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I had a CT w/contrast for investigation of micro hematuria.

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Urologist said that my kidneys...
I had a CT w/contrast for investigation of micro hematuria. Urologist said that my kidneys, ureter, and bladder looked good. He did not say anything about CT scan. Today, I saw actual results show up in portal.It shows the following:
VISUALIZED THORAX: Dependent atelectasis in both lower lungs. Left lower lobe scarring.
ABDOMEN:
Liver: Unremarkable.
Gallbladder: Surgically absent.
Spleen: There is a 1.2 cm splenule anterior to the spleen.
Pancreas: Unremarkable.
Adrenal glands: Unremarkable.
Kidneys/ureters: There are no renal or ureteral calculi, renal masses, or urothelial lesions.
Small bowel: Unopacified small bowel unremarkable.
Adenopathy: None.
Fluid: No free fluid or fluid collection.
Vascular: Unremarkable.PELVIS:
Multiple phleboliths are visualized in the left hemipelvis.
Colon: Opacified colon unremarkable. Appendix is surgically absent.
Uterus/adnexa: Unremarkable.
Bladder: Unremarkable.
Adenopathy: No significant adenopathy.
Fluid: No free fluid or fluid collection.OSSEOUS STRUCTURES:
Degenerative changes of the thoracic and lumbar spine.It is compared to CT done in October 2013 (for generalized illness, mono twice in 6 months, shortness of breath). In 2013, CT report said:
Thorax:
No evidence of pulmonary embolism, aneurysm, or dissection. Coronary
artery atherosclerotic calcifications are visualized. There is mild
enlargement of the left ventricle. No evidence of pericardial effusion.
No evidence of adenopathy. Trachea and large airways are unremarkable. A
subpleural, sub-4 mm nodule is present at the left lung base, as marked
on PACS. No suspicious nodularity or consolidation.
Abdomen:
Visualized lung bases: Unremarkable.
Liver: Small focal hyperdensity is present at the lower anterior lateral
right lobe of the liver and is too small to characterize. Liver otherwise
is unremarkable.
Gallbladder: Surgically absent.
Spleen: Unremarkable.
Adrenal glands: Unremarkable.
Kidneys: A tiny nonobstructing right renal calculus is noted. The left
kidney is unremarkable.
Pancreas: Unremarkable.
Small bowel: Unremarkable.
Vascular: Unremarkable.
Other findings: No free fluid or lymphadenopathy.Pelvis:
Bladder: Unremarkable.
Colon: Unremarkable.
Uterus/adnexa: Unremarkable.
Other findings: None of significance.Osseous structures: Mild degenerative changes are present. No acute
osseous lesion.In March 2014, because my dad died of lung cancer (back in 2006) and because I was still sick (enlarged lymph nodes in my neck, elevated CRP, elevated Sed rate), and losing weight unintentionally, they did followup CT to check on the lung nodule noted in October 2013 scan. That CT was normal and showed the following results:
FINDINGS:
1. Previously described left lower lobe sub-4 mm pulmonary nodule is not visualized on today's examination. There is no evidence of worrisome nodule or mass seen within the lungs.All scans were done at same facility, but not by same radiologist. Should I be concerned about recent findings in the lungs (Dependent atelectasis and lower left scarring)? I had pneumonia in April 2013 prior to the first scan, but haven't had respiratory illness since then (except for occasional cold). Should I be concerned about splenule that was picked up in most recent scan when it was not mentioned in prior two scans? I thought that a splenule was congenital and would have been there at birth.In April 2014, I was diagnosed with Lyme Disease (positive antibodies). After I began treatment, I became well again. I see a cardiologist for small aortic insufficiency. I am on meds for high blood pressure. I also have been diagnosed with Primary Sjogren's Syndrome and see rheumatologist every 6 months. I had cystoscopy and CT scan last week to rule out kidney stone or mesh erosion as reasons for microscopic hematuria. Looks like it has just been from multiple UTI's in the last 18 months.My question is should I be concerned about recent incidental findings? Should I schedule appointment with PCP to go over those other CT findings? My PCP is at a different facility. I do not think that she would automatically get a copy of these results.
Submitted: 7 months ago.Category: Medical
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Answered in 3 minutes by:
10/3/2017
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,121
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

What is your age?

Do you smoke or were smoker?

Are you worried about lung Atelectasis and left lower lobe scarring?

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Customer reply replied 7 months ago
I am 49y10mo. I have never smoked, but grew up in a house full of second hand smoke as a child.I do not think I have symptoms associated with partial collapsed lung. Ever since I had pneumonia, though, I do have times where it is painful to take a deep breath. I tend to take shallow breaths. I am concerned about scarring because it wasn't ever mentioned before and there would seem to be no reason to have scarring show up recently. Also, I read that there tends to be a link between scarring and lung cancer.
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Let me at the outset tell you that lung atelectasis and scarring are NOT due to cancer. A second hand smoking / passive smoking do affect the lungs as you already know and these changes may also be due to the past pneumonia. The modern CT is very sensitive investigations which picks even tiniest of the aberration from the normal lung anatomy. So a CT scan done before and recently will have small differences. These changes essentially do not point to any disease or need any active treatment.

Overall there is nothing worrisome.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 7 months ago
just to clarify, the splenule is also not of concern?
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

No. Splenule are common findings in many individuals.

This is not disease or pathological.

It is privilege assisting you.

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Customer reply replied 7 months ago
If splenule is a congenital finding and often incidental finding on CT scans, why was it not picked up on previous scans? At 1.2 cm, it should have been noticeable, even in 2013.
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Splenule can be congenital as well as acquired and are formed later in the life too.

Some Splenule are small which attain bigger size afterwards.

Also CT techniques change slightly so previously not seem findings may become obvious in later scans.

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Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Was this information helpful to you? I would be glad to answer any further questions.

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