CT CHEST and ADOMEN
Mesothelioma Chemotherapy ? Response
Comparison made with the previous CT scan dated 11/07/2012. The left apical mass has not significantly changed in size, measuring 45 x 22 mm on the current examination (46 x 22 mm previously). the left supraclavicular lymph node has slightly reduced now measuring 5 mm , previously measuring 7 mm. The left internal mammary lymphadenopathy has slightly reduced, for reference now measuring 8 mm in short axis (Series 2 image 82) previously 10 mm at the same level. The aortopulmonary window adenopathy has also slightly reduced. The disease at the left lung base has not significantly changed. The left paracardiac lymph node (series 2 image 233) has slightmy reduced from 7 mm to 5 mmin short axis. The metastatic disease within the right lung base posterior to the suprahepatic IVC has not significantly changed. The metastatic deposit related to the oblique fissure on series 4 image 147 has reduced from 12 mm to 10 mm. The more cranial pleural deposits within the right oblique fissure (e.g. series 4 image 132) Have however significantly increased in size and now appear confluent (merging together) The appearance in the right hemithorax are otherwise unchanged. The inflammatory changes with in the left lung base has improved. The Tracheo Oesophageal Fistula remains patent (open) The liver and adrenal glands remain clear. The small gastrohepatic lymph nodes are unchanged. Cholecystectomy noted normal pancreas, spleen and kidneys. No suspicious bone lesions.
Overall mixed appearances with some evidence of response to treatment, but unfortunately progression of some of the pleural metastases within the right oblique fissure. Otherwise stable appearances.