I've included a transcription of the radiologists report on my Chest CT. I bolded the portions I thought were most pertinent.
EXAM:
Chest Thorax w/wo IV contrast CTS
CLINICAL INDICATION:
48-year old patient with a history of cyrptococcosis 117.5
COMPARISON:
9/7/2014
CONTRAST:
90 mL Isovue 370
EXPOSURE:
474 mGycm
FINDINGS:
Cuts through the chest were obtained from the thoracic inlet through the costophrenic sulci with and without intravenous contrast enhancement.
The mediastinal vascular structures enhance normally. The aorta is normal in caliber without evidence of dissection. The pulmonary arteries are well visualized and normal in appearance. There is no adenopathy present in the hila or mediastinum.
Within the bilateral upper lobes, there has been interval improvement in the amount of airspace disease/opacity. There is a small cavitary lesion in the left upper lobe measuring approximately 1.7 x 1.4 cm which was not definitely visualized on the prior
study. The right lower lobe airspace disease has nearly completely resolved with only a mild amount of opacity present (series 4, image 48). No new pulmonary masses or opacities identified.
The visualized portions of the upper abdominal viscera are grossly normal.
IMPRESSION:
1. Significant improvement in the bilateral upper and right lower lobe opacities compared to the prior study of 9/7/14 compatible with interval response to treatment. Residual opacity is present in the bilateral upper lobes. There has been near complete resolution of the right lower lobe opacity. Continued followup is recommended.
2. Interval development of a probable small cavitary lesion measuring 1.7 cm in the left upper lobe. Opacity is identified within the lumen which likely represents residual airspace disease. Followup is recommended.
What looks better?
What looks normal and/or unchanged?
What looks worse?
Medical terminology
Caution I have no formal medical training or education. What I know (and think I know) I learned by reading about my disease, internet searching, and speaking to doctors. So my definitions of medical terminology are worth what you paid for them :)
What it all means
Well, my ID doctor was tickled with the results :)
No new areas of disease
Some areas are almost completely healed.
Other areas show significant improvement with much of the remaining "opacity" due to scarring and not fungus.
One region of fungal infection developed a "cavitary lesion" which looks like normal disease & healing progression
EXAM:
Chest Thorax w/wo IV contrast CTS
CLINICAL INDICATION:
48-year old patient with a history of cyrptococcosis 117.5
COMPARISON:
9/7/2014
CONTRAST:
90 mL Isovue 370
EXPOSURE:
474 mGycm
FINDINGS:
Cuts through the chest were obtained from the thoracic inlet through the costophrenic sulci with and without intravenous contrast enhancement.
The mediastinal vascular structures enhance normally. The aorta is normal in caliber without evidence of dissection. The pulmonary arteries are well visualized and normal in appearance. There is no adenopathy present in the hila or mediastinum.
Within the bilateral upper lobes, there has been interval improvement in the amount of airspace disease/opacity. There is a small cavitary lesion in the left upper lobe measuring approximately 1.7 x 1.4 cm which was not definitely visualized on the prior
study. The right lower lobe airspace disease has nearly completely resolved with only a mild amount of opacity present (series 4, image 48). No new pulmonary masses or opacities identified.
The visualized portions of the upper abdominal viscera are grossly normal.
IMPRESSION:
1. Significant improvement in the bilateral upper and right lower lobe opacities compared to the prior study of 9/7/14 compatible with interval response to treatment. Residual opacity is present in the bilateral upper lobes. There has been near complete resolution of the right lower lobe opacity. Continued followup is recommended.
2. Interval development of a probable small cavitary lesion measuring 1.7 cm in the left upper lobe. Opacity is identified within the lumen which likely represents residual airspace disease. Followup is recommended.
What looks better?
- Left upper lobe
- Right upper lobe
- Especially the right lower lobe (almost no sign of disease now)
What looks normal and/or unchanged?
- Heart
- Major blood vessels
- Pulmonary (lung) blood vessels
- Lymphnodes
- Left lower lobe (not much sign of disease there in the first report)
- Everything below the diaphragm
What looks worse?
- Development of a new "cavitary lesion"
Medical terminology
Caution I have no formal medical training or education. What I know (and think I know) I learned by reading about my disease, internet searching, and speaking to doctors. So my definitions of medical terminology are worth what you paid for them :)
- Bilateral - both sides (left & right)
- Lobe - consider each lung divided in half into upper and lower lobes
- Opacity - unable to see through it on the x-ray - caused by disease or scarring
- Residual opacity - I suspect but have not confirmed that this means the radiologist thinks my body has eliminated the disease in this spot and the remaining "opacity" is due to lung scarring - not disease.
- Cavitary lesion - "cavitary" means a cavity and implies it is gas filled (otherwise they might call it a cyst). However, the radiologist cannot determine whether the cavity is fluid filled or gas filled by means of x-ray or CT scan. A lesion of this sort indicates some of my lung tissue or fungal tissue died and is in the process of being absorbed by my body. Cavitary lesions are a common feature of fungal lung infections (along with several other types of infections like m. Tuberculosis)
- Residual airspace disease - means my body is exuding fluids into my lungs (aka pneumonia) from fighting the fungus.
What it all means
Well, my ID doctor was tickled with the results :)
No new areas of disease
Some areas are almost completely healed.
Other areas show significant improvement with much of the remaining "opacity" due to scarring and not fungus.
One region of fungal infection developed a "cavitary lesion" which looks like normal disease & healing progression
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