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why would lymnodes be swollen in the chest after a right lung lobectomy?

Posted by Alisa

69 year old male presents with lung cancer. Has 2 lower right lung lobes removed. What was left of the upper right lung does not inflate and they go in again to remove the rest of the right lung.  It has been 3 months since left lung lobectomy and pet scan shows swolloen lymphnodes. Cancer was stage one tumor and was not present in the lymphnode biopsy.
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Usually they're swollen because they are infected with the cancer (may even be microscopic).  PET scan most likely did not light up in lymph nodes because they were the nodes closest to the tumor and could have possibly been so microscopic they didn't appear or else mistaken for part of the tumor in lower lobe.  It sounds like he may have to be rediagnosed...which would most likely put his staging between a 2b/3a. 
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