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PAST HISTORY : Diabetic
Patient asked followup Question: 12 years ago
Please let me know what does the following CT scan report tell: LIVER- Normal SPLEEN - Normal PORTAL VENOUS SYSTEM: Normal IVC, HEPATIC VEINS: NORMAL BILIARY SYSTEM and GALL BLADDER; NORMAL PANCREAS: NORMAL ADRENALS: NORMAL KIDNEYS: 9X7mm simple cyst in the left kidney mid pole PEVI-CALYCEAL SYSTEMS: Normal URETERS: NORMAL BLADDER: NORMAL BOWEL: NORMAL PERIOTNEUM, OMENTUM, MESENTERY - patchy fat stranding in the mesenetery. widespread fine omental fat stranding / nodularity seen. mild peritoneal thickening n the lower abdomen. NODES: Small volume left cardiomediastinal fat pad lymph node noted measuring 5mm in short axis FLUID: -moderate free fluid noted in the subphrenic space, around the liver, right paracolic gutterand pelvis - Mild pleural effusion bilaterally UTERUS: Normal OVARIES: NORMAL VISUALISED LUNGS: - Bibasal atelectasis, small bilateral pleural effusions ABDOMINAL WALL: Normal. IMPRESSION: 63 year old lady with abdominal distension, to r/O malignanacy CT Abdomen and pelvis with oral and intravenous contrast demonstrates: - Moderate free flyuid as described - Patchy fat stranding in the mesentery. widespread fine omental fat stranding / nodularity seen. Mild peritoneal thickening in the lower abdomen. - Bilateral plerual effusion. Appearances are likely to suggest Koch's abdomen. Albeit, recommend tumour markers (CA 125) to rule out possibility of malignancy although no direct evidence of such is seen. Post above CT scan report, further test were done with regard to CA 125, Fluid analysis (cytology): RESULTS as under CA 125 - 482.4 U/ML (Basic reference range - 35 U/ml) Flucid cytology report confirms Negative for any malignancy. AFB stain too negative. Please take the above in to consideration and let me know what the results indicate. What should i do next. I appreciate any of the doctors out there responding to this query on an critical and urgent basis. Please suggest. Cheers: Vinod Cell: 8884964555
Dr. Puneet Madan answered : 12 years ago
Hi,
The report shows that the patient is suffering from from lung and intestinal disorders which shows that she has fluid in the lungs and also some part of the lung is also collapsed and she has either a granulomatous infection in itestine or may be a malignancy which needs to be ruled out for which a pet scan is adviced probably.
The tumor marker you got is usually done for ovarian cancer and afb is done for tuberculosis(but this canot rule out t.b).kochs abdomen is intetinal tuberculosis.
Now it depends what your doctor is thinking as a diagnosis because for that you also assess the patient clinically
Dr. Puneet Madan answered : 12 years ago
Hi,
Cost of pet scan may be around 8-12 thousand i m not very sure.