Question about Radiologist Report

Since I am not able to post a photo on this form, please review the photos to be found on my personal blog --

http://tiny.cc/lmPmb

and here...

http://tiny.cc/Vx0n4

Now... the question.  :)

History:  Vague upper abdominal discomfort.  Early satiety.  Delayed gastric emptying.  Unexplained weight loss.

Same symptoms persisting for more than a year now.  Had a CT scan in March 2008 that didn't answer any questions.  Had an EGD performed.  Gastroenterologist discovered a fundic gland polyp (didn't biopsy) and intraepithelial lymphocytes in the second and third stage of the duodenum.

Last Friday, March 13, 2009, had another abdominal CT scan with oral and IV contrast -- same as in 2008.

I am an NIH employee, have a family history of cancer (father, older brother, older sister) and I always get copies of the films when I have a test done.  I compared them frame for frame and expected the radioligist to say SOMETHING about the enhancing blob you can see at the URL's I provided -- a blob in the antrum of the stomach that appears for 14 frames of the CT series... and in several frames of the coronal series taken at the same time.  But the word "stomach" doesn't even show up in the radiologist report!  He comments about a small umbilical hernia, a small hiatal hernia, some areas of low attenuation on the kidneys and a kidney stone that has been there for years.  Not a peep about this large, enhancing mass in the antrum.

I am having a repeat EGD and colonoscopy on the 23rd.  But -- without diagnosing me based on a few photos, which I sincerely hope you will either take a moment to look at -- can you explain what ELSE could create what looks like a large, irregular, lobulated mass in the antrum of my stomach... said mass that was NOT apparent in previous CT series done in 2008 and 2005?  If it's food remnants, then that food was in there for 18 hours.  If it's not food, what else might it be?

Thank you for your time.

Bill

[Kevin Pho, MD]

Can't say for sure.

Possibilities can include the stomach polyp that was seen on the EGD, or possibly, contrast material that has not passed through the stomach yet.

I agree with repeating the EGD, which is going to be a more sensitive test in examining the inside of the stomach than an abdominal CT scan.  

The upper endoscopy will give the definitive answer as to what that is.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd

[bschmalfeldt]

Is anyone going to answer my question?  I see that two that were posted after mine have already been addressed.

Thanks.