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Where there's smoke,
there's fire!!
Picture of techguy
posted
I had a ct scan done last week in reference to kidney stone issues. I got the results back today and it showed a “14mm nodule with Hounsfield units less than 10 is in the right adrenal gland”. The urologist said it was nothing to be concerned about and did not recommend additional testing but I had a ct scan done back in December 2019 because of kidney stones and that ct scan said my adrenal glands were unremarkable. Should I have this looked into further?

This message has been edited. Last edited by: techguy,
 
Posts: 1585 | Location: Kentucky | Registered: February 16, 2005Reply With QuoteReport This Post
Oriental Redneck
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Something new that wasn't there previously is always a concern. But, new stuff popping up on the adrenal gland by a CT scan oftentimes is just benign, what docs like to call an incidentaloma. But, always consult with your PCP.
 
Posts: 20350 | Location: TEXAS | Registered: September 04, 2008Reply With QuoteReport This Post
The Unmanned Writer
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Lop it off at the shoulders and hope it don't survive. Big Grin









Only in an insane world are the sane considered insane.


 
Posts: 12037 | Location: It was Lat: 33.xxxx Lon: 44.xxxx now it's CA :( | Registered: March 22, 2008Reply With QuoteReport This Post
Corgis Rock
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As your doctor to translate. Write the reply down and read. It back to understand. Please don’t depend on your invisible friends.



“ The work of destruction is quick, easy and exhilarating; the work of creation is slow, laborious and dull.
 
Posts: 5817 | Location: Outside Seattle | Registered: November 29, 2010Reply With QuoteReport This Post
Something wild
is loose
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quote:
Originally posted by Icabod:
As your doctor to translate. Write the reply down and read. It back to understand. Please don’t depend on your invisible friends.


This. Incidental findings of adrenal nodules are becoming much more common with better CT technology and resolution, increasing with age. The vast majority are benign, and are found in upwards of 5% or better of patients scanned for other than adrenal symptoms. Previously, surgery wasn't indicated for anything under 6 cm, since lowered to 4 cm as a "recommendation," unless malignancy was otherwise indicated, but you're nothing close to that. As advised, always best to consult with your PCP or specialist to discuss concerns and options, but more than likely just something for you and your urologist to keep an eye on and not be overly concerned unless he/she advises you otherwise. That said, don't depend exclusively on your invisible friends, including me. Smile



"And gentlemen in England now abed, shall think themselves accursed they were not here, and hold their manhoods cheap whiles any speaks that fought with us upon Saint Crispin's Day"
 
Posts: 2733 | Location: The Shire | Registered: October 22, 2011Reply With QuoteReport This Post
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Doc H. I am asking you to look at the units you have used in your post. Note, 4cm is equal to 40mm and in English that dimension is a bit over 1 1/2 inch. That isn't some little "nodule" that is something near the size of a golf ball.

BTW, I'm a manufacturing engineer in Automotive and had to cope with mixed Metric and SAE dimensions for a bit over 30 years now. On the plus side the standard unit of measure for the Metric system is the Millimeter, even great big Cruise Ships are dimensioned in millimeters.

Only does the Medical industry mix Centimeters and Millimeters and getting things mixed up, as I suspect is the case here, is the end result. If you have any voice at all in the medical profession you should really consider it your duty to get your industry to standardize on a single specific unit of measure. Because if you write a prescription for x milligrams and the pharmacist puts in x kilograms somebody is going to have a a very tough pill to swallow.


I've stopped counting.
 
Posts: 4624 | Location: Michigan | Registered: November 07, 2008Reply With QuoteReport This Post
Oriental Redneck
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quote:
Originally posted by Scooter123:
Doc H. I am asking you to look at the units you have used in your post. Note, 4cm is equal to 40mm and in English that dimension is a bit over 1 1/2 inch. That isn't some little "nodule" that is something near the size of a golf ball.


Doc H. is correct about sizing, there.
 
Posts: 20350 | Location: TEXAS | Registered: September 04, 2008Reply With QuoteReport This Post
Something wild
is loose
Picture of Doc H.
posted Hide Post
quote:
Originally posted by Scooter123:
Doc H. I am asking you to look at the units you have used in your post. Note, 4cm is equal to 40mm and in English that dimension is a bit over 1 1/2 inch. That isn't some little "nodule" that is something near the size of a golf ball.

BTW, I'm a manufacturing engineer in Automotive and had to cope with mixed Metric and SAE dimensions for a bit over 30 years now. On the plus side the standard unit of measure for the Metric system is the Millimeter, even great big Cruise Ships are dimensioned in millimeters.

Only does the Medical industry mix Centimeters and Millimeters and getting things mixed up, as I suspect is the case here, is the end result. If you have any voice at all in the medical profession you should really consider it your duty to get your industry to standardize on a single specific unit of measure. Because if you write a prescription for x milligrams and the pharmacist puts in x kilograms somebody is going to have a a very tough pill to swallow.


Centimeters is correct - the size of a nodule is one indication for its malignant potential. Less than 4 cm (about 1.5") is less likely to present as a malignancy absent other findings, and not generally indicated for surgical removal absent those other indications according to current guidelines. Size is one of the threshold criteria for determining adrenal malignancy, along with other indicators like hormonal findings and imaging abnormalities. Seventy-five percent of these "incidental" nodules are adenomas - sort of a fatty benign tumor (and only a "tumor" because it doesn't belong there) - and with HU of less than 10 on an unenhanced CT it's 98% specific that the OP's nodule is an adenoma, especially with the small size of 14 mm. Hence the urologist's recommendation. And again, Internet medical advice is worth exactly what you paid for it, hence my recommendation to consult with a PCP (and if genuinely concerned and the PCP or urologist recommend, with a good endocrinologist). But in my Internet opinion - for what it's worth - not needed given the description absent more significant findings. And I hear your recommendation. The problem with units of measure in medicine, in my experience, is more related to physicians' handwriting than the units themselves. Razz

*As an anecdotal aside to writing, resident notes always require a credentialed provider's co-signature. It is assumed that the co-signer reads the note. Some providers tend to just sign - long hours, long notes. The Joint Commission, and Administrators, really frown on that. As did I as Department Chief, and all my previous staff. One of my residents, in the patient's permanent record, at the end of his note wrote "I bet 5 bucks nobody reads this." Alas for him, I did. Mentoring ensued.



"And gentlemen in England now abed, shall think themselves accursed they were not here, and hold their manhoods cheap whiles any speaks that fought with us upon Saint Crispin's Day"
 
Posts: 2733 | Location: The Shire | Registered: October 22, 2011Reply With QuoteReport This Post
Where there's smoke,
there's fire!!
Picture of techguy
posted Hide Post
quote:
Originally posted by Doc H.:
quote:
Originally posted by Icabod:
As your doctor to translate. Write the reply down and read. It back to understand. Please don’t depend on your invisible friends.


This. Incidental findings of adrenal nodules are becoming much more common with better CT technology and resolution, increasing with age. The vast majority are benign, and are found in upwards of 5% or better of patients scanned for other than adrenal symptoms. Previously, surgery wasn't indicated for anything under 6 cm, since lowered to 4 cm as a "recommendation," unless malignancy was otherwise indicated, but you're nothing close to that. As advised, always best to consult with your PCP or specialist to discuss concerns and options, but more than likely just something for you and your urologist to keep an eye on and not be overly concerned unless he/she advises you otherwise. That said, don't depend exclusively on your invisible friends, including me. Smile



Thank you, Doc. I appreciate it.
 
Posts: 1585 | Location: Kentucky | Registered: February 16, 2005Reply With QuoteReport This Post
Something wild
is loose
Picture of Doc H.
posted Hide Post
quote:
Originally posted by techguy:
quote:
Originally posted by Doc H.:
quote:
Originally posted by Icabod:
As your doctor to translate. Write the reply down and read. It back to understand. Please don’t depend on your invisible friends.


This. Incidental findings of adrenal nodules are becoming much more common with better CT technology and resolution, increasing with age. The vast majority are benign, and are found in upwards of 5% or better of patients scanned for other than adrenal symptoms. Previously, surgery wasn't indicated for anything under 6 cm, since lowered to 4 cm as a "recommendation," unless malignancy was otherwise indicated, but you're nothing close to that. As advised, always best to consult with your PCP or specialist to discuss concerns and options, but more than likely just something for you and your urologist to keep an eye on and not be overly concerned unless he/she advises you otherwise. That said, don't depend exclusively on your invisible friends, including me. Smile



Thank you, Doc. I appreciate it.


More than welcome, and sounds like you've got a good urologist.



"And gentlemen in England now abed, shall think themselves accursed they were not here, and hold their manhoods cheap whiles any speaks that fought with us upon Saint Crispin's Day"
 
Posts: 2733 | Location: The Shire | Registered: October 22, 2011Reply With QuoteReport This Post
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