[HMS: Medical Human Story–Episode 72]-Prologue: In Front of the CT Monitor, on a Late Autumn Afternoon
[HMS: Medical Human Story–Episode 72]
Prologue: In Front of the CT Monitor, on
a Late Autumn Afternoon
I have always loved that quiet hour in the evening when the lights throughout the hospital begin to fade, one by one.
The incessant ringing of call bells that echoed through the day, the urgent messages from the operating rooms, and the relentless requests for emergency image interpretations all seem to vanish as if by magic.
Gradually, the entire hospital settles into a
profound stillness.
Inside the radiology reading room, only the cold blue glow emanating from the monitors and the low, continuous hum of the computer cooling fans remain.
It is within that silence that I often find myself listening to the most honest
stories the human body has to tell.
To many people, a CT scan may appear to be nothing more than a collection of grayscale images—a series of monochrome data.
To me, however, every CT examination is the unfolding story of an individual's life.
Hidden within those meticulously stacked cross-sectional images are the memories of a passionate youth, treasured moments shared with family, and sometimes even the traces of a love story that was never allowed to reach its final chapter.
As I adjust the
window and level on the monitor, I try to look beyond the pixels, hoping to
encounter the person behind the images in their entirety.
That evening seemed no different from countless others.
6:42 p.m.
An emergency request for an abdominal CT interpretation arrived from the
emergency department.
"Sixty-eight-year-old male."
The clinical information on the requisition form occupied only a few brief
lines:
"Persistent abdominal pain. Recent unintentional weight loss of 5
kilograms. Intermittent constipation. Mild anemia on laboratory
evaluation."
From a medical standpoint, these findings were remarkably common—which was
precisely what made them dangerous.
Abdominal pain is among the most frequent reasons patients seek medical attention. Most cases ultimately prove to be gastritis, enteritis, or irritable bowel syndrome brought on by stress.
Yet, on rare and cruel occasions,
abdominal pain becomes the first quiet whisper of a malignancy approaching
unnoticed.
With a growing sense of unease, I moved the mouse and opened the patient's
CT study.
The instant the first axial image appeared on the screen, my hand froze in
midair.
Too Large... Yet Too Quiet
The lesion in the descending colon was unmistakably abnormal.
There was a segment of circumferential, localized bowel wall thickening
extending over a relatively long length of colon. The enhancement pattern was
homogeneous throughout.
Yet something felt profoundly wrong.
I found myself staring at the monitor before quietly murmuring,
"Why... why isn't it obstructed?"
Ordinarily, a colonic carcinoma of this size would already have occluded
the lumen, producing bowel obstruction severe enough to bring the patient to the
emergency department in acute distress.
But this bowel looked astonishingly calm.
Despite the extensive involvement, the lumen remained widely patent, as
though it continued to breathe naturally. Rather than appearing constricted,
the affected colon almost seemed relaxed.
That peculiar tranquility opened an old drawer in the back of my memory.
"When the lesion is large but the bowel isn't obstructed, always
suspect lymphoma."
The words of my residency mentor—a professor renowned for his exacting
standards—returned with remarkable clarity, as if he had spoken them only
yesterday in the reading room.
I immediately magnified the images.
The bowel wall demonstrated smooth, uniform thickening. There was little
infiltration into the surrounding pericolic fat. No necrosis. No calcification.
Apart from mildly enlarged regional lymph nodes, the lesion appeared
almost... too clean to be an ordinary carcinoma.
At that moment, I felt a quiet heaviness settle into my chest.
"This could be colonic MALT lymphoma."
The Unfamiliar Name: Colonic MALT Lymphoma
Most people have heard of colorectal cancer.
Far fewer have ever heard of primary colorectal lymphoma.
And colonic MALT lymphoma is rarer still—a disease so uncommon that
even experienced physicians may encounter only a handful of cases, if any, over
an entire career.
It accounts for only 0.2% to 1.2% of all malignant colorectal tumors,
a condition spoken of almost like a medical legend.
But rarity does not mean nonexistence.
In fact, it is often because a disease is so rare that we fail to
recognize it when it finally appears before us.
[Medical Insight]
[Figure]
With a heavy heart, I placed my hands on the keyboard to begin dictating
the radiology report.
Yet, for reasons I could not explain, the words refused to come.
Beyond the numbers, beyond the pixels, I found myself wondering about the
man behind the images.
Jun-ho Park.
Sixty-eight years old.
A retired high school Korean literature teacher who had devoted his life
to introducing generations of students to the beauty of language and
literature.
He had a son and a daughter.
Then a small note tucked away in the electronic medical record caught my attention:
"His wife became concerned about his recent weight loss and
encouraged him to seek medical evaluation."
I stared at that sentence for a long time.
Not every great medical discovery begins in a research laboratory.
More often than not, illness is recognized first—not by the patient—but by
the loved one standing quietly beside them.
A spouse's subtle concern.
A lingering sense that something is not quite right.
A simple act of love.
Sometimes, those seemingly insignificant observations become the very key
that saves a life.
The following morning, I met him in the outpatient clinic.
He sat quietly beside the window, wearing a gentle smile.
His wife sat next to him.
Her eyes, however, already carried the silent knowledge that an unexpected
and difficult journey had begun.
As I watched the couple walk away after the consultation, I found myself
overcome by a quiet certainty.
This would not become merely another case report describing a rare
malignancy.
It would become the story of a love patiently built over forty-four
years—a testament to two lives intertwined through devotion, resilience, and
unwavering companionship.
[Medical Recommendation]
|
The above content is a web novel adapted from the article
published on https://leesangbock.blogspot.com/2026/06/colonic-malt-lymphoma-ct-imaging-ai-healthcare.html. |
Next Chapter ☞Part I: When Did the Abdominal Pain Begin?
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