Female 50 years old; Reason: pre-EGD/biopsy of GEJ mass at OSH. 50F with h/o L RCCA s/p nephrectomy. Requested by Interventional GI (contact p7943) History: worsening pain mid-chest and dysphagia CHEST:LUNGS AND PLEURA: No pleural effusions.MEDIASTINUM AND HILA: Left para-aortic lymph node measuring 1.3 x 1.3 cm (image 17/series 501). CHEST WALL: Surgical changes above the xiphoid process.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. There are postsurgical changes in the caudate. There is a new poorly enhancing lesion within the right hepatic lobe measuring 0.8 x 0.8 cm (image 12/series 2605), suspicious for metastatic disease. There is mild intrahepatic delayed ductal dilatation. Gallbladder is unremarkable.The hepatic and portal veins are patent.SPLEEN: The spleen is absent.PANCREAS: The pancreatic body and tail are severely atrophic. This is possibly due to radiation. Pancreatic duct is mildly prominent but not dilated.ADRENAL GLANDS: Right adrenal gland is unremarkable. Left adrenal gland has been resected.KIDNEYS, URETERS: Status post left nephrectomy. Right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: There postsurgical changes near the gastroesophageal junction.BOWEL, MESENTERY: Diffuse circumferential wall thickening of the distal esophagus near the GE junction. There is also thickening of the gastroesophageal junction. This is in the region of prior nodal tumor. There is focal soft tissue thickening involving the gastric wall near the fundus about the gastroesophageal junction measuring 2.3 x 2.1 cm (image 308/series 2101). No bowel obstruction.BONES, SOFT TISSUES: Postsurgical changes in the intra-abdominal wall and chest wall.OTHER: No upper abdominal fluid collections.
1.Findings of diffuse distal esophageal wall thickening with a soft tissue nodule measuring 2.3 cm in the adjacent gastric wall. This is located in the site of prior nodal disease and likely represents recurrent disease.2.No esophageal obstruction.3.Subcentimeter right hepatic lobe metastases.4.Enhancing nodule adjacent to the aorta in the mediastinum. Likely represents mediastinal nodal metastases