CT ABDOMEN WITH CONTRAST- Confirmed cancer non-hodgekins lymphoma.
Indication- Epigastric pain.
History- Breast ca and mastectomy.
Findings- Bilateral breast prostheses are noted. There is no
pericardial or pleural fluid. The lung bases are unremarkable. The
osseous structures demonstrate a scoliosis but no suspicious lytic
or blastic lesions are identified.
Abnormal ill-defined soft tissue density is seen infiltrating the
epigastric region encasing the portal vein, and left renal vein.
This most likely represents adenopathy. A large mantle of
adenopathy on image #26 measures 4cm x 4.4cm and is centered in the
porta hepatis region. Probable adenopathy is also seen just
superior to the pancreatic body as well as in the gastrohepatic
ligament. There are no focal intrahepatic lesions identified.
There has been prior cholecystectomy with associated prominence of
the common bile duct, likely relating to the prior cholecystectomy.
The adrenal glands and kidneys and spleen are unremarkable. No free
fluid or free air or inflammatory bowel wall changes.
On image #40, there is a 6mm abnormal soft tissue density nodule
seen in the anterior peritoneal cavity adjacent a loop of colon.
This is of uncertain clinical significance. There is a similar
appearing small nodule seen measuring 5mm in size just anterior to
the superior tip of the right iliac wing. A smaller similar
appearing nodule is seen more inferiorly within the right iliac
fossa measuring only 2mm in size.
IMPRESSION-
1. Abnormal epigastric adenopathy. There is a nonspecific
appearance. The appearance alone would suggest lymphadenopathy
associated to lymphoma, but given the history of breast cancer,
metastatic adenopathy cannot be excluded. Several prominent
retrocrural lymph nodes are also noted and likely associated with
the same process.
2. There are several small peritoneal sub-cm nodules that are
suspicious for adenopathy but less pronounced in size when compared
to the epigastric process.
