Pre-study CT Scan of Chest, abdomen, and pelvis JUNE 4th 2009

CT scan of the chest abdomen and pelvis:
June 4, 2009.

History: Neuroblastoma. Evaluate extent of disease.

Comparison: February 12, 2009.

Technique chest: After the administration of intravenous contrast,helical scans were obtained from the lung apices through the diaphragms.

Technique abdomen: After administration of intravenous contrast,scans were obtained from above the dome of the diaphragms through the iliac crests.

Technique pelvis: After administration of intravenous contrast, scans were obtained from the iliac crest through the ischial tuberosities.Coronal and sagittal reformations were obtained.

Findings:Once again seen is abnormal soft tissue mass at the apex of the left hemithorax extending around the left vertebral artery and into the superior left mediastinum. In comparison with the previous examination, this appears stable in extent. The soft tissue mass is of mixed density with some areas demonstrating increased enhancement and other areas demonstrating decreased enhancement. It extends along the anterolateral chest wall adjacent to the first rib as on the previous examination. The overall size is unchanged. It is quite difficult to measure. The maximum SI diameter is 2.9 cm versus 2.5 cm on the previous examination (measured on coronal chest image 37). The transverse diameter on this image is 2.9 cm versus 3.1 cm on the previous examination. A small enhancing nodule adjacent to the left hand aspect of aorta and gastroesophageal junction is similar in appearance to the previous examination. It measures 8 mm AP on the current examination on sequence 83, image 12. The transverse diameter on this series is 6 mm.Motion artifact obscures much of the lung. Dependent atelectasis is present.The bones of the chest are normal in appearance. A chest port is seen in the anterior tissues of the right chest.Abdomen and pelvis:The liver, spleen, pancreas, kidneys and gallbladder are normal in appearance. The adrenal glands are normal in appearance bilaterally.The aorta and IVC are normal in diameter.There is no intra-abdominal lymphadenopathy. Evaluation of the pelvis demonstrates no pelvic lymphadenopathy. Physiologic free fluid is noted in the pelvis.The bones of the pelvis and abdomen are unremarkable in appearance.

Impression:
Essentially stable examination in comparison to prior study of February 12, 2009.
No new lesions are identified.
Stable size of the left hemithorax apical lesion and left periaortic lesion are noted.