that the "Grim" Pet scan report showing increased growth in the cancer nodes/size is not a result of an infection. I can't seem to get anyone to think in depth about this.

    My mom's decline was rapid, right around the time her neck/chest became red and inflammed and suddenly grew very large and started weeping. I was thinking cellulitus. Since she ended up in the hopsital and has been on antibiotics, this area on her front has shrunk, in fact many of the nodes have shrunk. Her entire neck is not swollen like it had been. Tonight I find that the "tumor" on her chest/neck is not longer weeping. It's almost flat to her chest, no longer buldging outward as much.

    She was to start Radiation tomorrow because of the sudden decline and we were at the office last week, a day before she went into the hospital with the pneumonia which the oncolocgist on call was not convinced it was a pneumonia at all. He thought it may just be the cancer but would treat my mother for pneumonia anyways. Radiation has been delayed until next week since she is still at the hospital. I don't even know if it is a good idea to do the radiation because the only reason they were going to do it is because of her sudden decline, It is such a vast area they were going to radiate that it comes with a high risk of damaging the lungs and with the shrinking of these areas I don't know if it would be better to hold off on the radiation. Perhaps the new chemo has had something to do with the shrinking of these areas and she would be better off forgoing the radiation and doing another round of chemo. Some of the staff has thought the neulasta is what made her white count go so high.

    I don't think I have mentioned this in my post prior but a year and a half ago my mother's house underwent some major renovations due to water leaking under the siding cuasing the side of the house to literally rot away. After it was discovered the side of the house was torn down and rebuilt. There was a lot of mold and rotted wood, insulation, etc. Her weight loss started shortly afterwards, then diagnosed in August with cancer.

    This is not a typical cancer, it is "angry" and large cells. Even the course of advancement has been strange. There is no "primary" site, It is just affected the nodes in the mediastenium advancing along the lymph nodes. It has not spread far, just advanced in the general area. The doctor even has said it is not typical of lung cancers.

    So I have asked for sputum cultures and mentioned/asked if this could be fungal. They all look at me like I am in denial about my mother's disease. Once you have a dx of cancer everything that goes wrong is blamed on the cancer. I really am not in denial, just concerned that the events leading up to this diagnosis are being overlooked.

    I wonder if this could all be related to a fungal infection from the mold that was stirred up when the house was torn down. I find things on fungal infections being misdiagnosed as cancer. I find things that fungi can lay dormant in the body until the immune system is weakened. Don't know if a biposy could mistake a fungal cell for a cancer cell but since the doctor said from the start that it was atypical I can't help but wonder.

    I think if someone would just rule this out for me I would accept my mother's fate with grace but I am afraid I will always wonder about this no matter what the outcome.

  7. #7
    Administrator Top User ChemoMan's Avatar
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    Hi

    A severe infection is going to make the PET scan basically useless for determining if cancer has present. The chance of false positive is so high its not even worth doing the scan. if a biopsy was done on the cancer then chances of false positives are low and you can be satisfied the diagnosis was correct. If a biopsy was done the slides can always be sent off for another opinion.

    good luck
    Age 58
    Diffuse Large B cell Lymphoma
    Stage 2a
    Finished six cycles of R chop 21 26th May 2008
    Officially in remission 9th July 2008
    Remission reconfirmed 1st October 2008
    Remission reconfirmed 17th June 2009
    Remission reconfirmed 7th June 2010
    Remission reconfirmed 6th July 2011
    NED on the 2/01/2013
    No more scheduled visits to the Prof
    http://cancerforums.net/viewtopic.php?t=9620

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  8. #8
    Administrator Top User pbj11's Avatar
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    Hi Mom's Daughter,

    WBC's can skyrocket when the body has a serious inflammatory process going on. Neulasta probably didn't help matters. I thought my husband was doing unbelievably well with such high WBC's, then was told it wasn't necessarily good news. WBC's will also spike with an infection. That's what they do to fight it off.

    I'm a little confused over this whole scenario. She had sepsis, right? Now the enlarged nodes are flattening out, so isn't it likely that it was infection causing the swelling?

    Pneumonia is tricky business when you are talking radiation. Rads will irritate the area and many times cause pneumonitis. http://www.mayoclinic.com/health/pneumonitis/DS00962

    Can you get another opinion on how to proceed from here? I'm guessing they are being particularly aggressive in wanting to do radiation, due to the cancer being large cell. Corral her doctor and get the answers to your questions. You hire them and that's part of their job.

    As for some type of fungus, that's always a possibility. That doesn't negate what they found in the cells from the biopsy. Would another biopsy be an option? Many lung cancer patients deal with multiple problems in their lungs. We discovered my husband had lung cancer, emphysema, and already knew he had multiple calcified nodules for years. I understand your concern over the house issue. We had an undisclosed slow leak from our water filtration system that got into the basement wall and carpet. We had four times the normal amount of two of the bad fungus and this was discovered right after my husband was diagnosed. Had to do a full on, zippered room, clean up.

    If she has a fungal infection going on, alongside the cancer, addressing that will help knock out one of her problems. Have you been to Dr. West's site yet? He's an oncologist with a lung cancer specialty. I can't remember if I mentioned it to you or not. Go to cancergrace.org and register. One of the volunteer doctors will answer you and maybe that will help give you some of the answers you seek.

    Overall, the tendency is for doctors and patients to tab any problems to the cancer, when it's not necessarily true.

    Good luck and God bless. Hope your Mom is doing better.

    PBJ
    Husband diagnosed with NSCLC Stage IV in 3/2005. Fought & lived over 2 1/2 years with multiple lines of treatment.

    Post describing our journey: http://cancerforums.net/viewtopic.ph...er=asc&start=0

    Left my embrace to live with our Heavenly Father in October of 2007 and now breathes with ease forever. I will miss this gentle, giving soul with the easy smile for the rest of my days, but have faith we will be together again. He's just getting a little break from me!

  9. #9

    clearing

    It has been an extremely tiring day today. Mom is still not home from the hospital. We are hoping tomorrow she will be allowed to go. I called the oncologist and spoke to him. He is again telling how very dire my mom's situation is. But considering how she was for the last 3 weeks and how she is now I have to say she is in much better shape now then she was going out on the strecther. Yes, the bulging "mass" that was leaking is completely dried up and is now flesh colored and almost completely flat. This was a huge area that has shrunk to almost nothing. The infection definitely had soemthing to do with this. (No matter what the oncologist tells me) I hope she regains enough strength to return to the quality of lofe she had before she began failing 3-4 weeks ago. He blood pressure is stable, breathing is still labaored but her color is much better.

    The oncologist says he will look at everything once she gets home and figure out the next step. I am hesitant on the radiation because it is such a large area they will radiate, they tell me it comes with it's own risks. We will see. They were not goig to give her radiation until she began to fail fast and started with an open "mass". Now that it's almost gone who knows.

    I will check out that website you mentioned. I am a little frustrated with my mother's doctors because twice I mentioned that I thought she had an infection and twice my concerns were dismissed.

 
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