Male 56 years old with peritoneal mesothelioma. Please compare to prior CT to evaluate disease for surgery. ABDOMEN:LIVER, BILIARY TRACT: There is again minimal scalloping of the liver margin. No focal hepatic lesions are identified. The patient is status post cholecystectomy with no intra or extrahepatic biliary ductal dilatation. The hepatic vasculature is patent.The amount of perihepatic and ascites (particularly in upper quadrants) has increased since the previous exam, resultant narrowing of the IVC noted and suggestive of a gelatinous/mucinous composition of the fluid.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Comparison of the peritoneal disease to prior CT imaging difficult due to differences in technique and modality. The peritoneal disease in the left upper quadrant is best seen on postcontrast images. A 2.5 x 2.1 cm left upper quadrant lesion medial to the spleen corresponds to a 0.7 cm focus on the prior CT (series 13, image 359; series 7, image 33 on the prior CT). The perigastric peritoneal lesion measured on the prior exam is difficult to compare and is possibly smaller measuring 2.0 x 1.9 cm (series 13, image 350; series 7, image 26 on the prior CT). There is nodular thickening of the dependent right peritoneal reflection (series 16, image 17) in the pelvis that was not well seen on the previous exam and may be new. Mild general peritoneal thickening is seen elsewhere as well, e.g., at level of pelvis.BONES, SOFT TISSUES: Susceptibility artifact in the anterior abdominal wall is most likely related to prior surgeries.OTHER: No significant abnormality noted.
1. Direct comparison with the prior CT suboptimal given differences in technique and modality.2. A left upper quadrant lesion medial to the spleen has increased in size since the previous exam. The perigastric peritoneal lesion measured on the prior CT exam is difficult to compare and is possibly smaller.3. Nodular thickening of the right dependent peritoneal reflection was not well seen on the previous exam and may be new. Mild generalized peritoneal thickening elsewhere appears similar to the previous exam.4. Amount of perihepatic and ascites (particularly in upper quadrants) has increased since the previous exam, resultant deformity and narrowing of the IVC noted and suggestive of a gelatinous/mucinous composition of the fluid.