Reason: Hx of peritoneal mesothelioma, eval disease progresion History: abdominal pain CHEST:LUNGS AND PLEURA: No gross abnormalities.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Tumor extending anteriorly within the cardiophrenic space is decreased since the prior exam.CHEST WALL: Subcentimeter axillary and internal mammary nodes are unchanged.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. Multiple perihepatic subserosal and peritoneal nodular implants extending along the right paracolic gutter are not significantly changed.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal nodule measures 1.4 x 1.2 cm, minimally increased since the prior exam.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple enlarged lymph nodes at the porta hepatis which have increased since the prior exam with increased necrosis.BOWEL, MESENTERY: Numerous soft tissue implants throughout the peritoneum and mesentery. Reference measurements are unchanged.BONES, SOFT TISSUES: Complex cystic lesion along the ventral incision site has increased in size.OTHER: Moderate ascites is unchanged.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Soft tissue implants throughout the pelvis with an unchanged reference lesion. Rectosigmoid anastomosis.BONES, SOFT TISSUES: Cystic lesion within the right gluteus minimus measures 1.5 x 1.7 cm. Right-sided paralabral cystOTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 6/13/2016 08:23:50)PERITONEAL NODULAR ADJACENT TO LIVER: 3.7 x 1.9 cm (Image 274, Series 2204); 4.1 x 2.2 cm on prior (4/6/2016) (Image 33, Series 209).PERIPANCREATIC NODULE: 2.5 x 2.6 cm (Image 189, Series 2204); 2.1 x 1.9 cm on prior (4/6/2016) (Image 38, Series 209).VENTRAL BODY WALL COMPLEX CYSTIC LESION: 12.2 x 5.4 cm (Image 1, Series 1701); 7.9 x 3.6 cm on prior (4/6/2016) (Image 57, Series 209).POSTERIOR PELVIC SOFT TISSUE IMPLANT: 3.0 x 2.8 cm (Image 84, Series 3001); 2.9 x 2.9 cm on prior (4/6/2016) (Image 80, Series 209).
1.Soft tissue implants along the anterior mediastinum have slightly decreased since the prior exam.2.Extensive peritoneal and mesenteric soft tissue implants are not significantly changed accounting for differences in technique.3.Peripancreatic lymph nodes are slightly increased in size with increased central necrosis.4.Large cystic lesion along the anterior abdominal wall is increased in size.5.Small cystic foci in the right gluteus minimus is of uncertain etiology.