Question: USG Reveals as Follows :
Liver Mildly enlarged in size. Parenchymal echo is enhanced with diminished visualisation of vascular marking. Normal intrahepatic biliary radicles and portal vein radicles. No focal lesion. Margin is smooth and regular.
IMPRESSION : MILD HEPATOMIGALLY WITH FATTY INFILTRATION OF LIVER (GRADE-III)Klebsiella Infections

Sir I am non alcoholic. Ex smoker. I find me better then earlier and started joining court proceedings. But very recently I am feeling uneasy for inflammation of the abdomen an their is mild pain sometimes when I bend foroward. I have no issue of Blood Pressure, Diabetics as yet. Lipid Profile done. it is within normal limit.

Sir,
I am a resident of XXXXXXX and practicing in the High Court. Mentally I am very much strong. The fact remains my wife was part and parcel of my life. She was everything for me, my father and only son. My wife was a working lady and she had to travel on working days more than 120 KM. on 12th August on the way while returning from office she felt pain in abdomen. From that evening she was under medical supervision. Then started loose motion. But ultimately she was suspected to have been suffering from Cancer. On 1st Sept 2014 she was referred to XXXXXXX New XXXXXXX by the Medical Board of Govt. of XXXXXXX On the next day in a precarious condition she was taken to XXXXXXX She was treated at XXXXXXX XXXXXXX State Cancer Institute, Tata medical Centre and at Regional Cancer Centre, XXXXXXX Her case was also referred to Cancer Research Centre, XXXXXXX
But unfortunately despite of all efforts Cancer though a diagnosis was made "Ca Ovary", but in fact the primary was not detected. Hence no surgery was permissible. After Chemotherapy there was good response. She had been transfused huge Blood units initially during first 4 months. Thee Hg was also stable. She was much better. But suddenly since 6th March 2015 her condition became unstable and ultimately despite of all efforts on 8th March 2015 her all organs suddenly collapsed and before last breath for more than 1 hour 28 mins she had no pulse and BP, but was having breath and giving response to call.
The fact remains, during the period of her illness I smoked a lot, which a man can normally can do in a couple of years.
I was out and out broke down at the death of my wife. in the mean time I stopped smoking. I undergone Cataract surgery at XXXXXXX Operation was successful. But on return to home few days after there was inflammation of eye and face and neck. Suffered constipation. Then just after 365 days of suspecting Cancer of my wife, I was suspected Cancer and on the next day I went to XXXXXXX and done Bronchoscopy, Pet CT etc and it was finally detected Ca Lung (Small Cell Lung Cancer).
As pet Ct report uptake in liver, spleen, rest of the lymph node region and rest of the skeletal system is within normal limit. Pet CT Findings Impression was " Pet Ct findings are consistent with known/suspected Ca Right Lung, possibly multi focal/intrapulmonary spreads with involvement of multiple Chest Node groups as described. The FDG uptake in tip of left scapula is suspicious for active (Metastatic) disease focus. The Asymmetric uptake in vocal cord is of uncertain clinical significance and may require further evaluation as clinically indicated." Pet CT was done on 26/8/15.

The Bronchoscopy done on 21/8/15 reveals "Infiltrative lesion in right bronchial tree with obstructions of right upper lobe.
EBUS FNAC reveals PD Carcinoma.
Endobronchial Lung Biopsy reveals Small Cell Lung Carcinoma.
Then on 32/8/15 itself Chemotherapy started and continued with Etoposide 170 mg and Carboplatin 450 mg 3 days per cycle. 5 Radio Therapy was also given for facial puffiness and puffiness disappeared after few days of 1st Cycle of Chemo.
Immediate after 1st Cycle of Chemo Tata Medical Centre ultimately made staging : Extensive Stage with SVC Syndrome.
After 3 Cycles of Chemo Tata Medical further assesses significant symptomatic improvement. SVC relieved. CT Scan Abdomen shows all normal except mild Fatty Liver. CT Scan Chest shows significant development. Left Lung and Scapula relieved.
After 5 Cycle of Chemo Lung X-ray shows left lung almost normal. effect in Right lung narrowed down to minimum.
Now 5 Cycles chemo completed. Next Chemo is scheduled on 18,19 & 20 Dec 2015. thereafter after CT Scan of Lung & Brain review would be on 30/12/2015.
Blood Report is normal. Hg 11.8. No transfusion of blood required as yet. I have no facial Puffiness. No Chest pain. No respiratory problem. But very recently abdomen has been inflmated. Feeling weakness and uneasy. Sonography suggestive of Fatty Liver Grade III.
This is my status. I would seek ur opinion with suggestion of a Specialist/Hospital where I can visit for total review of my case.
Yours faithfully XXXXXXX Chakrabarti
Advocate,
P.O. Jogendranagar, XXXXXXX XXXXXXX