CT scan results

Les had her CT scan at Duke two weeks ago.  She was supposed to get a PET/CT with contrast, but once again, insurance got in the way of what the doctors requested.  Anyway, they found a place on her liver, and a small spot on one of her lungs.  The doctors requested an MRI to take a closer look at the liver, but seem to not be excited about the lung.  We head back to Duke tomorrow for the MRI.  Here is what was written about the CT:

CT chest, abdomen, and pelvis with IV contrast

Comparison: Outside PET/CT dated 2/27/2014.

Indication: V10.82 Personal history of malignant melanoma of skin, eval
for metastases

Technique: CT imaging was performed of the chest, abdomen, and pelvis
following the uncomplicated administration of intravenous contrast
(Isovue-300, 150 mL at 3 mL/sec). Iodinated contrast was used due to the
indications for the examination, to improve disease detection and to
further define anatomy. The most recent serum creatinine is not available.
3-D maximal intensity projection (MIP) reconstructions of the chest were
performed to potentially increase study sensitivity. Coronal images were
also generated and reviewed.

Findings:
Chest:
There is a faint nodular opacity measuring 4 mm in the right lower lobe
(series 6, image 37). There is bibasilar atelectasis and scarring. There is
biapical pleural scarring.

The thyroid gland is normal in appearance. There is no evidence for
axillary, mediastinal, or hilar adenopathy. The heart is normal in size.
There is no pericardial effusion. The pulmonary parenchyma is normal in
appearance, with no abnormal pulmonary parenchymal opacities. There is no
pleural effusion. The central airways are patent.

Abdomen/Pelvis:
There is a enhancing lesion within the dome of the right hepatic lobe
measuring 1.7 x 1.3 cm (series 6, image 52). No additional hepatic lesions
are identified.. There is no intrahepatic or extrahepatic biliary
dilatation. The hepatic arteries, hepatic and portal veins are patent. The
gallbladder is normal. The adrenals, pancreas, and spleen are unremarkable
without evidence for focal lesion.

The kidneys enhance symmetrically. There is no pelvicaliectasis or
ureterectasis. There are no renal parenchymal lesions.

There are multiple loops of nondilated large and small bowel without
evidence for bowel obstruction or bowel wall thickening. There is no
abnormal mesenteric stranding. There is no mesenteric or retroperitoneal
lymphadenopathy. The urinary bladder is normal. There is no pelvic
lymphadenopathy.

There are no suspicious osseous lesions. There is a scoliotic curvature of
the thoracolumbar spine with degenerative changes.. There is a stable
sclerotic lesion in the left pubic ramus. There is a soft tissue density in
in the anterior left thigh measuring 2.5 x 1.4 cm, which is likely
postoperative (series 6, image 125).

Impression:
1. Hyperenhancing lesion within the dome of the right hepatic lobe, which
is indeterminant. Differential diagnosis includes both benign and malignant
pathology (benign: FNH, adenoma; malignant: metastatic melanoma). Further
is characterization with MRI is recommended.
2. Tiny right lower lobe pulmonary nodule.

We will be taking a print of this with us to ask questions as there are a couple of things mentioned that concern me that the doctors don't seem excited about.  I am going to do a little research into the medical terminology in the report this evening to try to put things in 'layman's terms' to try to understand better, and be able to ask intelligent questions. Hopefully the MRI will bring good news…