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What Does My Ultrasound Scan Report Indicate?

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Posted on Fri, 5 Jun 2015
Question: Name;-XXXX                    Age:- 43 Sex:-Female
Pregnancy test was negative test then further these tests were got conducted on the advice of the Doctors as the Periods were delayed for five days.

Adnexae:-A 25x24mm anechoic cyst seen in it/echo free area with septa in lumen is seen in Rt.ovary.
     A 70x48 mm echo free area with septa in lumen is seen in Lt.ovary.
Impression:-Findings are suggestive of :-1.SOLin uterus ?Fibroid uterus
2.B/L Ovarian Cyst
Onn Doppler:evidentperilesional low velocity low amplitude vascular flow with broadening of systolic peak &RI.58 noteed with s/0 no evident torsion.
UNILOCULAR SEPTATE LT OVARIAN CYST AS DESCRIBED (likely benign imaging features
Pap Smear Report:-
Microscopic Exam:-Smear show sheet of basal cells, parabasalcells,intermediatecells,metaplasticcells,candidialpseudohyphae,neutrophils and lymphocytes.No evidence of dysplasia/malignancy is seen.
BETHESDA CATEGORY-Given smear show Cytomorphological features-Negative for intra epithelial lesion or Malignancy..
Chronic cervicitis
Test Description
Tumer Marker                Observed Value          Biological Reference Interval
CA 125, serum by CMIA 39.90                    Adults<35 u/ml
                                   *Premenopausal (woman)<200U/ml
                                        *Postmenopausal (Women)<35
                              CMIA:-ChemilumnescenceMicroparticleImmunossary.
So please give your precious Opinion/Advice Regarding it , what should be done and why?

doctor
Answered by Dr. Vivek Chail (58 minutes later)
Brief Answer:
Do a CT scan abdomen and pelvis (with contrast) and proceed

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. The findings of the ultrasound scan shows

(i) A follicular cyst in right ovary measuring 25 x 24 mm. This is not a significant finding

(ii) A septated cyst in left ovary measuring 70 x 48 mm. This is a large cyst and requires detailed evaluation, probably this is the reason why CA 125 was done for you. On imaging it appears like a benign cyst.

(iii) There is a fibroid in the uterus which is a benign finding.

2. Pap smear shows features of chronic cervicitis.

3. CA 125 is 39.90 U/mL which is borderline high

CA 125 is increased in benign and cancerous conditions. In benign conditions it can be increased in the following
Endometriosis
Liver disease
Menstruation
Pelvic inflammatory disease
Pregnancy
Uterine fibroids

In cancer ovary, it is highly raised but this is not always a reliable marker.

4. Since your CA 125 is not very high then it can still be a benign cyst.

5. The fibroid measurement is not given but I assume it is less than 3 cm in size.

In conclusion, under recommendation of gynecologist please get a CT scan abdomen and pelvis done to know the exact size and nature of the left ovarian cyst and more details which are not visible on ultrasound scan. If CT scan shows possible malignant features then surgery is to be discussed with your gynecologist.

If CT scan shows features of a benign lesion then under recommendation of your gynecologist, you might choose to take medical treatment for chronic cervicitis, cyst in left ovary and fibroid uterus and get ultrasound scan repeated after 3 to 6 months. In 3 to 6 months time with treatment, if there is progressive increase in size of cyst and fibroid with increase in symptoms then surgery is required.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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What Does My Ultrasound Scan Report Indicate?

Brief Answer: Do a CT scan abdomen and pelvis (with contrast) and proceed Detailed Answer: Hi XXXX, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. The findings of the ultrasound scan shows (i) A follicular cyst in right ovary measuring 25 x 24 mm. This is not a significant finding (ii) A septated cyst in left ovary measuring 70 x 48 mm. This is a large cyst and requires detailed evaluation, probably this is the reason why CA 125 was done for you. On imaging it appears like a benign cyst. (iii) There is a fibroid in the uterus which is a benign finding. 2. Pap smear shows features of chronic cervicitis. 3. CA 125 is 39.90 U/mL which is borderline high CA 125 is increased in benign and cancerous conditions. In benign conditions it can be increased in the following Endometriosis Liver disease Menstruation Pelvic inflammatory disease Pregnancy Uterine fibroids In cancer ovary, it is highly raised but this is not always a reliable marker. 4. Since your CA 125 is not very high then it can still be a benign cyst. 5. The fibroid measurement is not given but I assume it is less than 3 cm in size. In conclusion, under recommendation of gynecologist please get a CT scan abdomen and pelvis done to know the exact size and nature of the left ovarian cyst and more details which are not visible on ultrasound scan. If CT scan shows possible malignant features then surgery is to be discussed with your gynecologist. If CT scan shows features of a benign lesion then under recommendation of your gynecologist, you might choose to take medical treatment for chronic cervicitis, cyst in left ovary and fibroid uterus and get ultrasound scan repeated after 3 to 6 months. In 3 to 6 months time with treatment, if there is progressive increase in size of cyst and fibroid with increase in symptoms then surgery is required. Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek