Urogenitaal geen aanwijzingen voor

Urogenitaal geen aanwijzingen voor RIP. Infrarenaal aneurysma aortae van 3.4 cm.
PET-CT 21-07-2016: Forse necrotiserende FDG avide tumor in de linker bovenkwab doorgroeiend in het mediastinum met uitgebreide mediastinale klierpathologie met de hoogste klier retroclaviculair en een sterke verdenking op een bijniermetastase rechts en dubieus links.
Bronchoscopie: maligne ogende afwijkende apieoposterior. Cytologische punctie carina: lokalisatie niet-kleincellig carcinoom, voorkeur plaveiselcelcarcinoom. Bronchusbiopt LBK: lokalisatie niet-kleincellig carcinoom, plaveiselcarcinoom.
MRI brein 21-08-2016: In de frontaal kwab rechts een voor metastase verdachte afwijking omgeven door oedeem met massawerking met midline shift naar links. Een tweede kleinere voor metastase verdachte afwijking rechts frontaal hoger aan de convexiteit. Voorts witte stof afwijkingen in de pons en de basale kernen, waarschijnlijk van vasculaire ischemische aard.
Bespreking:d"Het betreft een 65-jarige man in matige conditie met een gemetastaseerd (stadium IV) longcarcinoom met 2 symptomatische hersenmetastasen. Deze zullen stereotactisch bestraald worden. Tevens had hij pijn links op de thorax, welke voldoende onder controle was met pijnstilling. Derhalve was hiervoor nu geen indicatie voor radiotherapie.
Radiotherapeutische gegevens:c?Doelgebied: 2 hersenmetastasen Dosis: 24 Gy in 3 fracties op de grootste metastase, 24 Gy in 1 fractie voor tweede kleinere metastase.
Bijwerkingen:
Korte termijn: haaruitval en huidirritatie in het gebied van de hoge dosis intredende radiotherapie bundels. Hoofdpijn, misselijkheid, braken en mogelijke toename (of recidiveren) van bestaande klachten (waarvoor zo nodig dexamethason).
Lange termijn: radionecrose (waarvoor zo nodig dexamethason of chirurgie).
Follow-up:
4 weken na bestraling zal ik patient bellen. Voor verdere follow up verwijs ik hem terug naar de longarts (afspraak staats reed gepland).
Patient is van plan naar Egypte (geboorteland) te gaan de komende tijd.
Indien zich tijdens de behandeling bijzonderheden voor doen, krijgt u nader bericht.
Met eollegiale hoogachting,
S.C.J. Bosma, radiotherapeut i.o. voor akkoord:
J.L. Knegjens, radiotherapeut-oncoloog

النتائج (الإنجليزية) 1:

Urogenital no evidence of RIP. Infrarenaal aneurysm aortae of 3.4 cm.PET-CT 21-07-2016: robust Necrotizing FDG avide tumor in the left bovenkwab doorgroeiend in the mediastinum with extensive Mediastinal pathology with the highest gland retroclaviculair gland and a strong suspicion on an adrenal gland metastasis right and dubious links.Bronchoscopy: malignant-looking foreign apieoposterior. Cytologic puncture carina: localization non-small cell carcinoma, squamous cell carcinoma preference. Bronchial biopsy LBK: localization non-small cell carcinoma, squamous carcinoma.MRI brain 21-08-2016: In the frontal lobe right a derogation for metastasis suspect surrounded by edema with mass effect with midline shift to the left. A second smaller for metastasis suspicious deviation right frontal higher on the convexity. Furthermore, white matter abnormalities in the pons and the basal nuclei, probably of vascular ischemic nature.Discussion: d "it concerns a 65-year-old man in moderate condition with metastatic (stage IV) lung carcinoma with 2 symptomatic brain metastases. These will be irradiated stereotactisch. Also he had pain on the left side of the thorax, which was sufficiently under control with pain medication. Now, therefore, was not an indicator of radiation therapy.Radiotherapy data: c? Target area: 2 brain metastases dose: 24 Gy in 3 groups on the largest metastasis, 24 Gy in 1 group for second smaller metastasis.Side effects:Short term: hair loss and skin irritation in the area of the high-dose radiotherapy incident bundles. Headache, nausea, vomiting and possible increase (or reoffend) of existing complaints (for which, if necessary, dexamethasone).Long term: radio necrosis (for which, if necessary, dexamethasone or surgery).Follow-up:4 weeks after radiation will I call patient. For further follow up I would refer it back to the pulmonologist (appointment State reed planned).Patient is going to Egypt (homeland) to go the next time.If during treatment details for doing it, you will get further notice.Please accept, Sir, the eollegiale withS.C.J. Bosma, radiation oncologist i.o. for agreement:J.l. Knegjens, radiotherapist-oncologist

النتائج (الإنجليزية) 2:

Genitourinary no evidence RIP. Infrarenal aortic aneurysm 3.4 cm.
PET-CT 21-07-2016: Sharp necrotizing FDG avid tumor in the left upper lobe by growing in the mediastinum with enlarged mediastinal lymph node pathology with the highest gland retroclaviculair and a strong suspicion of bijniermetastase right and dubious links.
bronchoscopy: malignant abnormal-looking apieoposterior. Fine needle aspiration carina: locating non-small cell carcinoma, squamous cell carcinoma preference. Bronchusbiopt LBK: locating non-small cell carcinoma, squamous carcinoma.
MRI brain 21-08-2016: In the right frontal lobe metastasis surrounded a suspected abnormality by edema with mass effect with midline shift to the left. A second smaller metastasis suspected right frontal deviation higher on the convexity. Moreover, white matter lesions in the pons and the basal ganglia, probably of vascular ischemic nature.
Talk: d "This is a 65-year-old man in moderate condition with metastatic (stage IV) lung cancer with two symptomatic brain metastases, which will be irradiated stereotactic. . he also had pain on the left chest, which adequately controlled was with analgesia therefore, for this was now no indication for radiotherapy..
radiotherapy data c Goal: two brain Dose: 24 Gy in three fractions on the largest metastasis, 24 Gy in one group for second smaller metastasis.
Side effects:
Short term: hair loss and skin irritation in the area of the high dose onset of radiotherapy beams Headache, nausea, vomiting and possible increase (or relapse) of existing conditions (for which, if necessary, dexamethasone)..
Long deadline: radionecrosis (for which, if necessary, dexamethasone or surgery).
follow-up:
4 weeks after irradiation should I patient call for further follow up, I refer (reed scheduled appointment state) him back to the pulmonologist..
patient is planning to Egypt ( homeland) to go the next time.
If, doing detail during treatment, you will receive further notice.
With eollegiale esteem,
SCJ Bosma, radiation oncologist io for approval:
JL Knegjens, radiation oncologist

النتائج (الإنجليزية) 3:

genitourinary no evidence for rip. infrarenaal aortic aneurysm of 3.4 cm.pet - ct 21 july 2016: severe necrotizing fdg avide tumor in the left upper lobe doorgroeiend in mediastinum with enlarged mediastinal klierpathologie with the highest retroclaviculair gland and a strong suspicion on a dubious bijniermetastase right and left.bronchoscopy: malignant looking different apieoposterior. carina: puncture cytological localization non-small cell carcinoma, squamous cell carcinoma, preference. bronchusbiopt ltos: localization non-small cell carcinoma, plaveiselcarcinoom.mri brain 21 - 08 - 2016: the right frontal lobe in a suspect for metastasis from surrounded by edema with massawerking with midline shift to the left. a second smaller for metastasis suspect deviation to the right frontal convexiteit higher. the white matter abnormalities in the pons and the basal nuclei, probably of vascular ischemic nature.discussion: "it is a 65 year old man in moderate condition with metastatic carcinoma (stage iv) with 2 symptomatic brain metastases. this will be stereotactic radiotherapy. he also had pain in the left chest, which was under control with adequate analgesia. therefore, there was no indication for radiotherapy.radiotherapeutic data: c? target area: 2 brain metastasis in 3 groups: 24 gy dose on the largest metastasis, 24 gy in 1 second smaller metastasis group.effects:short term: hair loss and skin irritation in the area of the onset of high dose radiotherapy beams. headache, nausea, vomiting and possible increase (or re offending) of existing complaints (which need dexamethasone).long term: radionecrose (which, if necessary, dexamethasone or surgery).follow-up:4 weeks after irradiation will call i patient. for further follow-up, i refer it back to the pulmonologist (meeting state was planned).patient is going to egypt (native) to the next time.if during the treatment details do you get further notice.with eollegiale consideration.s.c.j. bosma, radiotherapeut i.o. for agreement.last knegjens, radiotherapeut - oncologist