Please review the CT scan of the abdomen report of my diabetic brother, who takes insulin four times.

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I have reviewed the attached CT (computed tomography) scan report (attachments removed to protect the patient's identity).

I also reviewed the short history you provided. Two points in history are not co-relating to the CT scan. The first thing is he has diabetes and is on insulin, which is not related to CT scan findings as such. The second thing is lots of tests were performed. Everything is normal, this is unusual to have significant abdominal findings, and baseline workup and physical examination would be unremarkable.

Now coming to the CT scan report,

1. Liver and spleen sizes have increased, and their texture is not normal, so Hepatitis B and C, alcohol, and fatty liver disease should be ruled out. There must be a correlation with liver function tests.
2. There is an abnormal-looking mass or unusual thickening within the abdomen, especially near the posterior wall. Along with these two more significant findings, the lymph node is enlarged, and there is free fluid within the abdomen which is again not normal.

So, I suggest visiting the doctor who suggested a CT scan abdomen and asking for a tissue sample or biopsy for a better diagnosis.

I hope this helps.

Thank you and take care.

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

The liver is diffusely enlarged, not a specific space-occupying lesion to target. Similarly, the spleen is enlarged too. But on the other hand, the retroperitoneal structure is something new or abnormal.

The target will depend upon a few things.

1. Clinical suspension after taking derailed history and examination, including family history.
2. Tumor markers or blood tests for both liver and retroperitoneal structure, whichever will be high, will be suggestive of primary.
3. Technical assessment for the approach of biopsy is available at your center.

I would go for tumor markers followed by a biopsy, and maybe I target retroperitoneal structure biopsy first.

I hope this helps.

Thank you and take care.