樵客

講述親身經曆，感悟天地人生

首頁文章列表博文目錄

個人資料

fuz (熱門博主)

給我悄悄話

博客訪問：

轉移

(2023-08-29 17:34:29) 下一個

還是第二原發癌？

這是最近一次CT檢查引出的問題。

2023-8-18 做了CT，最終的報告五天後才出來。據醫生說幾乎所有會讀片的都看了，反複幾稿才定下來。初稿中說肝區多個微小新癌變灶，改成了末定。

Impression

1. No new lung nodules are seen. Interval slight increase in the right lower paratracheal lymph node, now measures 10 mm in comparison to the prior PET dated 06/06/2023.

2. Stable post radiation fibrosis bronchiectatic changes are seen in the left lung.

3. Unchanged right moderate and left loculated moderate pleural effusion with consolidation and or atelectasis of the lung bases. Continued follow-up is recommended.

4. Interval multiple new hypodensities along the right dome of the liver causing scalloping of the liver surface, concerning for peritoneal deposits.

5. 3 discrete stable hypodense lesions of the and hemangioma seen within the liver. Interval development of subcentimeter tiny hypodensities in the liver, too small to characterize.

6. Interval development of new ascites and omental stranding.

7. Uncomplicated right sided inguinal hernia containing fat, fluid, and vasculature. 8. Cholelithiasis without acute cholecystitis.

在分區細節中提到右肺的變化：

There is interval slight increase in the right lower paratracheal lymph node, now measures 10 mm in the maximum short axis dimension.

New pleural effusion seen on the right with blunting of the costophrenic angle.

Right lower lobe atelectasis is seen.

8-23日看了醫生。在仔細核實並對比以前的影像檢查後，醫生很躊躇，到底右肺和肝上發生了什麽。我則直接點題：轉移、還是第二原發？

討論一番後，初步定下來：

1. 抽右側胸水，做細胞學和生化檢查。

2. 肝髒MRI掃描，以期確認那些新增病灶。

3. 腹水檢測。

4. 結腸鏡檢。