Anastasia Zherlitsyna — timeline

Ministry of Health of Ukraine
DOCTOR FILIN LLC

Ukraine, Kyiv, K. Malevicha str, 86-G; pr t.L. Huzara, 3, k-5., Vidpochynku str, 11

phone: 237-13-43, 095-5576633, 098-5576633

License of the Ministry of Health of Ukraine AB No. 539367

DOCTOR FILIN

EXPERT CENTER OF TOMOGRAPHY

MEDICAL DOCUMENTATION

Primary accounting form documentation No. 028/0 APPROVED

Order of the Ministry of Health of Ukraine

14.02.12 No. 110

COMPUTER TOMOGRAPHY DESCRIPTION PROTOCOL

Name of the survey: CT scan of the chest cavity, abdominal cavity organs with retroperitoneal space and pelvic organs before and with contrast.

Contrast agent: Omnipak 350 mg of iodine/ml. volume 100 ml.

Radiation load: 1537 mGy* cm.sq

There was no reaction to the contrast agent

Patient's name: Zherlitsyna Anastasia Stanislavivna. Patient's ID: 74595

Date of birth: 25.04.1976 Examination date: 01.12.2022

CT operator who performed the examination: Nataliya Volodymyrivna Zhukovska

Clinical history:

After the previous CT scan from 23.08.2022 - Palliative chemotherapy.

Protocol:

Supra- and subclavian lymph nodes are not enlarged.

Axillary lymph nodes are not enlarged.

The thyroid gland is not enlarged, single small hypodense foci.

The lungs are uniformly pneumatized, no infiltrative areas were found, a few small nodules up to 3 mm (without dynamics). There are centrilobular and paraseptal bullae, mainly in the upper parts.

The trachea and main, partial and segmental bronchi are passable. No free fluid was detected in the pleural cavities.

The heart is not enlarged, the cavities are evenly contrasted. Free fluid is not visualized in the pericardium. The ascending and descending aorta, cephalic trunks are unchanged. Pulmonary arteries, superior vena cava and inferior vena cava are not dilated, without changes.

Intrathoracic lymph nodes are not enlarged. Esophagus is not dilated, its walls are not thickened. Diaphragm without features.

Cardia, stomach, duodenum, small and large intestine are not expanded, without reliable lesions.

The liver is significantly enlarged, the craniocaudal dimension of the liver is 220 mm, single formations of heterogeneous structure, with necrosis in the center, marked vascularization on the periphery are visualized in white color; in dynamics, their sizes increased: in Sg 8, two formations merging with each other, total size 94x63 mm (was 79x56 mm), in Sg 2-3 - 84x56 mm (was 66x48 mm). Partial hepatic veins, the left portal vein are contrasted, the right portal vein is not visualized. In one of the formations, against the background of extensive necrosis, a small amount of hemorrhagic density content is revealed.

Intrahepatic bile ducts: local expansion in Sg3, not expanded in other spaces of the liver.

In the hepatoduodenal ligament: the portal vein is not dilated. The choledoch is not dilated.

Gallbladder is not visualized.

The pancreas is compressed, the parenchyma contrasts uniformly. The duct of the gland is not expanded. Above the tail of the pancreas, a nodular formation of heterogeneous density, with pronounced vascularization, is visualized, closely adjacent to the stomach, loops of the jejunum, measuring 56x46mm (it was 54x46mm, more likely not connected with the pancreas, compressing it from the outside).

The spleen is not enlarged, the structure is uniform. The splenic vein is not dilated. The lymph nodes of the portal of the spleen are not enlarged.

The adrenal glands are symmetrical and not enlarged.

Kidneys: the right is displaced downward by an enlarged liver, the left is located in a typical place. The parenchyma of both kidneys is not thinned. Cortico-medullary differentiation is not disturbed. Pelvicalyceal system, ureters are not expanded. There are no calculi in the renal pelvis and ureters. The excretory function is not disturbed. The trunk vessels of the retroperitoneal space are unchanged.

Lymph nodes of the retroperitoneal space: few para-aortic ones up to 9 mm along the short axis (without dynamics).

Urinary bladder - the walls are not thickened, there are no intraluminal formations.

At the level of the bottom of the uterus, above the urinary bladder - a nodular heterogeneous formation (subserous), with pronounced vascularization, with single small calcifications, size 87x64 mm (was 95x63 mm);

The body of the uterus is not enlarged, on the right surface there is a nodule without significant dynamics of 37x27 mm (myoma). Above and to the right of the uterus - a rounded formation of 67x52 mm (without significant dynamics, it was 67x57 mm, without obvious accumulation of contrast - a hemorrhagic cyst of the right ovary?).

Ovaries are differentiated, not enlarged. A small amount of fluid in the pelvis. The lymph nodes of the abdominal cavity, pelvis, and groin are not enlarged.

In bones without destructive foci.

CONCLUSION

Sa of the uterus according to the pathohistological examination, bilobed metastases in the liver, neoplasms in the abdominal cavity at the level of the stomach-tail of the pancreas (implant).

Uterine myoma, hemorrhagic cyst? of the right ovary. Single small nodules in the lungs - without dynamics.

Compared to the previous CT scan from August 23, 2022, the size of the formations in the liver increased, the node at the level of the uterine fundus decreased moderately; otherwise, there were no significant changes.

Recommendations: comparison with MRI data of the small pelvis. Control in dynamics.

Date: 01.12.2022 _____________________________ Official Seal

Roentgenologist: Liya Viktorivna Tselovanska _________

(signature)

*This conclusion is not based on a clinical diagnosis. This document should be interpreted by the attending physician in accordance with the clinical picture.