แปลผลการตรวจ CT SCAN CHEST WITH UPPER ABDOMEN

CT SCAN CHEST WITH UPPER ABDOMEN HISTORY: A case of right pleural effusion, pleural fluid- positive for malignancy.

CHEST FINDINGS: There is an I-defined hypoenhancing mass involving right bronchus intermedius contiguous with subcarinal node, measured about 4.8x2.0x5.0 cm (TRxAPxCC), causing mild luminal narrowing of right main bronchus and abutting right main pulmonary artery. Suggestive of lung malignancy There is atelectasis of lateral segment of RML, superior segment of RLL, anterior and posterior basal segments of RLL There is another hypoenhancing nodule at anterobasal segment of RLL, measured 1.0x1.3 cm, possibly another tumour nodule or obstructive pneumonitis. Few tiny solid lung nodules at anterior and apicoposterior segment of RUL, up to 0.4 cm, indeterminate nodules. There is moderate right pleural effusion with circumferential nodular pleural thickening at right hemithorax, predominantly in the inferior aspect, probably representing pleural metastasis. Paraseptal emphysema at medial aspect of both apical lungs are seen. Centrilobular emphysema at LUL is detected. Multiple lymph nodes at prevascular, bilateral paratracheal, subaortic, right hilar, right interlobar and anterior superior diaphragmatic nodes, up to 1.1 cm in short axis diameter at right hilar and right interlobar nodes No cardiomegaly is detected. There is' no pericardial effusion. Osteoporotic fracture of T8 is noted. Osteopenia and degenerative change of spine is seen. Few tiny right thyroid nodules are noted. Liver appears normal size an hepatic segment IVa is noted. Multiple small gallstones, up to 0.5 cm,without evidence of acute cholecystitis. There is no CBD or IHD dilatation. Several cortical cysts at both kidneys, up to 1.5 cm at mid pole of right kidney. Pancreas, spleen and bilateral adrenal glands are unremarkable Stomach and included bowel are unremarkable No significant enlarged paraaortic node. There is no ascites. Osteopenia and degenerative change of spine is seen.

IMPRESSION - A 4.8x2.0x5.0- cm hypoenhancing mass involving right bronchus intermedius contiguous with subcarinal node.Suggestive of lung malignancy.Moderate right pleural effusion with circumferential pleural thickening,representing pleural metastasis. Another hypoenhancing nodule at anterobasal segment of RLL, 1.0x1.3 cm in size, possibly another tumour nodule or obstructive pneumonitis - Two tiny solid lung nodules apicoposterior segment of RUL, up to 0.4 cm, indeterminate nodules. -Multiple mediastinal nodes at prevascular, bilateral paratracheal, subaortic, right hilar, right interlobar and anterior superior diaphragmatic nodes, up to 1.1 cm at right hilar and right interlobar nodes. Multiple small gallstones, up to 0.5 cm. No evidence of liver metastasis.