My 12 yr old son had ALL and relapsed. Just this past April he had two masses (one on the 5th rib) the other in the right lung. He successfully had radiation to shrink the tumors. We are waiting to go to CHOP for TCell therapy trial. This past week during a CT scan to prepare for the trial, they found more masses in his lung. I was hoping you could tell me in plain words what the following means. They said he might have to go into palliative care if he doesn t respond to a trial drug called Inatuzomab to get the cancer under control for CHOP. What is your opinion????? Mediastinum: 2 enlarged lymphnodes are seen in the subcarinal region with largest measuring 1.1 x 1.1 cm. These lymph nodes appear new as compared to previous scan. A new right of soft tissue is seen on the posterior lateral aspect of the junction between IVC and right atrium measuring approx. 1.4 x 2.8 cm. No other obvious masses or lymph nodes seen in the mediastinum Pleural cavity: Several new pleural-based nodular masses are seen in the right hemothorax. The 1 on the medial aspect of the right apex measures approx. 2.8 x 1.8 cm while another flat nodular lesion on the lateral aspect measures approx. 1.2 x 5.4 cm. Large soft tissue lesion is seen in the right lung base extending posterior to the right hemidiaphragm almost up to the level of midpole of right kidney. The soft tissue lesion has significantly increased as compared to previous scan and measures approx. 2.7 x 8.1 cm (previously 1.5 x 5.8 cm respectively). Several smaller nodules are seen throughout the right pleural surface. There also multiple areas of nodular thickening in the major and minor fissure on the right side. There is trace of pleural effusion in the right lung base. The pleural surfaces in the left hemothrax are clear without any masses.