의학용어 잘 아시는 선생님 계신가요? 의무기록 해석 부탁드립니다.
의무기록 해석에 어려움이 있어 질문 남깁니다.
의학용어 잘 아시는 분 계신다면 번거로우시겠지만 하나하나 해석 부탁드립니다.
∙ 2016.02.24 ABDOMEN & PELVIS MDCT-Contrast
Findings & Conclusion
1. About 13.4cm sized mixed cystic and solid mass with scattered fatty & calcified component and enhancing solid portion in right ovary.
- Probable immature teratoma.
2. About 6.8cm sized mixed cystic and solid mass with fatty & calcified.
component without hypervascularity.
- Probable mature teratoma.
3. Hemoperitoneum.
4. No definite evidence of peritoneal seeding nodules.
5. Subsegmental atelectasis, LLL.
∙ 2016.03.02 Whole body fusion PET-torso
[Conclusion]
1. Suggesting post of change in pelvic cavity and abdominal wall.
2. Mildly increased FDG uptake in above mentioned lymph nodes, metastasis less likely. Rec) follow-up
3. A small nodular lesion in LLL of lung with equivocal significance.
Rec) follow-up chest CT
Pathologic Report
2016.02.25. [Ovary]
1. Ovary and salpinx, right, salpingoophorectomy :
Immature teratoma, right ovary, presence of yolk sac tumor component with
1) size : 14×9×8cm
2) lymphovascular invasion : not identified.
3) no definitive capsular invasion.
4) clear resection margin.
[Results of immunohistochemistry]
Pancytokeratin : positive.
AFP : positive.
GFAP : negative.
S-100 protein : focal positive.
2. Ovary, left, cystectomy : Mature cystic teratoma.
3. Ovary, left, #2, cystectomy : Consistent with Corpus luteal cyst.
안녕하세요 아하(Aha) 의료, 코로나 카테고리에서 활동중인 전문의입니다.
해당 영상검사 기록을 종합하면 우측 난소에 지름 14cm 가량의 기형종이 존재하는 소견입니다.
참조하시어 도움이 되기를 바랍니다.
