Dr. Roach: Patients must take charge of following up on lab, scan results
Dear Dr. Roach: Recently I was in the hospital. I had a CT scan and was told that I have a “mass” on my kidney (unrelated to my hospital stay). One doctor said they would probably do an aspiration to determine what was in it, and another doctor told me not to worry, that it was just a cyst. This was concerning, as I have no symptoms or problems with my kidneys and I drink tons of water. Should I see a kidney doctor?
Dear P.S.: Incidental findings — conditions discovered unintentionally in the course of unrelated testing — are increasingly common given the advanced imaging tests routinely used in the hospital. In the kidney, abnormal masses (in this context, “mass” is just a general term for something that doesn’t belong there) are separated into solid masses and cystic ones. A cyst is a fluid-filled structure. A solid mass greater than 1 cm is risky and is usually biopsied.
Cystic masses are very common. The CT scan is good at separating low-risk cysts from moderate- and high-risk ones. Low-risk cysts generally cause no symptoms and do not need further evaluation, although some experts will get a sonogram in six to 12 months to be sure it is stable. A sonogram or ultrasound uses soundwave, not radiation, and is very good at looking at cysts in particular.
You should find out more about the abnormality on the scan. I suspect it is a simple, low-risk kidney cyst based on what the second doctor told you, but I think it prudent to be sure. Your regular doctor should be able to find out, but may want to refer you to a kidney specialist.
Doctors should be diligent about following up on your results. If you don’t hear from your doctor, don’t assume everything is OK. It is definitely in your best interests to make sure any abnormal findings you hear about get the appropriate follow-up, and you can’t know that until you know your test results. If no follow-up is necessary, your doctor should be able to explain why. In your case, I suspect it was that the cyst was of the lowest risk category.
Dear Dr. Roach: I’m writing to ask if it’s a problem if my poop floats. It has been for a few months. Should I see a doctor about this?
Dear C.C.: This is a question that is asked often, and the answer is that it is probably not a problem. If you made a change in your diet a few months ago, especially increasing your fiber consumption, that is likely the cause. If you have no other symptoms, there is very likely no cause to be concerned.
There are serious medical conditions that should be considered. They are in the general category of malabsorption. The most common causes of malabsorption are celiac disease, lactose intolerance and pancreatic insufficiency, though there are dozens more. Symptoms to be concerned with include abdominal discomfort, especially after eating; weight loss; and an oily residue in the toilet bowl. Any of those symptoms should definitely prompt you to see your doctor to evaluate any potentially serious issues.
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