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Dr. Andrew Rynne

Family Physician

Exp 50 years

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CT Scan Report: There is partial resolution of the left

CT Scan Report:
There is partial resolution of the left main pulmonary artery thrombus since the previous scan (Aug-2018).There is however still considerable thrombus noted with in the distal main pulmonary artery extending into the proximal lobar branches on the left.

As noted previously, there is cavitating left infrahilar lesion measuring 2.4 cm x 2.1 cm. This has increased since the previous scan. There is associated mild thickening of the cavitating lesion with part of the pulmanary artery eroding in to the cavity. Does the patient have any hemoptysis ? In addition there is further nodular opacity noted in the left lower lobe measuring 2.4 x 1.2 cm.
There is minimal left sided pleural effusion.
Multiple lymphnodes are noted in the mediastinum, the largest of which measures 1.0 cm in the precarinal location.

Patient: Female 53 years non smoker.
Earlier diagnosed with PE and got treated 5 days with injection and then on blod thinner (Pradaxa 300 mg per day) for since 28-aug-2018. But in recent CT scan they are saying thrombus is persistent and cavity imeasuring got increased.

what can we do now ?
Doctor is suggesting for biopsy for the patient as she is on pradaxa asked us to stop for two days and take biopsy ?
will there be any alternative to biopsy to asses
or if we have to do biopsy what can be best method in doing and what can be complications after word
Please suggest.                              
Fri, 2 Nov 2018
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