CT SCAN chest, abdomen and pelvis - Details
Narrative
[HST]: neuroendocrine tumor of pancreas
[SAS]: restaging
Exam: CT chest, abdomen and pelvis with contrast
History: Restaging neuroendocrine tumor of pancreas
Comparison: CT Chest, 10/17/2012. MR Liver, 3/22/2013. CT Abdomen,
4/17/2013.
Technique: CT scan chest, abdomen and pelvis with 100 cc Optiray 320
IV and oral contrast, without event in both arterial and venous
phases. Coronal and sagittal reconstruction images were viewed on
the viewing station. However, due to small PIV used 22 G restricted
injection speed and venous phase is in more delayed phase.
Findings:
Chest:
There is minimal right basilar atelectasis.
Previous pulmonary nodule in the right posterior lung base (image 58,
series 6) has increased in size measuring 5 mm (previously measured 4
mm) when compared to 10/17/2012. New subtle 3 mm ground glass nodule
in the left apex (image 8, series 6).
Subtle 3 mm groundglass opacity in the left pulmonary fissure (image
30, series 6) and right minor fissure (image 33) may represent
intrafissural lymph nodes.
Left node located in the anterior upper thorax just below the
clavicle (image 10, series 5) has slightly increased in size
measuring 11 x 10 mm (previously measured 10 x 5 mm). Similar
appearance of subcentimeter axillary lymph nodes. No new mediastinal
or hilar lymphadenopathy.
Heart size is stable. No pericardial effusion.
Abdomen:
Patient has undergone resection of the left hepatic lobe. Previous
metastases in the right anterior inferior and right hepatic lobe are
similar considering differences in technique when compared to
4/17/2013, but are better appreciated on the prior MR abdomen from
3/22/2013. No definite new hepatic lesions, but limited due to timing
bolus. Small calcified granulomas again noted in the liver.
No hypervascular enhancing lesions within the pancreas or new ductal
dilatation. As before, patient is status post cholecystectomy. The
spleen, adrenal glands and kidneys are unremarkable in appearance. No
hydronephrosis.
The aorta is normal in size and caliber. No new retroperitoneal
lymphadenopathy.
Bowel loops are unremarkable in appearance. No small bowel
obstruction.
Pelvis:
Bladder is normal in appearance. The uterus is unremarkable. Adnexa
are not well visualized. No free pelvic fluid. No pelvic or inguinal
lymphadenopathy.
Again noted is severe disc height loss at L2-L3 and minimal Grade I
anterolisthesis of L4 on L5 with moderate disc height loss. Stable
sclerotic lesions within the bilateral iliac wings, sacrum, pelvis,
right acetabulum, T12, L1, L2 and L4 vertebral bodies when compared
to 4/17/2013. No pathologic fractures.
[SAS]: restaging
Exam: CT chest, abdomen and pelvis with contrast
History: Restaging neuroendocrine tumor of pancreas
Comparison: CT Chest, 10/17/2012. MR Liver, 3/22/2013. CT Abdomen,
4/17/2013.
Technique: CT scan chest, abdomen and pelvis with 100 cc Optiray 320
IV and oral contrast, without event in both arterial and venous
phases. Coronal and sagittal reconstruction images were viewed on
the viewing station. However, due to small PIV used 22 G restricted
injection speed and venous phase is in more delayed phase.
Findings:
Chest:
There is minimal right basilar atelectasis.
Previous pulmonary nodule in the right posterior lung base (image 58,
series 6) has increased in size measuring 5 mm (previously measured 4
mm) when compared to 10/17/2012. New subtle 3 mm ground glass nodule
in the left apex (image 8, series 6).
Subtle 3 mm groundglass opacity in the left pulmonary fissure (image
30, series 6) and right minor fissure (image 33) may represent
intrafissural lymph nodes.
Left node located in the anterior upper thorax just below the
clavicle (image 10, series 5) has slightly increased in size
measuring 11 x 10 mm (previously measured 10 x 5 mm). Similar
appearance of subcentimeter axillary lymph nodes. No new mediastinal
or hilar lymphadenopathy.
Heart size is stable. No pericardial effusion.
Abdomen:
Patient has undergone resection of the left hepatic lobe. Previous
metastases in the right anterior inferior and right hepatic lobe are
similar considering differences in technique when compared to
4/17/2013, but are better appreciated on the prior MR abdomen from
3/22/2013. No definite new hepatic lesions, but limited due to timing
bolus. Small calcified granulomas again noted in the liver.
No hypervascular enhancing lesions within the pancreas or new ductal
dilatation. As before, patient is status post cholecystectomy. The
spleen, adrenal glands and kidneys are unremarkable in appearance. No
hydronephrosis.
The aorta is normal in size and caliber. No new retroperitoneal
lymphadenopathy.
Bowel loops are unremarkable in appearance. No small bowel
obstruction.
Pelvis:
Bladder is normal in appearance. The uterus is unremarkable. Adnexa
are not well visualized. No free pelvic fluid. No pelvic or inguinal
lymphadenopathy.
Again noted is severe disc height loss at L2-L3 and minimal Grade I
anterolisthesis of L4 on L5 with moderate disc height loss. Stable
sclerotic lesions within the bilateral iliac wings, sacrum, pelvis,
right acetabulum, T12, L1, L2 and L4 vertebral bodies when compared
to 4/17/2013. No pathologic fractures.
Impression
Impression:
1. Previous right posterior lung base nodule now measures 5 mm
(previously measured 4 mm) with new 3 mm nodule in the left apex. Two
new 3 mm subtle nodular opacities in the left pulmonary fissure and
right minor fissure may represent intrafissural lymph nodes.
2. Lymph node in the left upper anterior thorax just below the
clavicle has slightly increased in size measuring 11 x 10 mm
(previously measured 10 x 5 mm) when compared to 10/17/2012.
3. S/P resection of the left hepatic lobe with multiple hepatic
metastases in the right hepatic lobe similar compared to 4/17/2013,
but better appreciated on the prior MR abdomen from 3/22/2013.
4. No new hypervascular enhancing masses within the pancreas or
ductal dilatation.
5. No new retroperitoneal or intraperitoneal lymphadenopathy.
6. Multiple sclerotic osseous lesions within the spine, pelvis,
bilateral iliac wings, sacrum and right acetabulum are similar
compared to 4/17/2013 and some of which are likely due to metastatic
disease.
______________________________________
Electronically signed by:SUNG E LOGERFO, MD
Date: 10/30/2013
Time:11:49
1. Previous right posterior lung base nodule now measures 5 mm
(previously measured 4 mm) with new 3 mm nodule in the left apex. Two
new 3 mm subtle nodular opacities in the left pulmonary fissure and
right minor fissure may represent intrafissural lymph nodes.
2. Lymph node in the left upper anterior thorax just below the
clavicle has slightly increased in size measuring 11 x 10 mm
(previously measured 10 x 5 mm) when compared to 10/17/2012.
3. S/P resection of the left hepatic lobe with multiple hepatic
metastases in the right hepatic lobe similar compared to 4/17/2013,
but better appreciated on the prior MR abdomen from 3/22/2013.
4. No new hypervascular enhancing masses within the pancreas or
ductal dilatation.
5. No new retroperitoneal or intraperitoneal lymphadenopathy.
6. Multiple sclerotic osseous lesions within the spine, pelvis,
bilateral iliac wings, sacrum and right acetabulum are similar
compared to 4/17/2013 and some of which are likely due to metastatic
disease.
______________________________________
Electronically signed by:SUNG E LOGERFO, MD
Date: 10/30/2013
Time:11:49
Component Results
There is no component information for this result.
General Information
Collected:10/30/2013 10:34 AM
Resulted:10/30/2013 11:49 AM
Ordered By:Eric Martin Feldman, MD
Result Status:Final result
Resulted:10/30/2013 11:49 AM
Ordered By:Eric Martin Feldman, MD
Result Status:Final result
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