Dr. Muhammad Shoyab
Radiodiagnosis
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am 27 years old. I consume alcohol two to three times a week. I do not have a family history of any disease. For one year. I have an issue of nausea and vomiting. I have an intense urge to gag. Symptoms do not correlate to meal times. OTC medications like tablet Promethazine have not helped much. Also, I am unable to use tablet Zofran due to interaction with tablet Lexapro. Sometimes. dry heaving relieves the attack and I feel better. Sometimes, I have one to three attacks per day, and other times I go days without an attack. I do not have a fever. MY GFR is 70 ml/min. My MRI report reads four small hyperintensity foci under T2 imaging, three in the right hemisphere and one in the left, 4 mm suspected benign dural calcification in the frontal lobe. neck imaging unremarkable, reactive cervical lymph nodes under mm and not suspected to be malignant. Moderate cervical spondylosis. My blood reports suggest slightly elevated RBC, hematocrit, hemoglobin, neutrophils, and sedimentation rate. Currently, I am using tablet Lexapro, tablet Adderall, tablet Wellbutrin, tablet Spironolactone, and tablet Mounjaro. Kindly advise on my MRI scan reports.
Thank you.
Hello,
Welcome to icliniq.com.
Thank you for addressing your health concerns to us. I have reviewed your attached brain and neck MRI (magnetic resonance imaging) scan reports (attachment removed to protect the patient's identity). I think there is no significant finding except for a small dural calcification. In particular, the epiglottis, larynx, and vocal cords do not reveal any abnormal signals or configuration. I hope that your upcoming chest and abdominal MRI reports come normal.
Best wishes.
Regarding follow up
Patient's Query
Hello doctor,
Is it possible for a dural calcification to be malignant?
Hello,
Welcome back to icliniq.com.
Dural calcifications are most often insignificant findings, and there is little to discuss them. So there is nothing for you to worry about on this point. Also, dural calcification is not the same as "dural-based mass lesion with calcification".
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
What about the cervical lymph nodes? I have felt one on my right posterior or supraclavicular area for a few months but was told that they were too small to be concerned about. Are they reactive?
Hello,
Welcome back to icliniq.com.
It is natural to feel worried when one has long-term symptoms. Regarding the lymph nodes, you do have some prominent lymph nodes. However, there are no critical features to label them as reactive. They are present at the submandibular level, and you may be able to feel one or two of them at the angle of your lower jaw. Lymph nodes are a part of normal biology, and their most important utility is related to cancers. So, when a lymph node does not represent cancer, we can ignore it by calling it "reactive".
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Do I need to get a biopsy done for my lymph node? It is the one I feel the most, but want to avoid invasive procedures if it is not worth it. Also, I do not have any active infection. What is the diagnosis based on my MRI reports?
Thank you.
Hello,
Welcome back to iclinq.com.
There is no need for a biopsy. Vomiting can be due to abdominal reasons related to issues of the liver, kidney, or stomach. I suggest you visit an internal medicine specialist.
I hope this helps.
Thank you.
Regarding follow up
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Radiodiagnosis
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