Worried...Please help me decipher this (long)

  1. Hi
    I am a third semester BSN student and my family is all calling me asking me what I think about my fathers last Ct scan. A little background:

    My dad has had asbestosis for years and has been receiving CT scans to look for any progression regularly. Recently he had a CT and now everyone is in panic mode. I will post an excerpt below. Anyway, as the Drs notes say--at first they wanted to treat him with antibiotics...wait a month and redo CAT. His specialist nixed that and has ordered a PET on Friday and an appt with a mesothelioma specialist next week. Could someone give me some insight into what they read in this Drs reprt? I really do not feel qualified to even explain this to my family. I am so worried and upset right now...but I would like honest answers please. Okay--here is an excerpt:

    Exam: CT THORAX W/O CONTRAST

    HISTORY: Asbestos exposure

    TECHNIQUE: Contiguous images of the thorax were obtained without intravenous contrast administration. The study is supplemented with coronal reconstructions and prone high-resolution images.

    FINDINGS: The preliminary digital radiograph of the thorax demonstrates calcified diaphragmatic and pleural plaques.

    Prone high-resolution images demonstrate perifpheral interstitial pulmonary fibrosis and irregular band of linear densities extending from the pleural surace to the lung parenchyma distortion of the lung parenchyma. Calcified pleural plaques are identified involving the upper, mid and lower lung zones bilaterally. There are rounded areas of atelectasis in the posterior right lower lobe. A soft tissue mass abutting the pleural surface in the posterior right lower thorax is noted measuring approximately 2.3 x 2 cm. There is no associated pleural effusion. This area is adjacent to rounded atelectasis in the posterior right lower lobe. The calcified and noncalcified pleural thickening in the right thorax diffusely involves the right thoracic cavity. Calcification and pleural thickening in the left thorax involves approximately two-thids of the thoracic cavity. There are extensive calcified diaphragmatic plaques.
    A poorly-defined, low-density, ground-glass attenuation nodule is demonstrated in the posterior segment of the right lower lobe measuring 2.2 x 2 cm. There are extensive atherosclerotic calcifications in the thoracic aorta and moderate calcifications in the coronary vessels. The heart is not enlarged. There are moderate osteoarthritic changes in the thoracic spine.

    IMPRESSION:
    1. Extensive calcified and noncalcified pleural and diaphragmatic plaques.
    2. Ground-glass attenuation nodular mass in the posterior segment of the left lower lobe. Treatment as acute pneumonic process suggested and a short interval followup in approximately 1 month. If this lesion does not resolve after treatment for acute pneumonia, biopsy is suggested.
    3. Rounded pleural-based mass in the posterior right lower lobe adjacent to areas of runded pulmonary atelectasis and pleural plaques. This area could represent fibrosis or rounded pulmonary atelectasis. However, the possibility of mesothelioma cannot be totally excluded. Comparison with prior studies and, if indicated, biopsy.

    Note Dr. XXXXX wrote in right here: 8-14-06
    Per Dr. Endress,
    Correct identificatin of R & L lower lobe lesions appears in "impression" section. The "findings" section incorrectly identifies the ground glass attenuation nodule as being the R lower lobe when it is actually in the lfeft lower lobe
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    About MuddaMia

    Joined: Jul '06; Posts: 250; Likes: 27

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  3. by   traumaRUs
    Am so sorry for your father's health problems. However, having us read the CT interpretation probably isn't going to be helpful. Please give his doctor a call. Take care.

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