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CT scan found kidney stone in ureter. Explain the meaning misty mesentery with shotty nodes. Help

During a CT scan in ER finding 8 mm kidney stone stuck in ureter and multiple smaller stones in each kidney, the radiologist found diffuse hepatic steatosis , misty mesentery with shotty nodes, mild stranding with lymphadenopathy r/o lymphoma . Repeat scan 2 months later found same finding, possible related to Mesenteric Paniculitis with lymphadenopathy. My enlarged kidney and the stone issue were resolved after I drank massive amounts of lemon juice, so the lithotripsy my urologist planned was cancelled the day before surgery after reading pre-op x-ray. My doctor ordered complete bloodwork which then flagged low platelets 117 (130-440), glucose 123 (74-106),BUN/Creat Ratio 18.6 (7-18.) a d low Vit D 13.5 (30.0-100.0). Then I was referred to a hemotologist/ oncologist who referred me to have a biopsy of lymph node. My symptoms: 169 lb female 58 years Changes in bowel habits, diarrhea often, walker s diarrhea , some tender areas in abdomen ( rt lower side and up on rt side closer to ribs), get very itchy on back side of head at times it sea to flare up especially in hot weather, hot flashes especially at night, stools have gotten skinner, looser. I m seeing a gastroenterologist next week and have scheduled an appt. w/ surgeon for biopsy, which I hope I don t need. The hematologist/oncologist said she doesn t think it is lymphoma, but she said some lymphomas can be obscure. She said a biopsy may show nothing, but suggested that as the next step. Overall, I feel good, but feel full and bloated a lot. I still have a strong appetite, but I m exercising and working hard to get my weight down. I ve had to deal w/lots is stress at work and the death of several family members in the past 7 years. A sibling had a carcinoid tumor that caused her great pain successfully removed several years ago and is doing well. Grandfather died of liver cancer, aunt died of multiple myeloma. Do you think I need to have a biopsy first or do a colonoscopy (just got notice I m due for it- 10 years since I was checked out due to anemia/very heavy menstrual periods at that time.) I ve been on synthroid and Benezepril for years.
Asked On : Wed, 19 Sep 2012
Answers:  2 Views:  339
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Radiologist 's  Response
I would like further details about the size of the nodes and the exact site. Is there any change in size and number of nodes between the 2 CT scans? These 2 issues are imperative in coming do a conclusion about further management.

If the SHORT AXIS dimension of the nodes is generally around or less than 1 cm, with mild or no decrease in size on the follow up scan, I wouldn't worry much. I would ask for another CT scan after 3 months and compare the findings. The description is fairly consistent with mesenteric panniculitis. Are you being treated for the same?

If there is increase in the SHORT AXIS dimension of nodes, by more than 5 mm, or if there are obvious new large nodes ( SHORT AXIS more than 1cm), on the 2 nd scan, I would probably ask for biopsy.

Answered: Wed, 17 Apr 2013
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Internal Medicine Specialist Dr. Prasad Akole's  Response
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- and am glad to address to your query here.

Yes, it is not classical of lymphoma, but variants may occur.
Your combination of Fatty liver (steatosis), mesenteric panniculitis (fat inflammation in the intestinal binder mesentry- misty mesentry), lymphadenopathy (enlarged, shotty lymph nodes), high glucose (? Diabetes), hypothyroidism, weight gain (obesity) and anemia, borderline low platelets and skin problems together point to other possibilities like:
1)     Lipodystrophy- fat metabolism disorders- check your fat (lipid) profile, liver enzymes
2)     Auto-immune disorders- self attacking systemic disorder like Lupus
3)     Other uncommon systemic inflammatory disorders
I would advise you a detailed evaluation including above tests, colonoscopy, biopsies of nodes
And multi speciality consultations (gastro enterology, physician, surgeon, hemato-oncology, if needed rheumatology)

As you have a strong family history of cancers, careful evaluation is must.

Hope this does not scare you, but guides you through.
It may not be that dangerous a disease.

You can get back to me directly at
Wish you best of health !

I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Good Luck!
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Answered: Tue, 16 Apr 2013
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