Correct!
5. More than one of the above
Given that the surgical resection was complete and uneventful, and the post-operative 18FDG – PET scan showed no residual disease, pelvic MRI is not indicated. The current prednisone dose is probably sufficient [the patient noted improvement in the oral and genital ulcers], and any adjustments in this medication would be best conducted after further observation of the effectiveness of the current dose. Pulmonary medicine consultation is appropriate given the persistent wheezing and abnormal pulmonary function testing performed preoperatively. Rituximab therapy is appropriate for treatment of the patient’s pemphigus associated with Castleman disease.
Pulmonary medicine was consulted nearly 3 months post-operatively. Pulmonary function tests were repeated, showing a FVC of 2.21L (63% predicted), a forced expiratory volume in the first second of exhalation (FEV1) of 1.08L (37% predicted), and forced expiratory flow rate25-75% = 0.45 L/sec (14% predicted). Repeat high-resolution chest CT (Figures 9 and 10) was performed.
Figure 9. Left (A-I): axial unenhanced inspiratory HRCT images through the upper (A-C), mid (D-F) and lower (G-I) lungs. Right: video of axial unenhanced inspiratory HRCT.
Figure 10. Left (A-F): Axial unenhanced post-expiratory HRCT images through the upper (A and B), mid (C and D) and lower (E and F) lungs. Right Video of axial unenhanced post-expiratory HRCT.
Which of the following represents the most appropriate description of the CT scan pattern? (click on the correct answer to be directed to the eleventh of twelve pages)