PET-CT Scan Report - Plain Language Summary

Patient & Clinical Background

• Referred by Dr. Sudarshan Davkhar, Shrinath Hospital
• Reason for scan: High white blood cell count (leucocytosis), atypical lymphocytes on blood smear - evaluation for a suspected chronic lymphoproliferative disorder (e.g., Chronic Lymphocytic Leukemia / CLL or lymphoma)

Most Important Overall Finding

Findings Region by Region

Lymph Nodes (Multiple Areas)

• Small lymph nodes seen in the neck (bilateral, levels I-V, supraclavicular), parotid region, armpits, and deep abdomen (around the liver, intestines, aorta)
• All are non-FDG avid and sub-centimeter in size - likely reactive (mild inflammatory swelling), not cancerous
• This pattern is very typical of indolent (slow-growing) lymphoproliferative disorders like CLL

Liver & Spleen (Significant)

• Liver mildly enlarged - 19 cm (normal ~15 cm)
• Spleen mildly to moderately enlarged - 18 cm (normal ~12 cm)
• Both show normal tracer uptake - no suspicious masses inside
• Liver has a few small non-enhancing hypodense spots - almost certainly benign cysts, not cancer
• Enlarged liver + spleen in this clinical context strongly fits CLL or similar indolent lymphoma

Kidneys & Urinary Tract (Needs Prompt Attention)

• 8 mm stone blocking the right upper ureter (just below the pelviureteric junction / PUJ) causing mild right hydronephrosis (kidney swelling from backed-up urine)
• A second tiny stone in the lower pole of the right kidney
• A small benign cyst in the upper pole of the left kidney
• This stone may need urological intervention as 8 mm stones rarely pass on their own

Fluid Accumulation

• Mild ascites (small amount of fluid in the abdominal cavity)
• Mild right-sided and minimal left-sided pleural effusion (fluid around the lungs)
• These fluid collections can occur in lymphoproliferative disorders or from the abdominal pressure of enlarged organs

Chest & Lungs

• No lung nodules or masses
• Mild subpleural atelectasis (small collapsed areas) - likely from the pleural fluid
• Heart and major blood vessels appear normal

Head & Brain

• Mild right maxillary sinusitis (sinus inflammation - common, incidental finding)
• Brain is completely normal

Spine

• Age-related degenerative wear-and-tear changes (normal for age)

Summary & What to Do Next

Disclaimer: This is an educational summary of the radiology report provided. It is not a medical opinion or substitute for consultation with qualified treating physicians. All decisions regarding diagnosis and treatment must be made by the patient's doctors.

Is There a Chance of Cancer?

What the Report Suggests

The Key Point: Non-FDG Avid = Not Aggressive

What Is NOT Seen (Reassuring Signs)

• No large masses anywhere
• No FDG-avid (hot/aggressive) lymph nodes
• No bone involvement
• No organ infiltration
• The final comment states: "No evidence of metabolically active disease in rest of the body"

What Needs to Be Confirmed

1. Flow Cytometry (blood test) - identifies the exact type and markers of the abnormal lymphocytes. This is the most important next test.
2. Bone Marrow Biopsy - may be done to assess how much the marrow is involved
3. LDH, Beta-2 microglobulin - blood markers that help stage the disease
4. FISH/cytogenetics - genetic tests to predict how fast it may progress

Bottom Line

The pattern strongly suggests CLL or a similar indolent blood disorder - which is technically a form of cancer (blood cancer), but is among the most slow-moving and manageable types. Many people live with it for 10-15+ years with minimal treatment or monitoring only. The absence of any FDG-avid activity is a good sign - it argues against any aggressive or high-grade transformation.

This is an educational explanation based on the radiology report. Only a qualified hematologist/oncologist can make a formal diagnosis after reviewing all blood tests, clinical history, and biopsy results.