With a recurrence in my right lung, I'm following plan A which is to try to get into a clinical trial in the immediate future. If I can't do that fairly quickly, plan B is to ask for IPI reinduction.
Bronchoscopy 2/6: An approximately 2 cm 4R lymph node identified. 4 separate passes of the transbronchial needle into this lymph node were made under direct ultrasound visualization. The cytopathologist was present in the room to confirm adequate sampling. The instrument was then slowly withdrawn and removed. Transbronchial Node aspirates x 4 were submitted to Cytology.
Path report 2/6: Aspirate material is abundantly cellular and composed of malignant cells arranged in poorly-cohesive aggregates and as single cells. The cells are characterized by scant-to-moderate dense cytoplasm, pleomorphic, irregular nuclei and prominent nucleoli. Intranuclear inclusions are present. Mitotic figures are readily identified. The cytologic findings are those of metastatic melanoma.
CT Scan 1/14: New 1.8 cm right paratracheal centrally necrotic lymph node suspicious for metastatic disease. No evidence of metastatic disease in the abdomen/pelvis.
MRI 1/14: Compared to 9/9/2013, no appreciable change in appearance of previously seen parenchymal metastatic lesions. No new enhancing lesions to suggest new metastatic disease.
Bronchoscopy 2/6: An approximately 2 cm 4R lymph node identified. 4 separate passes of the transbronchial needle into this lymph node were made under direct ultrasound visualization. The cytopathologist was present in the room to confirm adequate sampling. The instrument was then slowly withdrawn and removed. Transbronchial Node aspirates x 4 were submitted to Cytology.
Path report 2/6: Aspirate material is abundantly cellular and composed of malignant cells arranged in poorly-cohesive aggregates and as single cells. The cells are characterized by scant-to-moderate dense cytoplasm, pleomorphic, irregular nuclei and prominent nucleoli. Intranuclear inclusions are present. Mitotic figures are readily identified. The cytologic findings are those of metastatic melanoma.
CT Scan 1/14: New 1.8 cm right paratracheal centrally necrotic lymph node suspicious for metastatic disease. No evidence of metastatic disease in the abdomen/pelvis.
MRI 1/14: Compared to 9/9/2013, no appreciable change in appearance of previously seen parenchymal metastatic lesions. No new enhancing lesions to suggest new metastatic disease.
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