As I’ve mentioned in post #6, Dr. Streett at Kaiser in Vallejo had ordered an ultrasound of the liver and upper abdomen to better evaluate my abdominal pain. Finally, some real tests, that led to other more real tests, that led to a world of information I never wanted to have in my head, and a carcinoma invasion of my liver. You don't have to be a doctor to get the gist of these reports.
Below are the tests results:
Ultrasound - Echo, Hepatic, B-Scan/RL TM-LTD on 03/05/2010
History: 54y male CAC infection, mildly elevated LFTs and question of varices in the gastric cardia. None noted in esophagus. Evaluate for portal hypertension, splenic vein thrombosis
Technique: Real time and static gray scale sonography with Doppler
Findings: ... The liver is markedly heterogeneous, with focal echogenic areas as cystic spaces, raising the possibility of metastatic disease, and there may be a small hemangioma in the left lobe. ...
Impression: Thrombosed portal venous system with associated varices and markedly heterogeneous liver suspicious for metastatic disease. Enlarged/prominent spleen measuring 15mm.
Alert Notification: Report called to on-call MD
CT Scan Abdomen on 03/05/2010
History: 54 y o m ultrasound shows suspected cirrhosis with pvt, but also possible mets in the liver. CT liver mass protocol recommended to assess for cancer in the liver.
Technique: Multiphasic contrast-enhanced hepatic Ct (100 mL of Omnipaque 240) with IV and oral contrast.
Findings: The examination is severely limited for the purpose of hepatic mass evaluation due to insufficient amount of contrast visualized in the vessels in all phases (nearly equivalent to noncontrast CT.)....
Impression: Severely limited examination as discussed above. Recommend repeat multiphasic hepatic CT or MRI if indicated. Hepatomegaly and varices. Likely cirrhosis. Heterogeneous hepatic parenchyma with multiple areas of subtle hypodensity (more prominent in the left lobe.) Differential diagnosis as discussed above. Portal vein thrombosis. Nonspecific nodular appearance of the gallbladder wall.
CT Scan of The Liver 03/10/2010
History: Liver mets, hepatoma
Comparison: Comparison is made to prior study of 3/5/10
Technique: Serial axial images of the liver were obtained utilizing a liver mass protocol. ...
Impression: Findings consistent with cirrhosis. There is accompanying right, left and main portal vein thrombosis. There are some mild accompanying varices.
Vague areas of enhancement within the liver. Given the additional findings, areas of malignancy cannot be excluded. There are numerous scattered hypodensities throughout the liver.
Lymphadenopathy as noted above.
Mild contour irregularity within the wall of the gallbladder. Differential diagnosis given above.
Splenomegaly.
Up to this point, Dr. Cohen requested a liver biopsy for further evaluation. And the biopsy was scheduled for March 31, 2010. A month away...seems a little long to me, and in retrospect, it begs the question of whether or not he consulted an oncologist with these results? But as you'll find out in the coming posts this guy has a particularly enormous sense of self-inflated worth; an ego you couldn't drown in the Pacific Ocean!
My heart was broken when I read your update in regards to your medical condition. Sometimes, we did our best to take care of everything, then lightning would come and strike us big time. Don’t lose hope. My advice is you check with an oncologist for further evaluation.
ReplyDeleteJulio Loose