Thickening/submucosal edema of the cecal wall, new from prior. Mild haziness of the adjacent pericolonic fat.
Moderate left hydroureteronephrosis appears similar to prior, with transition to normal caliber ureter at the left pelvic sidewall implant.
Similar several irregular retroperitoneal/periaortic lymph nodes. Left periaortic node may invade the left renal vein as it appears attenuated in this region. Slight enlargement of left psoas metastasis.
Diffuse stranding and enlargement of the right external iliac vein through the common femoral and visualized femoral and profunda femoral veins. Increased asymmetric edema of the right lower extremity. The vein appears to be obstructed at the level of the enlarged right pelvic sidewall lymph node.
IMPRESSION:
1. New cecal submucosal edema with mild pericolonic inflammation, consistent with typhlitis/neutropenic colitis.
2. Suspected acute deep vein thrombosis of the right external iliac vein and femoral veins, likely due to compression or invasion by right pelvic sidewall lymph node. Confirmation with ultrasound is suggested.
3. Similar metastatic adenopathy with the exception of enlargement of the left psoas intramuscular metastasis.
4. Similar moderate left hydronephrosis with ureteral obstruction at the level of the left pelvic sidewall lymph node. Similar suspected left renal venous invasion secondary to metastatic periaortic adenopathy.