Wilkes-Barre General Hospital – Thomas P. Saxton Medical Pav
Patient:CASTON, FRANCIS MRN:977666
DOB: 6/20/1962 Sex: Male
Location:PAWBTPS RA2
Ordering Physician: SAIDMAN, BRUCE H MD
Computed Tomography
ACCESSION EXAM DATE/TIME
606-21-018-00059 1/18/2021 08:43 EST
Reason For Exam
C49.A2-GASTROINTESTINAL STROMAL TUMOR
Report Result:
CT abdomen and pelvis with intravenous contrast
Comparison: CT abdomen/pelvis 7/21/2020
Indication provided by ordering physician: “C49.A2-GASTROINTESTINAL STROMAL TUMOR”
Additional history: Stomach cancer status post partial gastrectomy.
Technique: Multiple contiguous axial CT images are obtained through the abdomen and pelvis,
following the uneventful administration of 100 ml Isovue 370. Oral contrast was administered
prior to the exam, 900 cc Redicat. Coronal and sagittal reformats are created from the axial
data.
At least one of the following dose lowering techniques was utilized: Automated exposure control,
adjustment of the MA and/or KV according to patient size, and/or use of iterative reconstruction
technique.
Findings:
Lung Bases: Mild dependent atelectasis.
Heart: Right heart defibrillator electrode noted.
Liver, Gallbladder, and Biliary: Liver is diminished in attenuation suggesting mild fatty
infiltration. No focal liver lesion is seen. Gallbladder is present. There is no biliary ductal
dilatation.
Spleen:Unchanged subcentimeter splenic hypodensity, too small to fully characterize.
Pancreas: Unremarkable.
Adrenal Glands: Unremarkable.
Renal: No hydronephrosis. There are 2 stable low-density lesions involving the anterior lower
pole of the left kidney with the larger measuring 2.7 cm. This probably represents cyst. It is
difficult to obtain accurate Hounsfield measurements due to adjacent dense oral contrast in the
duodenum, resulting in streak artifact. Additional subcentimeter bilateral renal hypodensities
are too small to fully characterize.
Bowel: Postsurgical changes of the stomach, similar to previous study. There is no nodular
enhancing soft tissue at the surgical site to suggest recurrent disease. Please note that the
stomach is underdistended in this region which does limit evaluation. No abnormally dilated
bowel loops. Normal appendix seen. There is extensive distal colonic diverticulosis. There is
diffuse wall thickening involving the distal descending and sigmoid colon which may be related
to a combination of nondistention and muscular hypertrophy from long-standing diverticulosis.
There are no surrounding inflammatory changes seen.
Mesentery and Peritoneal Cavity: Unremarkable.
Lymph nodes: Unremarkable.
Computed Tomography Report
Pelvic Viscera: Bladder is mildly distended and grossly unremarkable. Prostate is enlarged,
measuring 5.7 cm in transverse dimension.
Bones and Soft Tissues: Degenerative changes in the spine. No aggressive osseous lesions
Vasculature: Extensive atherosclerotic calcification is seen.
Impression:
Postsurgical changes from partial gastric resection. No CT evidence of metastatic disease in the
abdomen/pelvis.
Mild hepatic steatosis.
Probable renal cysts and too small to characterize renal hypodensities, similar to previous.
Sigmoid diverticulosis.
Prostatomegaly.
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