รบกวนคุณหมอช่วยแปลผล CT ของคนไข้มะเร็งเต้านมหลังให้เคมีบำบัดให้หน่อยค่ะ

คนไข้ตรวจพบเป็นมะเร็งเต้านม CT หลังจากคีโมครั้งที่ 6 ครบ

CT Chest and upper abdomen with contrast at 29 July 2020

History: Known case right breast cancer S/P chemotherapy
Findings: **Compared with previous study on 24 Feb 2020**

- No longer seen right breast masses and enlarged right axillary lymph nodes.

-Diffuse interstitial thickening at both lungs.

-Newly seen subsegmental atelestasis at anterior basel segment of left lower lobe.

-No define pulmonary nodule or mass is seen.

-Slightly increased right pleural effusion and newly developed left pleural effusion.  No abnormal pleural thickening is detected.

-Newly developed central intraluminal thrombus along the right interlobar, extending to the posterior segmental branch of right lower lobe pulmonary arteries.

Also seen intraluminal thrombus in the lateral segmental branch of lest lower lobe pulmonary artery

-Unchanged several subcentimeter mediastinal lymph node at prevascular, paratracheal, precarina and right hilar regions, size up to 0.8 cm.

-Trachea and main bronchi appear normal.

-The main pulmonary artery shows no enlargement, measured about 2.0 cm. No pericardial effusion is detected.

-No longer seen a 1.4 cm hypodensity lesion hepatic segment 5/6.

-A 0.5 cm non-enhancing hypodensity nodule at hepatic segment 5, too small to characterized

-No IHD or CBD dilated is noted.  The hepatic veins, portal veins, splenic vein and SMV are patent.

The gallbladder shows well distention and thin wall without stone.  The pancreas, spleen and both adrenal glands are unremarkable.

-Normal size of both kidneys without stone or hydronephrosis are seen.

-The stomach and visualized bowel loops are unremarkable.  No ascites fluid is seen.

-No size significant intraabdominal lymph node is detected.

-Newly seen compression fracture at the T7 and T11 vertebral bodies, possible osteoporotic or pathological fracture.

IMPRESSION:

1.       No longer seen right breast masses and enlarged right axillary lymph nodes.

2.       Newly developed acute pulmonary embolism along the right interlobar, extending to the posterior segmental branch of right lower lobe pulmonary arteries and lateral segmental branch of left lower lobe pulmonary artery.

3.       Slightly increased right pleural effusion and newly developed left pleural effusion.

4.       No longer seen a 1.4 cm hypodensity lesion hepatic segment 5/6.

5.       A 0.5 cm non-enhancing hypodensity nodule at hepatic segment 5, too small to characterizes.

6.       Newly seen compression fracture at the T7 and T11 vertebral bodies, possible osteoporotic or pathological fracture.  Clinical correlation and bone scan may be helpful.