Patient Medical Report

Total abdominal Hysterectomy + Bilateral salpingo-oophorevtomy

Plan will be according to the PET scan report

For ca staging

Findings Chest CT scan with IV contrast: No lung consolidation. Multiple clustered lung nodules seen in the right upper lobe. The largest measuring about 1 cm appears spiculated (series #3 image #91) with surrounding tree-in-bud appearances for clinical correlation as tree-in-bud suggest infection. Evidence of right middle lobe nodule measuring about 4mm (series #3 image #140). Mosaic lung appearances in both lower obes. Few scattered linear atelectatic bands. No definite fibrotic changes No pleural effusion. No pneumothorax. Enlarged right lower paratracheal group lymph node measuring about 1.4 cm. No definite hilar lymph node enlargement seen. Left axillary rounded lymph node measuring about 1,1 x 1cm. Mild increased cardiac size The ascending sorta appears dilated with maximum AP diameter of around 3.3 cm with evidence of mild atherosclerotic change involving the aorta The visualised parts of the neck show enlarged thyroid gland for further evaluation by ultrasound The visualized portions of the bone show no definite destructive lesion.

In comparison to the previous study: • No changes regarding the antrum and pyloric stomach increased wall thickness, the stomach shows no distension in this study. Multiple prominent perigastric lymph nodes the largest seen in the lesser curvature group measuring about 7, mm. Minimal amount of pelvic and right paracolic gutter free fluid seen in this study. Was no present in the previous study.

Multiple lung nodules as described above with mediastinal and left axilla enlarged lymph nodes. For further evaluation by PET scan Increased ascending aorta diameter. Enlarged thyroid for further evaluation by ultrasound Multiple prominent appearing gastric lymph nodes as desoribed.

For further investigation regarding the epigastric pain

Abdomen ct with IV contrast Evidence of distended stomach with food like material with evidence of minimal thickening of the pylorus with minimal enhancement No free fluid in the pelvis No pneuomoperitonium

For further evaluation by upper endoscopic biopsy

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