Posts by wanderingcobra76

feralridge3 said:Thanks for such a detailed response—everything is much clearer now. 😢
not again. 🙂

The diagnosis is an anaplastic ganglioglioma. The tumor was completely removed three years ago—that was the first time. Then, nine months later, there was a recurrence which was also fully excised. Since finishing Temozolomide chemotherapy back in November 2009, I have been in recovery. Things were steadily moving in the right direction... so where does that leave me now?

I forgot to mention—I am sent for follow-up MRIs every six months.

I am so sorry if I had to dampen your spirits 😢, but looking at those spectroscopy results—it isn't actually convincing that a recurrence is present, especially considering that area has undergone surgery, re-operation, and radiation...—and I say this not just to comfort you, but because it is truly the case (while MR spectroscopy is important, its results can often be quite non-specific).

Unfortunately, we both know that the diagnosis is quite daunting, but it is certainly not unbeatable. Keep your chin up and stay strong 🙂

Angela Wright said:I’m having a bit of trouble following—how exactly does that connect to what we were discussing? I wonder if anyone else has been following the recent developments regarding Colin? It seems like quite a situation—though, perhaps I am being too dramatic—but one does have to ask: where does this leave everything moving forward? With some common sense—if we can call it that? 😕

feralridge3 said:🤷
I’ve been doing some digging online lately—and while my long-term memory seems to be improving, my short-term recall is still a bit hit-or-miss. Honestly, I sometimes lose my train of thought mid-sentence and can't quite remember where I even saw certain information! However, based on everything I've managed to gather, I’ve started wondering if increased choline intake might actually suppress the immune system—which, in turn, could potentially trigger a relapse? What do you all think? 🤷
I find myself quite puzzled—how on earth did one arrive at such a conclusion? 😕 The images haven't even been reviewed yet—and honestly, none of the previous specialists have offered a single word of insight or written a solitary note! At this point, all I've been given is for my neurologist to send me in for an EEG in three months. Is anyone else dealing with this kind of standstill?
😕

That particular type of choline isn't actually related to the specific concentration of choline measured within the brain at its exact target site—if you catch my drift—and I really think the explanation provided in the previous post clarifies that distinction quite nicely. Wouldn't you agree?
There is really no need for concern—the scans have been thoroughly reviewed. Typically, at an institution like the Mayo Clinic, several specialized radiologists examine the data to ensure they are all in agreement before finalizing the report. It’s important to remember that the final conclusion isn't just based on "standard" images; rather, it relies heavily on spectroscopic measurements—which, if you're wondering, aren't your typical X-rays, but rather a series of color-coded intensity maps paired with a complex array of curves.

feralridge3 said:should I be worried? 🤔

The MRI results look fine—she’s already seen the neurosurgeon, the neurologist, and most recently an oncologist who confirmed there are no signs of tumor recurrence—but...

spectroscopy shows elevated choline levels relative to NAA. They’re requesting a follow-up brain MRI with spectroscopy. If the spectroscopic findings come back positive, they would recommend chemotherapy following a VCR/CCNU regimen.

😕

The real challenge when performing MRIs on patients who have undergone brain tumor surgery—especially if that area was subsequently treated with radiation—is distinguishing between post-operative changes, radiation-induced effects, and an actual recurrence (a new tumor forming in the same spot) or residual tumor tissue.
When things are unclear, doctors turn to MR spectroscopy. It isn't just a standard scan; instead, it focuses on a specific target area—like a suspicious zone—to measure certain metabolites and compare them against healthy tissue.
In fact, MR spectroscopy has evolved specifically to evaluate these types of brain changes. There are several standard metabolites measured, and while their concentrations matter, the ratios between them are often even more critical in determining whether we are looking at healthy tissue or tumor cells.

One such metabolite is NAA, which serves as a marker for healthy neurons. A drop in NAA can signal neuron loss due to a tumor, though it can also decrease as a result of radiation therapy.
Choline, on the other hand, is a marker for cell membranes. Its concentration spikes when cells are multiplying rapidly—as is the case with fast-growing tumors—so an increase often points toward a recurrence.
Another important metabolite typically measured is creatine, which acts as an indicator of cellular metabolism levels.
There are others, of course, but they are generally less significant in tumor cases.
Ultimately, specialists examine the ratios of these various concentrations to try and draw a meaningful conclusion.

To make matters more complicated—and it certainly isn't simple—this type of imaging is technically demanding and can be influenced by many different variables. Furthermore, there aren't "absolute" values to use as a universal benchmark, so even after spectroscopy, the results can sometimes remain ambiguous.

In this particular case, I suspect the findings unfortunately point toward a probable recurrence—though, I should note, the rise in choline and the dip in NAA aren't quite extreme enough yet to be stated with absolute certainty.
That is likely why they are requesting a repeat brain MRI and spectroscopy after a set period; if the choline continues to climb, it would confirm a recurrence, at which point the VCR/CCNU chemotherapy protocol would be initiated.

Yes, certain institutions simply won't provide those files on a CD.
They tend to store everything for a specific window of time—and once that period passes, the data is wiped from the archives.

Though... I'm not entirely sure how much sense it makes to make the trip there if their house rule is to refuse CD requests in the first place.🤷
Besides, if you’re heading in for a follow-up with a specialist at the same hospital, they should be able to access those images just fine through the hospital's internal computer system.

Austin Price2 said:Could someone please clarify this specific part of my report? It’s the section I've highlighted most. Thanks!

...An irregular oval hyperdense zone is visible subpleurally in the projection of the X segment of the left lower lobe, along with pleural thickening at the same level. While differential diagnosis would primarily suggest scarring, I still recommend a follow-up CT scan in 3 months—including these current images for comparison—to rule out any neoplastic process.

Big Bang?😁
The description refers to a finding just beneath the rib cage on the lower left side. Based on its characteristics, it looks mostly like scar tissue (there might even be similar spots elsewhere in the lungs)—but because the shape is irregular, they want to run a control CT scan. By comparing the new scans with these current ones, they can see if there have been any changes in that area.
If things *have* changed, it means it isn't just a scar, which would then require further diagnostic steps (likely a biopsy) to ensure it isn't a tumor—though based on how it looks right now, that seems less likely.

Kate James9 said:Can anyone help me make sense of these results?!

Breast Ultrasound:

The breasts show mixed density, with a normal sonographic structure in both the skin and subcutaneous tissue.
Cooper's ligaments are intact.
Within the fibroglandular tissue, located prepectorally at the border of the upper quadrants of the left breast, there is a cyst measuring 2.5 mm.
Pectoral muscles are unremarkable.
Axillary lymph nodes show no pathological changes.

Blood work looks good, except for my MPV—the normal range is 6.8 - 10.4, but mine is 12.8.

Thanks in advance!

Aside from the cyst (which is a completely benign finding and doesn't increase cancer risk), everything else looks perfectly normal.

electricpanther55 said:Hi there!
I'm looking for a layman's interpretation of this report:

The joint structures shown in the right foot X-rays are congruent.
There are no signs of periosteal reaction.
No definitive osteolytic skeletal changes are identified.
Mineralization is appropriate for age.

Thanks in advance!

It looks like a perfectly normal X-ray of the right foot.

Sam Flores4 said:The report states

Functional imaging of the lumbar spine segment. Flexion and extension ranges are somewhat reduced. No disruption of the posterior intercorporeal line during flexion or extension. Reduced disc space at L5-S1 with osteochondrosis present here. Also, a reduced dorsal portion of the disc space at L4-L5 during flexion and extension. Wedge-shaped L2 (Genant Grade 1)

This is the finding four months after my discectomy. As I understand it—is osteochondrosis the formation or loss of bone mass? In this case, I assume it’s bad since the diameter of the disc space is shrinking...
I am not quite sure what the intercorporeal line is, or what a wedge shape and Genant grades imply...

Any clarification?

The posterior intercorporeal line is the line traced along the back surfaces of the vertebral bodies—it needs to remain continuous, meaning there shouldn't be any forward or backward shifting that would compress the end of the spinal cord, such as nerve endings, or cause spinal instability.

The reduction in disc space width at those two levels means the disc thickness has decreased due to degenerative changes (which can start as early as your twenties)—as a result, the adjacent bone reacts, which is what we call osteochondrosis.

A wedge-shaped vertebra means the height has decreased in the front segment—this could be from trauma, osteoporosis, or even just general degenerative changes (Genant 1 is simply the first of three total grades).

Crucially, the spinal canal itself isn't described as narrowed.

All in all, the findings suggest mild to moderate degenerative changes—nothing particularly alarming, though it's worth noting that if there were a herniated disc, a standard X-ray wouldn't show it; you'd need an MRI for that.

Look, rather than rewriting everything from scratch, just take a peek here:
link to the psoriasis thread

Alex Scott60 said:Does anyone happen to know what MCP, IF, or RC joints actually are?

Those are all just different types of hand joints.
RC stands for radiocarpal—essentially the connection between your radius (that larger bone in your forearm) and the small bones of your wrist.

MCP refers to the metacarpophalangeal joints—the ones sitting between the bones in your palm and your finger bones.

Then you have the IF (or IP) joints, which are the interphalangeal joints—the little joints located between the segments of your fingers.

If you want a clearer visual, check out this diagram at http://www.chionline.com/anatomy/anat4.html

"Bill" is actually short for bilateral—which basically means the changes are mutual and two-sided.

To be perfectly honest, I haven't the slightest clue what DR4+ refers to? It sounds suspiciously like some kind of medical grading system used to track disease progression, though I've certainly never come across anything quite like it before. 🤷

An ultrasound allows us to see the physical structure of the kidney. When we are dealing with acute inflammation, the kidney usually looks perfectly normal on an ultrasound—you typically won't see any visible changes unless there is more severe glomerulonephritis, or perhaps in cases of chronic inflammation where the kidney tissue begins to develop scarring.
Ultrasounds can certainly pick up kidney stones, but generally only once they reach about 5mm in size or larger; anything smaller than that is virtually impossible to distinguish from the surrounding kidney tissue on an ultrasound scan.
What does this mean for you? Well, it means it is entirely possible to have a tiny stone in your kidney that simply doesn't show up on the imaging. Furthermore, if a stone has already started traveling down the ureter toward the bladder—which, by the way, causes excruciating pain, often compared to childbirth—it won't be visible on an ultrasound regardless of its actual size.

Since you were prescribed Spasmex, I am assuming the medical conclusion was that this is indeed a stone rather than an infection.
It is worth noting that the Spasmex they gave you isn't actually a standard painkiller; instead, it acts as a muscle relaxant for smooth muscles, such as those found in the ureter. The goal is to help the ureter relax around the passing stone, which should make the movement much less painful.
While taking the Spasmex, it is absolutely vital that you stay hydrated—if it is indeed a stone, you really need to flush your system out.
If there is nothing else you need to do, why not just lie in a warm bath to help your body relax while you focus on drinking plenty of fluids?

Michelle Williams5 said:Thanks so much for getting back to me—that was exactly what I needed to hear. 😍
It sounds silly, I know, but honestly? Between the idea of a tunnel and how long the procedure would take, I was absolutely terrified. 🤣

There really isn't any room for fear here. You'll be finished before you even get bored lying there 🙂.
With those older single-slice machines, the scan might take a bit longer, but for sinuses? I don't think it lasts more than a minute, if I recall correctly.

I am not entirely sure what the current medical landscape looks like in San Francisco or the surrounding areas, but I can tell you this—there is absolutely nothing about this scan that you should be fearing.

The process is quite straightforward: you lie down on a table positioned beneath a CT ring that is roughly 30 cm wide—it isn't a long, claustrophobic "tunnel" like you might find with an MRI. The table moves, gliding you through that ring once very quickly (just 3 to 4 seconds) to map out the scan, and then it passes through again for the actual imaging—which usually lasts anywhere from 6 to 30 seconds depending on the specific machine being used.

If the doctors determine it is necessary, they will administer a contrast agent through your vein and simply repeat the procedure once more.
And that really is all there is to it.

Those "spots" mentioned in the report actually correspond to what is described as demyelinating lesions of vascular origin.

Essentially, these kinds of changes can occur simply as part of the natural aging process—or perhaps due to shifts in the blood vessels—and they don't necessarily result in any significant clinical symptoms.
On the other hand, demyelinating lesions can also show up as part of certain conditions, such as Multiple Sclerosis; which is why it’s recommended to consult with a neurologist.

To ensure you don't jump to conclusions immediately—the description provided in this report isn't enough to diagnose MS, as one would need to see changes in other locations of the brain as well. Furthermore, the radiologist who interpreted the scan noted that the findings look primarily like the result of changes in the small blood vessels.
That being said, you should definitely take the results to a neurologist so they can compare them against your specific symptoms and the findings from a neurological exam.

electricmarlin29 said:The lumbar spine imaging shows a mild rightward deviation of the spinal axis—the vertebral bodies remain tall, though there's an initial Schmorl's lesion at the L5 level. There is increased sclerosis in the small joints of the lower third. On the AP view, a more massive transverse process of the L5 vertebra extends to the left, making direct contact with the lateral mass of the sacrum. Overall, the bone structure and mineralization look age-appropriate, and the joint spaces are well-maintained. On the profile view, the tibial tuberosity is more pronounced on the left side. 😕Could someone break this down for me? I have an appointment with my orthopedic surgeon in three weeks, but I actually had the scans done about six weeks ago... 😠 Thanks in advance...........

It isn't anything major.
The report describes some early degenerative changes—which, honestly, are quite common even in people in their 30s.
As for that more pronounced tibial tuberosity in the knee, it could simply be a physiological variation in how you developed (after all, our bodies aren't perfectly symmetrical!) or perhaps a result of extra strain on that left knee joint.
Generally speaking, these bone changes aren't particularly striking or specific enough to point toward a particular pathology.
Once you see the orthopedist, they will perform a physical exam to see if your clinical symptoms align with these imaging results; from there, they might refer you for further testing if they suspect an issue with the meniscus, ligaments, or something similar.

Samuel White11 said:Can anyone tell me if passing an endoscope through the esophagus, stomach, and small intestine can actually rule out a tumor or a gastric ulcer? If so, how certain can we be?

You can't say for sure.
When performing a passage, doctors are essentially looking for indirect signs—visual cues that might point toward a pathological process. But what if the issue is incredibly small? If it hasn't caused visible changes to the mucosal lining—or the wall of the digestive organ, to be precise—it simply won't be detected.
In cases like this, a standard gastroscopy would certainly be much more accurate, wouldn't it?

If your disc has herniated by about half an inch—based on what you've been told via an MRI or perhaps a CT scan—it essentially means the tough outer layer of the disc has ruptured. This creates a gap through which the soft, jelly-like center leaks out, pressing directly against your spinal cord or nerve roots.

In such a critical situation, seeing a chiropractor might be a fantastic idea... if your ultimate goal is to spend the rest of your life unable to move.

All jokes aside, please don't even consider it.

These reactive lymph nodes are primarily an indicator of inflammatory changes.
That doesn't necessarily mean there is an active inflammation occurring right now—it's important to remember that lymph nodes undergo structural changes while performing their function during an inflammatory response, and they often retain that altered appearance even after the inflammation has subsided.

Regarding the hypoechoic zone in the thyroid, this is a finding that warrants further investigation. While it could certainly be a completely benign change, it would be prudent to have the thyroid evaluated by a specialist in a nuclear medicine department.

From what I can gather, the lymph nodes located between the pectoral muscles have been removed—though my axillary nodes were already cleared four years ago alongside the primary tumor. But honestly, that's secondary at this point.

Yes, unfortunately, we are looking at metastases—which is just a technical way of saying the cancer cells have spread to the lymph nodes.
The next step will likely involve more diagnostic testing to confirm whether the involvement is limited strictly to those nodes.
If it’s just them (and hasn't reached, say, the brain, liver, or bones), then there is a silver lining to be found—it would mean we are dealing with regional metastases, which offers a much more favorable prognosis.
That is precisely why the recommendation is to contact your oncologist, who will determine the best course of treatment once the additional scans are complete.