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MY CT CONTRAST RESULT help anyone??
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MY CT CONTRAST RESULT help anyone??









* * *Final Report* * *

DATE OF EXAM: Apr 5 2013 12:21PM

MCC 0333 - CT LIVER WWO CONTRAST / ACCESSION # 91420155

PROCEDURE REASON: Cirrhosis of liver without mention of alcohol
* * * Physician Interpretation * * *

CT ABDOMEN WITHOUT AND WITH IV CONTRAST


HISTORY: Esophageal varices and thrombocytopenia.

TECHNIQUE: Non-IV contrast enhanced and bolus phase imaging preceded
hepatic portal venous phase imaging of the abdomen IV contrast only.

Contrast:
IV: 100 ml of Ultravist 300
Oral Contrast: None

CT Radiation dose: Integrated dose-length product (DLP) for this visit =
315 mGy*cm.

COMPARISON: None.

RESULT:

Hepatic morphology and masses: Morphologic changes of early cirrhosis.

This is a 1.8 x 2.0 cm cyst in the left hepatic dome (series 5 image
15). A few additional subcentimeter low attenuation lesions which are too
small to characterize are noted in the liver (for example series 5 image
24 and 29 and 40).

Hepatic vasculature and collaterals:

Portal venous system - There is no thrombus in the portal venous system
(splenic vein, main portal vein, left and right anterior and right
posterior portal vein branches.
Portal vein diameter - 1.2 cm.
Celiac trunk and SMA - No stenosis.
Hepatic artery - The hepatic artery is patent. There is an accessory
left hepatic artery arising from the left gastric.
Hepatic veins - The hepatic veins are patent.
Collaterals: There is no spontaneous splenorenal shunt. There are no
large mesenteric portosystemic collaterals. There is no recanalization of
the paraumbilical vein. There are small esophageal varices.

Related extrahepatic findings (i.e. ascites, splenomegaly):
Spleen - The spleen measures 12 cm in length, normal. There are
no focal splenic masses.
Ascites - There is no ascites.

Biliary system and pancreas: There is no intrahepatic or extrahepatic
biliary dilatation. The gallbladder is normal. There are no pancreatic
masses or pancreatic ductal dilation.

Kidneys: There is a cortical scar in the upper pole of the left kidney
with a 1 cm focus of dystrophic calcification. The inferior half of the
left kidney is atrophic. Fused supernumerary right kidney (rare
congenital anomaly) is noted.

Adrenal glands: The adrenal glands are normal.

Bones: degenerative changes without destructive lesion.

Lung bases: There is honey combing with sparing of the costophrenic
angles.
IMPRESSION:

MORPHOLOGIC CHANGES OF EARLY CIRRHOSIS. SMALL ESOPHAGEAL VARICES.

HONEY COMBING WITH SPARING OF THE COSTOPHRENIC ANGLES, LIKELY FIBROTIC
NONSPECIFIC INTERSTITIAL PNEUMONITIS GIVEN HISTORY OF SJOGREN'S.
DEDICATED CHEST IMAGING IS RECOMMENDED.























    MyChart ID: Paula319 | MRN: 71725588 | PCP: Christopher Stetler, MD


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446474_tn?1404424777
This indicated you have early compensated cirrhosis with some increase in portal hypertension but not enough to cause splenomegaly or dilation of the portal vein.

The masses?

"1.8 x 2.0 cm cyst in the left hepatic dome."
Liver cysts occur in approximately 5% of the population. However, only about 5% of these patients ever develop symptoms. The vast majority are benign. It will be watch during future imaging studies.

"A few additional subcentimeter low attenuation lesions which are too
small to characterize are noted in the liver"
What type of lesions they are can not be determined at this time. Most lesion have to be 1-2 cm to make a diagnosis. Since you have cirrhosis you will need 6 month cancer surveillance and all growths will be monitored to look for any growth over time.

Of course your hepatologist should explain all of this to you. Ordering a test and developing a diagnosis is only part of their job. The other very important part of their job is to answer the patient's questions.

Only your hepatologist can say what test result mean in the context of your health history and current status as they are the only ones privy to that knowledge. While is can be good to ask others about general situations, each persons circumstance is unique and can't be fully address by others.

As long as you have on going imaging surveillance I would worry about them. Many people have growths in their livers, but since they are benign,  they never know it. The other factor in your favor is that liver cancer is about 3 times more common in men than women.
------------------------------------------------------------------------------------------
HONEY COMBING WITH SPARING OF THE COSTOPHRENIC ANGLES, LIKELY FIBROTIC, NONSPECIFIC INTERSTITIAL PNEUMONITIS
(INTERSTITIAL PNEUMONITIS) = fibrosis/scarring of the lungs.

Chest imaging needs to be performed to further assess the scarring of your lungs. Caused by Sjögren syndrome? An autoimmune disease that can affect body organs such as the lungs.

!!!It is very important to have followup with a pulmonary doctor doctor!!!
Be proactive. Don't wait. Get an appointment for the study ASAP.
While I have no personal experience in this area I do know that honeycomb lung pathology can be a very serious condition!
----------------------------------------------------------------------------------------------------
You can write in the Autoimmune Community to Dr. Kokil Mathur and she can give you more information about HONEY COMBING WITH SPARING OF THE COSTOPHRENIC ANGLES, LIKELY FIBROTIC, NONSPECIFIC INTERSTITIAL PNEUMONITIS .

Please follow up with a chest scan or Pulmonary doctor soon.

Take care.
Hector
10 Comments Post a Comment
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Avatar_m_tn
That doesn't sound too bad. Early cirrhosis, but I think you knew that already. Im surprised about the varices though because I always though the spleen would be enlarged with varicose. You should ask the doctor in the liver transplant forum
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89592_tn?1391278022
what about the masses??  and the non specific interstitial pneumonitis lungs?   UGH,,,    

I did post to Dr S.  

Thank you...Paula
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446474_tn?1404424777
This indicated you have early compensated cirrhosis with some increase in portal hypertension but not enough to cause splenomegaly or dilation of the portal vein.

The masses?

"1.8 x 2.0 cm cyst in the left hepatic dome."
Liver cysts occur in approximately 5% of the population. However, only about 5% of these patients ever develop symptoms. The vast majority are benign. It will be watch during future imaging studies.

"A few additional subcentimeter low attenuation lesions which are too
small to characterize are noted in the liver"
What type of lesions they are can not be determined at this time. Most lesion have to be 1-2 cm to make a diagnosis. Since you have cirrhosis you will need 6 month cancer surveillance and all growths will be monitored to look for any growth over time.

Of course your hepatologist should explain all of this to you. Ordering a test and developing a diagnosis is only part of their job. The other very important part of their job is to answer the patient's questions.

Only your hepatologist can say what test result mean in the context of your health history and current status as they are the only ones privy to that knowledge. While is can be good to ask others about general situations, each persons circumstance is unique and can't be fully address by others.

As long as you have on going imaging surveillance I would worry about them. Many people have growths in their livers, but since they are benign,  they never know it. The other factor in your favor is that liver cancer is about 3 times more common in men than women.
------------------------------------------------------------------------------------------
HONEY COMBING WITH SPARING OF THE COSTOPHRENIC ANGLES, LIKELY FIBROTIC, NONSPECIFIC INTERSTITIAL PNEUMONITIS
(INTERSTITIAL PNEUMONITIS) = fibrosis/scarring of the lungs.

Chest imaging needs to be performed to further assess the scarring of your lungs. Caused by Sjögren syndrome? An autoimmune disease that can affect body organs such as the lungs.

!!!It is very important to have followup with a pulmonary doctor doctor!!!
Be proactive. Don't wait. Get an appointment for the study ASAP.
While I have no personal experience in this area I do know that honeycomb lung pathology can be a very serious condition!
----------------------------------------------------------------------------------------------------
You can write in the Autoimmune Community to Dr. Kokil Mathur and she can give you more information about HONEY COMBING WITH SPARING OF THE COSTOPHRENIC ANGLES, LIKELY FIBROTIC, NONSPECIFIC INTERSTITIAL PNEUMONITIS .

Please follow up with a chest scan or Pulmonary doctor soon.

Take care.
Hector
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89592_tn?1391278022
When I saw the word masses..that concerned me..also the fibrosis in the lungs.  I plan on calling my hep on Monday. I know there ate two types of this disease, cell and fibrotic and of course I have the fibrotic.  I know  a lung transplant is the only cure for it.  I will be calling them on Monday and in the meantime will write to Dr Mathur.  I'm on prednisone now.
  
Of course, its maddening when your test results come thru and the office is closed for the weekend.  Its always best to wait till Monday to post them unless you get happy news which is not what I get alot of.  
I wish this was better news. The last MARCH US I had mentioned 3 total cysts, 2 in left lobe msrg 2.4 and 1.9 cm and 3rd in rt lobe 2.1 but they called them hepatic cysts.
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89592_tn?1391278022
Thank you Hector..how are you doing?  

Still offering up my prayers.  Paula
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89592_tn?1391278022
I've requested an appt to see my hepatologist earlier.  Will call the pulmonoligust this week also.  

Just wondering how this would affect my chance of a liver transplant. Guess I'll cross over that bridge when...
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446474_tn?1404424777
Hi Paula!

I am hanging in here one day at a time.

☆★☆☆★☆ I'll cross that bridge when I come to it. ☆★☆☆★☆
I couldn't agree more!
---------------------------------------------------------------------------------------
More words of wisdom for dealing with serious medical issues...

‘Live one day at a time’

‘Put one step in front of the other’

‘I did the best I could do with what I knew, but when I knew better I did better’. -Maya Angelou

Knowledge is power.

"YOU NEVER KNOW HOW STRONG YOU ARE UNTIL BEING STRONG IS THE ONLY CHOICE YOU HAVE"
-----------------------------------------------------------------------------------------
From the ‘Things I learned from having cancer’ file
Death is way too complicated – I think I’ll skip it. ;-)

Hector



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89592_tn?1391278022
LOVE IT HECTOR.....think I'll skip it too.
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5032487_tn?1365827621
sounds complicated.  You can always have the doctor go over the test results with you.  You can write down any questions or concerns you have...or of course like Hector says skip it as it is what it is and all that jargen isn't going to change anything.  Can we remember to LIVE, LOVE, LAUGH?  Take care dear one.  You are not alone we are all on this ship together. I can think of a name of a famous ship but I'm not going to say the name of it. kelly  
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89592_tn?1391278022
Thank you.  

I cant get into see a pulmonologist till May 30th but you know I'll be calling to see if there are any cancellations before time.  

I have a 2 o clock appt for a breathing test and then 3 o clock to see the dr.  I had no clue I have lung disease.

It just keeps piling up.  
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