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Follow Up Investigation : |
Prior to our Treatment :
(28.9.99)
Abdomen
Hemangini (Lect.)
Plain cutlines and contrast enhanced axial CTscan of abdomen has been
performed with oral and IV contrast.
Hetrogenpusly enhancing mixed density lobulated mass is seen arising from
midpole and lower pole of Lt. Kidney, pushing the pelvicalyceal system
medially. Mass measures approximately 4 x 5 x 8cms. However the Lt. Ureter
is normal, with good function on left. The perirenal fat shows stranding.
Posterior pararenal space and psoasis normal on Lt. side. Rt. Kidney is
normal with normal PCS and Ureter. Urinary Bladder is normal. seminal
vesicles and prostate are normal. Liver, Spleen and Pancreas are normal.
Both the adrenals, GB are normal.No evidence of lymphadenopathy. IVC &
left renal vein are normal.
No free fluid.
IMP : Malignant mass arising from mid and lower pole of left kidney most
likely. Renal cell caranoma with perirenal extension.
After our treatment
CT Scan of abdomen and pelvis (30/06/2000)
CT Scan of abdomen and pelvis has been done with and without
intravenous contrast. Bowel loops were opacified with dilute gastro
graffin.
Study reveals a moderately large well defined inhomogenous enhancing soft
tissue density mass in left kidney at left mid and lower pole region
measuring 5.1 x 4.8 cms with a supero-inferior extent of 6.5 cms. The mass
is effacing the adjacent calyces and has a lobulated appearance along with
its inferior extent. Perinephric soft tissue stranding is noted along the
left lateral aspect.
Residual renal cortex shows normal enhancement.
Left ureter appears normal.
IVC and left renal vein appear normal.
No hepatic metastasis or ascites.
Liver is normal in size and shows homogenous parenchymal density. No focal
hepatic lesion or mass is noted. No subphrenic pathology is noted.
Gal bladder is well distended with smooth outline. There is no evidence of
any radio opaque calculi. No intra luminal mass is seen.
Pancreas is seen in its entire length and is normal in size and
configuration. No focal lesion, mass or pancreatitis is noted.
The spleen is normal in size shows homogenous parenchyma.
Right kidney appears normal.
The aorta and the venacava appear normal. No evidence of pre and para -
aortic lymphadenopathy is noted.
Opacified bowel loops appear normal.
The contrast filled urinary bladder shows normal outlines.
The pelvic fat planes are well maintained and appear normal.
The pelvic musculature and the pelvic fat planes are well maintained.
There is no evidence of solid or cystic mass lesion in the pelvis or any
evidence of pelvis lymphadenopathy.
The contrast enhanced pelvic vascular structures appear normal.
IMPRESSION :
Lobulated neoplastic soft tissue density mass in relation to the left
kidney (MID and LOWER POLAR REGION) with mild perinephric soft tissue
stranding. The lesion measures 5.1 x 4.8 x 6.5 cms.
IVC and left renal vein appear normal.
No liver metastasis noted.
CT Scan of abdomen and pelvis (2/2/2001)
Follow up scan has been done in a case of left renal mass with and
without intravenous contrast. Bowel loops were opacified with dilute
gastro graffin.
Present study reveals the left renal mass located in mid and lower polar
region measuring 5 x 4.8 cms with supero inferior extent of approximately 6
cms effacing the adjacent calyces. This mass lesion appears similar in
size and appearance as on the last scan dated 30/06/2000.
Mild perinephric soft tissue stranding noted.
Residual renal cortex shows normal enhancement.
Left ureter appears normal.
IVC and left renal vein appear normal.
No hepatic metastasis or ascites.
Liver is normal in size and shows homogenous parenchymal density. No focal
hepatic lesion or mass is noted. No subphrenic pathology is noted.
Gall bladder is well distended with smooth outline. There is no evidence
of any radio opaque calculi. No intra luminal mass is seen.
Pancreas is seen in its entire length and is normal in size and
configuration. No focal lesion, mass or pancreatitis is noted.
The spleen is normal in size shows homogenous parenchyma.
Right kidney appears normal.
The aorta and the venacava appear normal. No evidence of pre or para
aortic lymphadenopathy is noted.
Opacified bowel loops appear normal.
The contrast filled urinary bladder shows normal outlines.
The pelvic fat planes are well maintained and appear normal.
The pelvic musculature and the bony pelvic walls show normal outlines.
There is no evidence of solid or cystic mass lesion in the pelvis or any
evidence of pelvis lymphadenopathy.
The contrast enhanced pelvic vascular structures appear normal.
Bones appear normal.
IMPRESSION
Follow up study reveals no significant increase in size of mass. Scan
appearance is also similar to the previous scan dated 30/6/2000.
IVC and left renal vein appear normal.
No liver metastasis.
CT Scan of Thorax (19/02/2002)
CT scan of thorax has been done. Multiple sections at 10 mm
interval has been taken before and after injection of intravenous
contrast.
Study reveals large right pleural effusion with associated compression
collapse / volume loss of adjacent lung.
Shift of mediastinum to right.
No obvious pleural basal metastasis.
No mediastinal or axillary lymphadenopathy.
Trachea and both main bronchi appear normal.
No endobronchial lesion.
Mediastinal vascular structures appear normal.
Mediastinal fat places are normal.
No lung parenchymal lesion is noted.
IMPRESSION
Large right pleural effusion with associated compression collapse /
volume loss of adjacent lung.
No significant mediastinal or axillary lymphadenopathy.
No lung parenchymal metastasis.
CT Scan of abdomen and pelvis(19/02/2002)
Follow up scan has been done in a case of left renal mass with and
without intravenous contrast. Bowel loop were opacified with oral
gastrograffin.
Present study reveals the left renal mass located in mid and lower polar
region measuring 5.4 x 4.9 cms with supero inferior extent of
approximately 6 cms effacing the adjacent cycles. This mass lesion appears
similar in size and appearance as on the last scan dated 02/02/2001.
Mild pherinephric soft tissue stranding noted.
Residual renal cortex shows normal enhancement.
Left ureter appears normal.
IVC and left renal vein appear normal.
No hepatic metastasis or ascites.
Liver is normal in size and shows homogenous parenchyma density. No focal
hepatic lesion or mass is noted. No subphrenic pathology is noted.
Gall bladder is well distended with smooth outlines, there is no evidence
of any redioopaque calculi. No intraluminal mass is seen.
Pancreas is seen in its entire length and is normal in size and
configuration. No focal lesion. Mass or pancreatitis is noted.
The spleen is normal in size and shows homogenous parenchyma.
Right kidney appears normal.
The aorta and the venacava appear normal. No evidence of pre or para-
aortic lymphadenopathy is noted.
Opacified bowel loops appear normal.
Urinary bladder appears well distended with smooth outlines.
Pelvic structures appear normal.
The pelvic musculature and the bony pelvic walls appear normal.
Pelvic fat planes are well maintained.
No abdominal . pelvic lymphadenopathy noted.
IMPRESSION
Follow up study reveals no significant increase in size of mass. Scan
appearance is also similar to the previous scan dated 02/02/2001.
IVC and left renal vein appear normal.
No liver metastasis.
HAEMATOLOGY REPORT(20/04/2001)
| Parameter |
Results |
Normal
Range |
Haemoglobin
(By cyanmeth method) |
10.80
gm/dl |
M:
13.0 to 18.0 gm/dl |
| F:
11.0 to 16.0 gm/dl |
| C:
10.0 to 14.0 gm/dl |
| R.B.C.
Count |
3.60
mill/ cu mm |
M:
4.5 to 6.5 mill/ cu mm |
| |
|
F:
3.8 to 5.8 mill/ cu mm |
| W.B.C.
Count |
15800
/cu mm |
4000-11000
/cu mm |
|
Differential Count :
| Neutrophils |
85% |
40 to 70 % |
| Lymphocytes |
14% |
20 to 45 % |
| Eosinophils |
1% |
0 to 6 % |
| Monocytes |
0% |
0 to 8 % |
| Basophils |
0% |
0 to 1 % |
Peripheral smear Examination
Normocytic and normochromatic
Platelets are adequate.
E.S.R. : 35 mm after 1 hr. M: 0 mm to 9 mm.
(By Wintrobe's) F: 0 mm to 20 mm.
BLOOD EXAMINATION (20/04/2001)
Test Name : Carcino Embryonic antigen - cea.
Method : C.L.I.A.
Values : 1.50 ng/ml
Interpretation :
Normal Range : Non Smokers : 0 - 3.4
Smokers : 0 - 6.2
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