Monday, August 2, 2021

Three-month Checkup

I had my three-month checkup after the surgery. I had hoped to get a final verification that all was well, but such was not to be.

The scan indicates a blood clot and a nodule. The nodule is new and may be just the result of the surgery. There will be another scan in three months.  

Despite this worrisome news, I have been feeling well lately. My lung has stopped hurting when I inhale and, after recent chiropractic treatments, the ache in my ribs eased. When I do normal activity, I feel like my regular self. I notice the diminished lung capacity when I exercise but this is minor in the scope of things.

For those who want the technical stuff, here it is: 

CLINICAL DATA: History of sarcoma.

COMPARISON STUDY: CT chest, abdomen, and pelvis with contrast 3/12/2021.

TECHNIQUE: Sequential axial images of the chest were obtained following a
helical acquisition and intravenous contrast administration of nonionic
contrast. Radiation dose reduction techniques were used.

FINDINGS:

CHEST WITH CONTRAST:
SUPERIORMOST ABDOMEN: The visualized portions of the superiormost abdominal
visceral organs are unremarkable except for 1.1 cm hypodense spleen lesion,
image 98.
MEDIASTINUM: The heart and great vessels of mediastinum are unremarkable except for thrombus in a posterior branch of the left lower lobe pulmonary artery along the course of the surgical staple line. No other pulmonary artery filling defects are identified. Soft tissue density node or nodule is seen in the left anterior lateral mediastinum abutting the pericardium, 1.2 x 1.5 cm with Hounsfield density units of 32, image 55. Otherwise there is no mediastinal or
hilar adenopathy nor pericardial effusion.


TRACHEA AND CENTRAL BRONCHI: The large airways are clear.

LUNGS: There is mild bilateral apical pleural-parenchymal opacity compatible with scarring. Two tiny nodules are seen in the Right Lower Lobe: 4 mm, image 67 and 3 mm, image 79. A 3 mm nodule seen in the Left Upper Lobe lateral, image 38. There are postsurgical changes partial Left Lower Lobe resection with surgical staple line and associated bandlike opacity in the left inferior posterior medial chest extending to the pleura where there is trace pleural fluid and pleural gas bubble, image 80.
PLEURA AND PLEURAL SPACE: There is no pleural effusion or pneumothorax.
MUSCULOSKELETAL: Unremarkable.

IMPRESSION:
1. Postsurgical changes of partial Left Lower Lobe resection with surgical staple line/bandlike opacity and thrombus within a posterior branch of the Left Lower Lobe pulmonary artery extending to the surgical staple line/bandlike opacity. No other evidence of pulmonary embolus.
2. Left anterior mediastinal node or nodule 1.3 x 1.5 cm, metastatic disease is in the differential, appears new from 3/12/2021, alternatively may be postsurgical change/reactive lymph node. RECOMMEND close interval surveillance with CT of the chest with contrast in three months.
3. Trace left pleural fluid and pleural gas bubble left inferior posterior chest.