Kaiser Permanente
Permanente Medical Group, Inc.
1425 South Main Street
Walnut Creek, CA 94596
925 295 4000 fax or 800...



September 12, 2008 1428

08 02 04 60 08091201




..
Subject:   CT Report

Dear Millie,

Here they are [results of CT test at Kaiser in Oakland performed on September 11, 2008, and as requested in your letter on August 11th].
..
Everything appears stable. That's good!

Sincerely,





..
Radiology Information Exam Date Exam Time
9/11/2008 1:30 PM

Note: the header stuff above needs updating from Kaiser, borrowed from
previous report on 080425


..
Document Text


CT OF THE CHEST, ABDOMEN AND PELVIS

..
** HISTORY **:


History of metastatic breast cancer who is currently on a clinical
trial at UCSF. Patient has a power port and will need port access
prior to the scan.

..
The patient is status post left mastectomy.

..
Comparison is made with the 7/18/08 Kaiser Walnut Creek scan.

..
TECHNIQUE:


The patient was given oral contrast material to drink. A total of
120 cc Omnipaque 350 was administered through the power port,
without complication.

..
** FINDINGS **:


Again seen are enlarged representing axillary lymph nodes. The largest two
nodes measure 2.0 x 1.5 cm (previously 1.8 x 1.5 cm) and 1.5 x 1.8 cm
(previously 1.3 x 1.3 cm). These are little changed, when accounting for
differences in technique and sampling variability. Smaller adjacent nodes are
also again seen, with a 1-cm node seen more inferiorly and posteriorly. This
is not significantly changed.

..
There is no significant left axillary lymphadenopathy.

..
Again seen is a hypodense lesion in the right thyroid lobe, unchanged.

..
There are small mediastinal lymph nodes, which are stable. No new hilar
adenopathy is seen. There is no pericardial or pleural effusion.

..
Strandy densities are seen at the left lung apex and also at the anterior
lingula. These are not significantly changed and may represent fibrotic
change/scarring. There is also some strandy density seen at the medial right
middle lobe and medial right posterior lower lobe, all of which appear little
changed. These could even be treatment related if the patient has had
radiation.

..
In addition, there are also several tiny nodular densities,
predominantly in the right lung. They are seen in the subpleural
right upper lobe on Image 19, near the major fissure on Image 36
and at the subpleural right middle lobe on Image 36 and subpleural
right lower lobe laterally on Image 44. These all appear
unchanged. No new nodules or masses are seen. There is no new
focal air-space consolidation. No pleural or pericardial effusion
is present.

..
A 1.7-cm hypodense lesion at the hepatic dome is stable, compatible with
cyst. There are no new hepatic lesions.

..
Again seen are several splenic calcifications, probably related to prior
granulomatous infection. There is dense calcification of the splenic artery as
well as some chunky calcifications adjacent to the splenic hilum. These may
represent splenic artery aneurysms, and they are unchanged.

..
The pancreas, gallbladder, adrenal glands and kidneys are stable in
appearance, with a few tiny renal hypodensities again noted.

..
There is no evidence of bowel obstruction. No identifiable bowel wall
thickening is seen. There is no ascites. No enlarged abdominal or pelvic
lymph nodes are seen.

..
Atherosclerotic calcification of the normal-caliber abdominal aorta is
present. The iliac arteries appear ectatic, also with calcifications. These
are unchanged.

..
The patient is status post hysterectomy. The bladder is unremarkable.
Degenerative changes are noted at the spine. No suspicious bone lesions are
seen.

..
** IMPRESSION **:


Status post left mastectomy. There has been little interval
change. Prominent right axillary lymph nodes are again noted,
little changed in size, which could be accounted for by sampling
variability. Reticular densities and tiny punctate densities in
the lungs are not significantly changed, and there are no new
identifiable lesions. No new adenopathy or ascites.