CT scan Thorax Abdomen and pelvis
History : Mesothelioma. assess response.
Comparison is made with the scan of February 2011
The mass at the left apex, left internal mammary adenopathy, aoratopulminary adenopathy and glands at the left hilum are all stable in appearance. The disease at the left base also remains static.
Since previous scan the patient now appears to have had an Amplatz occluder device put across the tracheal oesophageal fistula. There is a large component present within the oesophagus measuring 12mm. This could be a potential source of disphagia.
The multiple bronchi centric nodules persist but are less frequent than previously in keeping with perhaps reduction in the degree of aspiration. However the nodule the right apex (series 4 image 48) has increased in size as has the lesion immediately inferior to this image 55 addition there are some new right sided pleural nodules, for example anteriorly image 74, anterolaterally image 106, postero laterally image 147 and on the right hemidiaphragm image 232. These are all relatively subtle but will need monitoring as they are likely to represent contralatoral disease.
The paracardiac node is unchanged in appearance. The small amount of pericardial thickening seen anteriorly is also static.
Still no evidence of the disease in the abdomen or pelvis.
Stable disease in the left lung. Possible subtle early disease in the right lung. Amplatz occluder within the oesophagus.