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MIMIC-CXR-JPG/2.0.0/files/p16201645/s59582448/95fb97df-5f16df5c-16074043-e14bf548-dc08f0b6.jpg
patient is status post right pneumonectomy. since yesterday, the right chest tube has been removed. there is more opacity of the right lower lung with decreased air. persisting mediastinal shift to the right side and extent of the subcutaneous air along the right lateral chest wall and the supraclavicular region is similar. left lung is clear. there are no lung opacities of concern. there is no pleural effusion on the left side.
to evaluate for interval changes, patient status post et tube removal.
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a port-a-cath terminates in the mid to lower superior vena cava. the cardiac, mediastinal and hilar contours appear changed. streaky opacities at the lung bases are more coalescent, corresponding to decreased lung volumes, suggesting waxing and waning atelectasis rather than pneumonia. the pulmonary vasculature appears within normal limits. there is no pleural effusion or pneumothorax.
lupus and serositis with pleuritic chest pain.
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the lungs are hyperinflated, likely reflecting chronic pulmonary disease. the lungs are clear without focal consolidation, pleural effusion or pneumothorax. there is no overt pulmonary edema. the heart is normal in size. a well-circumscribed round opacity along the right heart border may reflect a bochdalek's hernia. calcifications are noted along the aortic arch, and no displaced rib fractures are seen. s-shaped scoliosis of the thoracolumbar spine is noted.
<unk>-year-old female with presumed fall down <unk> foot wall. evaluate for intrathoracic injury.
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the lungs are hyperinflated. biapical scarring is unchanged from prior. there are no focal opacities concerning for aspiration or pneumonia. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.
<unk>-year-old male with dysphagia. evaluate for evidence of aspiration or pneumonia. .
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the tip of the endotracheal tube projects in <num> cm from the carina. the tip of the left internal jugular central venous line projects over the mid svc. <num> left chest tubes are present as is a new right sided chest tube. no large pneumothorax identified. extensive opacities again project over the right mid to lower hemithorax as well as at the left lung base and are grossly unchanged. a right pleural effusion is present. the size of the cardiomediastinal silhouette is enlarged but unchanged. extensive subcutaneous emphysema.
<unk>m w/ l bronchopleural fistula ptx s/p placement of <num> more l side chest tube and <num> r side chest tube. // eval for interval change
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portable chest radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours. there is improved aeration of the lung bases particularly on the right. no reaccumulation of pleural effusions or development of pneumothorax. dobbhoff tube is seen with tip in the mid stomach. left-sided picc line tip terminates in the distal svc.
bilateral chest tubes now on waterseal. please evaluate for interval change.
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enteric tube terminates within the proximal stomach and could be advanced <num> - <num> cm for appropriate positioning. heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen.
<unk> year old woman with new ngt // ngt placement
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact.
<unk>f with palpitations x <unk> min. evaluate for pneumonia or other intrathoracic pathology.
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the patient is intubated. the endotracheal tube terminates near the thoracic inlet, approximately <num> cm above the carina. the balloon is not well seen. the lung volumes are low. allowing for technique, the cardiac, mediastinal, and hilar contours are probably within normal range. the lungs appear clear. the extreme left costophrenic sulcus is partly excluded, but there is no evidence for pleural effusion. there is no pneumothorax.
seizure and status post intubation.
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ap upright and lateral views of the chest provided. lungs appear hyperinflated with upper lobe lucency likely relating to emphysema. there is airspace consolidation in the right lower lobe compatible with pneumonia. no large effusion or pneumothorax. cardiomediastinal silhouette is unchanged. bony structures appear intact.
<unk>m with non-productive cough, fever
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there is bulky asymmetry of the right hilum. there is also an asymmetry abutting the lower right peritracheal stripe. mild enlargement of the cardiac silhouette. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
<unk> year old woman with r/o sarcoidosis // follow up on history of sarcoidosis
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pulmonary hyperinflation. the heart size is normal. the hila are normal. no airspace consolidation. small granuloma seen in the lateral aspect of the right upper lobe. no pleural effusions. spondylotic changes of the thoracic spine.
<unk> year old man with atrial fibrillation and asthma; shortness of breath and fatigue // r/o pneumonia, chf
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the lung volumes are low, resulting in crowding of the bronchovascular structures. patchy opacity at the left lung base, best appreciated on the lateral view, is presumably atelectasis. there is no pleural effusion or pneumothorax. heart is mildly enlarged and unchanged. there is no evidence of pulmonary edema. the aorta is calcified and tortuous, which results in rightward bowing of the trachea. otherwise, the mediastinal and hilar structures are unremarkable. severe degenerative changes involve the glenohumeral joints bilaterally.
dizziness and hyperglycemia. rule out an acute process.
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lungs are fully expanded and clear without consolidations or effusions. heart size is normal. cardiomediastinal and hilar silhouettes are normal. pleural surfaces are normal. an et tube terminates <num> cm above the carina. the side port of an enteric tube projects over the expected location of the gastric body.
<unk> year old woman with post-op // please evaluate
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et tube terminates <num> cm above the carina. right ij terminates in the low svc. left ij terminates in the left brachiocephalic vein. dobhoff and ng are seen coursing below the diaphragm, however the tips are not seen. sternotomy wires appear intact and appropriately aligned. the previously visualized rounded opacity over the left first rib is no longer seen. unchanged bilateral pleural effusions, left greater than right, with compressive atelectasis. stable moderate postoperative enlargement of the cardiomediastinal silhouette. the pulmonary vasculature is normal. no pneumothorax is seen.
<unk> year old woman s/p type a dissection repair // f/u asssess for lul nodule
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the lungs are clear. there is no effusion or pneumothorax. the cardiomediastinal silhouette is normal. note is made of congenital lack of fusion of the posterior elements of t<num>.
<unk>m with fever, cough, eval for pna // eval for pna
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pa and lateral views of the chest provided. right chest wall port-a-cath is seen with catheter tip in the region of the low svc. there is elevation of the right hemidiaphragm. innumerable pulmonary metastatic lesions are re- demonstrated. interval resolution of right pleural effusion. no definite signs of edema though evaluation limited given extensive background metastatic disease. cardiomediastinal silhouette appears grossly unchanged.
<unk>m with <unk> swelling, baseline sob // please eval for pulmonary edema
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no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected on this single frontal view. lung volumes are low. heart and mediastinal contours are within normal limits. there is a right cervical rib.
<unk>-year-old female with fever.
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tracheostomy ends <num> cm from the carina in appropriate position. the right picc ends in the mid svc. a left subclavian central venous line ends in the low svc. the cardiomediastinal and hilar contours are normal. no focal consolidation, pleural effusion or pneumothorax. no mediastinal widening.
pic line.
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the lungs are clear of airspace or interstitial opacity. the cardiac silhouette is top-normal. no pleural effusions or pneumothorax. no acute or aggressive osseus changes.
<unk> year old woman with new doe on an mtor inhibitor // evidence of pulmonary edema
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right extrapleural mass and left extrapleural mass both associated with rib destruction appears similar compared to chest radiograph <unk>. cardiac size is enlarged but unchanged compared to previous. bilateral low lung volumes. there is no pneumothorax or pleural effusion. partially visualized cervicothoracic fusion hardware in unchanged alignment and appears intact. right port-a-cath with tip in the upper right atrium. osseous lesions better seen on recent ct.
<unk> year old woman with myeloma. increased dyspnea. please eval on <unk> <num> bmt treatment room <num> // <unk> year old woman with myeloma. increased dyspnea. please eval. on <unk> <num> bmt treatment room <num>
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pa and lateral images of the chest demonstrate well expanded lungs. a small patchy density is seen in the lingula, consistent in appearance with atelectasis or scarring. the lungs otherwise are clear. the there is slight prominence of the central pulmonary vasculature, consistent with pulmonary venous hypertension. cardiomediastinal silhouette is unremarkable. there is no pneumothorax or pleural effusion. visualized osseous structures are unremarkable.
<unk>-year-old female with persistent cough and hemoptysis, concerning for pneumonia.
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ap and lateral views of the chest are compared to previous exam from <unk>. again seen are left greater than right pleural effusions. indistinct pulmonary vasculature markings, particularly on the left are seen. there is no large confluent consolidation. cardiac silhouette is enlarged but stable in configuration. single-lead pacing device is seen with the lead tip in the right ventricle apex. hypertrophic changes seen in the spine. osseous and soft tissue structures are otherwise notable for left shoulder arthroplasty.
<unk>-year-old female with wheezing and dyspnea.
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the heart is normal in size. the mediastinal and hilar contours are within normal limits. there is no pleural effusion or pneumothorax. streaky left basilar opacity suggests minor atelectasis.
epigastric pain.
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frontal radiographs of the chest demonstrate a stable top normal heart size. the mediastinal silhouette and hilar contours are normal. the lungs are clear. no pleural effusion or pneumothorax. no displaced rib fracture identified.
chest pain, frequent falls without pneumothorax
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mild vascular congestion appears improved since <unk>. the lungs are clear without focal opacity, interstitial pulmonary edema, pleural effusion or pneumothorax. mild to moderate cardiomegaly is stable. aortic knob calcifications are again noted.
<unk> year old woman with diffuse wheezing, right chest discomfort, hx chf // r/o chf, pna, other
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right upper lobe collapse upper lung zone around a central tumor is longstanding; less severe left upper lobe atelectasis has been variable. the lung volumes are low. persistent, moderate bilateral pleural effusions, left greater than right, are somewhat larger. small multifocal lung metastases are better characterized on the recent ct. the cardiomediastinal silhouette is difficult to evaluate given the low lung volumes and effusion.
dyspnea with a history of malignant pleural effusions.
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a single-lead pacemaker device terminates in the right ventricle. there is mild unfolding of the thoracic aorta. the heart is moderately enlarged. indistinct enlargement of each hilum is most consistent with mild vascular congestion but similar to the prior study. there is no pleural effusion or pneumothorax. the chest appears somewhat hyperinflated. bony structures are unremarkable.
dyspnea. history of congestive heart failure and copd.
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there is mild enlargement of cardiac silhouette which is unchanged. the mediastinal and hilar contours are stable. the pulmonary vasculature is normal. apart from a linear opacity in the right lung base which is compatible with subsegmental atelectasis, the lungs are clear. no pleural effusion, focal consolidation or pneumothorax is visualized. no acute osseous abnormality is visualized.
confusion.
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the cardiomediastinal and hilar contours are within normal limits. lungs are well expanded and clear. there is no focal consolidation, pleural effusion or pneumothorax.
<unk> year old man with cough, fever and scattered rhonchi // r/o pneumonia .
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ap portable upright view of the chest. suture material is again noted projecting over the right mid to lower lung in this patient with history of prior wedge resection of the right middle lobe. hazy opacity at the right lung base may represent a small pleural effusion and possible pneumonia. left lung is clear. cardiomediastinal silhouette is stable. no large pneumothorax. bony structures are intact.
<unk>f with bradycardia // eval for infiltrate
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pa and lateral views of the chest. previously identified right middle lobe opacity is no longer visualized. the lungs are now clear without consolidation or effusion. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities identified.
<unk>-year-old female with midsternal chest pain.
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persistent complete opacification of the left hemithorax. the right lung is clear. no right pleural effusion or pneumothorax identified. right internal jugular hemodialysis catheter is present, the tip extending to the superior cavoatrial junction.
<unk> year old man with small cell lung ca now febrile w/ cough // r/o pna
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the patient is status post coronary artery bypass graft surgery. the heart is at the upper limits of normal size. the aortic arch is partly calcified. the pulmonary vasculature is minimally prominent suggesting pulmonary venous hypertension or slight congestion without frank congestive heart failure. there is also a patchy right infrahilar opacity, suspected to represent minor streaky atelectasis. a linear opacity seen posteriorly on the lateral view probably is due to stable scarring in the left lower lobe. there are no pleural effusions or pneumothorax. thin anterior flowing syndesmophytes are present along the lateral and anterior aspects of the visualized thoracic spine, which could be seen with idiopathic skeletal hyperostosis.
increasing shortness of breath. history of congestive heart failure.
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a small right apical pneumothorax persists. cardiomediastinal and hilar contours are stable and within normal limits. lungs are otherwise clear. no new focal consolidations identified.
<unk>-year-old man with right first rib fracture, small apical pneumothorax. evaluate pneumothorax progression.
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semi-erect portable chest radiograph demonstrates stable mild cardiomegaly and bilateral hilar prominence. new significantly increased bibasilar consolidations are evident, left greater than right, which may represent bilateral pleural effusions with an element of lobar collapse on the left, although there is not the expected secondary findings of signficant volume loss. no pneumothorax evident. sternotomy sutures are midline and intact. stable splenic artery calcifications identified.
patient with congestive heart failure, severe cad, status post mi, now presents with hemoptysis. please evaluate for pneumonia or pleural effusion.
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ap portable upright view of the chest. lung volumes are somewhat low. overlying ekg leads are present. allowing for these limitations, the lungs are clear without focal consolidation, large effusion or pneumothorax. the cardiomediastinal silhouette appears normal. bony structures are intact. no free air below the right hemidiaphragm.
<unk>m with chest pain
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heart size is top normal in size. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
<unk> year old woman with esrd on pd with hx of htn. // pre-kidney transplant evaluation and clearence, r/o cardiopulmonary abnormalities.
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as compared to <unk>, mild pulmonary edema has worsened. lung volumes remain low with increasing bibasal opacities. no pneumothorax or significant effusions. moderate cardiomegaly with increasing vascular engorgement.
<unk> year old man with hypotension // eval for pna, edema, effusion
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ap single view of the chest has been obtained with patient in semi-upright position. comparison is made with a similar preceding study obtained three hours earlier during the same day. during the latest interval, a right-sided pigtail-end drainage catheter has been introduced through the lower lateral chest wall remaining with its pigtail tip end in the lateral lower portion of the right pleural sinus. the drainage was very effective as the pleural effusion on the right base has been practically eliminated totally making the contour of the right diaphragm well visible. there is no evidence of pneumothorax in the apical area of the right hemithorax. previously described tracheal cannula remains in unchanged appropriate position. the pulmonary vascular pattern has not been altered. the left-sided basal pleural density which appeared similar with the previous appearance of the right side remains unchanged.
<unk>-year-old female patient, postoperative day #<unk>. ascending aortic repair, now status post right pigtail catheter placement.
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as compared to prior chest radiographs from <unk>, there is persistent elevation of the right hemidiaphragm. increased focal opacity at the right lung base likely reflects atelectasis as it has not significantly changed since prior examination from <unk>. no focal abnormality to suggest pneumonia is identified. there is no large pleural effusion or pneumothorax. the cardiomediastinal and hilar contours are normal.
history of dyspnea, wheezing, history of asthma but no exacerbation in the past <unk> years. question pneumonia.
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normal cardiomediastinal and hilar contours. normal pleural surfaces. clear lungs.
<unk>-year-old man with chest pressure and shortness of breath.
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there has been interval placement of a dobbhoff tube which projects over the trachea and appears to enter the left mainstem bronchus in course inferiorly, presumably penetrating the diaphragm and with distal tip projecting over the mid left abdomen. there is a large left pneumothorax with rightward shift of mediastinal structures. there is stable position of right-sided port with distal tip projecting over cavoatrial junction. allowing for changes due to mediastinal shift, the cardiomediastinal silhouette is unchanged. the bilateral hila are not well visualized. the left lung is collapsed against the left mediastinum secondary to large pneumothorax. the right lung is clear without evidence of focal consolidation. there is no right pneumothorax. there are no pleural effusions.
<unk> year old man with dobhoff placement // dobhoff placement
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the lungs are well-expanded and clear. the cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax, pleural effusion, or consolidation.
history: <unk>m with chest pain, hx of hiv // eval for infiltrate
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as compared to prior chest examination, lung volumes are decreased, accentuating the bronchovascular structures and cardiac silhouette. there is bibasilar atelectasis. there is no definite focal consolidation concerning for pneumonia. there is no pleural effusion or pneumothorax.
history: <unk>m with fever // evidence of infection evidence of infection
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the patient is rotated to the low. endotracheal tube and right ij central venous catheter grossly unchanged in position. newly placed enteric tube ends in the stomach. density projecting over the mid thoracic spine may represent a esophageal manometry. no significant interval change to diffuse alveolar lung opacity.
<unk> year old man with post esophageal balloon placement
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thick wall cavity in the right upper lobe measuring <num> x <num> cm, and <num> cm in wall thickness. the cavity is essentially replacing the right upper lobe with associated partial collapse of the right upper lobe and asymmetry of the right hila. possible nodular opacities in the right lower lobe. the left lung is essentially clear. the cardiac silhouette is not enlarged. no pleural effusions or pneumothorax.
<unk> year old man with h/o rul cavity // size of cavity
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endotracheal tube is in standard position, terminating <num> cm from the carina. orogastric tube tip courses through the stomach, with tip projecting off the inferior borders of the film. left basilar chest tube remains in unchanged position. the heart size remains moderately enlarged. mediastinal contours are relatively unchanged, with mild calcification of the thoracic aorta noted. there is mild pulmonary vascular congestion, with cephalization of the pulmonary vascular markings, new compared to the prior exam. partially loculated right pleural effusion which is moderate in extent appears relatively unchanged, and a small left pleural effusion persists. bibasilar airspace opacities likely reflect atelectasis. there is no pneumothorax. no acute osseous abnormalities are detected.
altered mental status. intubated.
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the heart is normal in size. the mediastinal and hilar contours appear within normal limits. there is no pleural effusion or pneumothorax. the lungs appear clear.
pleuritic chest and abdominal pain.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with sob x<num> days // sob
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left chest wall pacer has leads in the right atrium and right ventricle. et tube is approximately <num> cm from the carina. left internal jugular central venous catheter terminates in the mid svc. enteric tube courses into the stomach and beyond the field of view. there is continued improvement in right upper lobe opacity. small bilateral pleural effusions are likely unchanged. there is no large pleural effusion or pneumothorax. severe cardiomegaly is unchanged.
<unk> year old man s/p cardiac arrest, now with worsening tachypnea and persist o<num> requirement // please assess for interval change
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lung volumes are within normal limits. the cardiomediastinal contour is normal. the heart is not enlarged. no pleural effusion, consolidation or pneumothorax seen. the visualized bony structures are unremarkable in appearance.
<unk> year old man with hiv and fever // does this patient have pneumonia
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lung volumes remain low. cardiac silhouette size is mildly enlarged with a left ventricular predominance. the aorta is tortuous and diffusely calcified. pulmonary vasculature is not engorged. mediastinal and hilar contours are similar. patchy opacities are noted in the lung bases most likely reflective of atelectasis. no large pleural effusion or pneumothorax is detected however the right costophrenic angle is excluded from the field of view. no acute osseous abnormalities detected. a remote left mid clavicular fracture is re- demonstrated.
history: <unk>m with stemi // eval aorta contour
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heart size is moderately enlarged but similar compared to the prior exam. the mediastinal and hilar contours are unremarkable. there is minimal pulmonary vascular congestion, but this is improved compared to the previous exam. small bilateral pleural effusions are re- demonstrated no focal consolidation or pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>m with shortness of breath
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the cardiac, mediastinal and hilar contours are unchanged, with the heart size is top normal. the aorta remains tortuous and minimally calcified. previously noted mild pulmonary edema has resolved with the pulmonary vascularity now appearing not engorged. trace left pleural effusion is noted. previously seen right pleural effusion appears resolved. there is no pneumothorax or focal consolidation. multilevel degenerative changes in the thoracic spine are again noted. deformity of the right shoulder and upper ribs is unchanged. a cardiac monitoring device is re- demonstrated in the left anterior chest wall.
chest pain.
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the right lung base is poorly assessed due to obscuration by atelectasis and effusion. small bilateral pleural effusions are as on the prior study. the heart is top normal in size with normal cardiomediastinal silhouette. apparent enlargment of the left hilus as on the prior study is likely due to a grouping of left pulmonary veins.
lymphoma, abdominal distension and aortic stenosis. assess for chf.
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the lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormality. laparoscopic band is partially visualized. there is no free intraperitoneal air.
<unk>f with epigastric pain // eval cardiopulmonary process
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frontal and lateral radiographs of the chest demonstrate increased peribronchial markings, which could be consistent with a viral respiratory infection. the cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax, pleural effusion, or consolidation.
history: <unk>m with fever, cough // evaluate for acute process
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the diffuse interstitial and airspace opacities are grossly unchanged. this could be due to multifocal pneumonia. the peripheral distribution of the opacities also raise concern for eosinophilic pneumonia. no obvious new consolidation. the hiatal hernia is again seen and unchanged. no pneumothorax or pleural effusion. healed right clavicle fracture is unchanged.
<unk> year old woman with pneumonia and possibly also chf. worsening hypoxia despite <num>hrs antibiotics and diuresis // evaluate for pattern of pulmonary infiltrates, progressive pneumonia?
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the cardiomediastinal silhouette and pulmonary vasculature are normal. the lungs are clear. there is no pneumothorax or pleural effusion.
<unk>f with pmhx of dka p/w abd pain, n/v. // infection?
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the cardiac, mediastinal and hilar contours appear stable. there is severe emphysema with unchanged areas of scarring in the right lower lobe. the chest is hyperinflated. the upper part of an aortic stent graft is partly visualized. there is no evidence of superimposed acute process. there has been no significant change.
fever.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
<unk> year old woman with cough, myalgias, chest pain // ? pneumonia
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the study of <time> shows no appreciable change in the small to moderate right apical pneumothorax. however, right basilar subsegmental atelectasis and surrounding airspace opacification has increased. the heart and mediastinum are magnified by the projection. a right pectoral infuse-a-port is unchanged in position. mild blunting of the left costophrenic angle may be due to a new small pleural effusion. the followup exam from <unk> hr shows worsening right middle and right lower lobe airspace opacification superimposed on subsegmental atelectasis. superimposed infection or aspiration cannot be excluded. the small to moderate right apical pneumothorax is unchanged. there is stable left retrocardiac linear atelectasis.
<unk> year old woman with pneumothorax. please evaluate for any interval change in pneumothorax.
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pleural catheter projects over the left lung base. there is diffuse opacification of the left lung, a combination of tumor and consolidation. the hydro pneumothorax is minimal, at the left apex. nodules in the right lung mild partially demonstrated, better evaluated on the recent chest ct. no right pleural effusion.
<unk> year old man with history of melanoma with new effusion. followup hydro pneumothorax.
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ap portable upright view of the chest. diffusely increased pulmonary ground-glass opacities concerning for pulmonary edema. underpenetration limits assessment. no large effusion or pneumothorax. cardiomediastinal silhouette is stable. clips in the left axilla noted. no acute osseous abnormality.
<unk>f with sob, hf // eval for fluid overload
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there is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. bibasilar atelectasis is similar to the prior study of <unk>. the cardiomediastinal silhouette is stable. hyperexpansion is unchanged.
<unk>f with decreasing o<num> and gib evaluate for free air or pulmonary edema.
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there is peribronchial airspace opacity within the right middle lobe, which appears chronic. small bilateral pleural effusions are probably present. there is moderate cardiomegaly, and calcification of the aortic knob. chronic interstitial abnormality is again noted and may reflect chronic mild fluid overload.
<unk>-year-old female with fall, question infiltrate.
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lung volumes are low, with minimal bibasilar atelectasis. no consolidation, pleural effusion or pneumothorax. cardiomediastinal contours are within normal limits. no radiopaque foreign body is identified in the chest.
history: <unk>f with swallowed soda can top accidentally <num>am, <num>wks pregnant // eval for foreign body location
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when compared to prior, there has been no significant interval change. changes at the right hilum are compatible with scarring and bronchiectasis. peripheral opacities in the lungs, right greater than left with an apical predominance are also unchanged. there is no new consolidation or effusion. cardiomediastinal silhouette is unchanged. atherosclerotic calcifications are seen at the aortic arch. left picc tip projects over the upper svc. no acute osseous abnormalities.
<unk>f with weakness and fevers // r/o acute process, infx
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there are low lung volumes which cause vascular crowding. there is persistent mild elevation of the right hemidiaphragm. there is right basilar atelectasis without definite focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are stable. there is subtle leftward deviation of the trachea at the thoracic inlet which is nonspecific, but can be seen in the setting of an enlarged right lobe of the thyroid.
history: <unk>m with cough*** warning *** multiple patients with same last name! // acute process?
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cardiac silhouette size is normal. the aorta is mildly tortuous with atherosclerotic calcifications noted at the knob. the pulmonary vasculature is not engorged. hilar contours are similar. lungs are hyperinflated with mild emphysematous changes again noted predominantly in the upper lobes. patchy opacities are demonstrated in the lung bases without focal consolidation. no pneumothorax is present. blunting of the costophrenic angles posteriorly on the lateral view suggests trace bilateral pleural effusions. no acute osseous abnormalities are visualized.
history: <unk>m presenting with lower extremity edema and cough // please evaluate for fluid overload
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the lungs are clear. there is no pneumothorax. the heart and mediastinum are within normal limits. regional bones and soft tissues are unremarkable.
<unk> year old woman with brain mass // pre-op for stereotactic mri brain bx on <unk> surg: <unk> (brain bx)
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heart size is normal. mediastinal and hilar contours are unremarkable. pulmonary vasculature is not engorged. no focal consolidation, pleural effusion or pneumothorax is present. no acute osseous abnormalities detected. there are diffuse degenerative changes within the thoracic spine.
history: <unk>f with syncopal fall, abrasion on right side face. not on blood thinners.
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there is been interval placement of a pleural drainage catheter projecting over the right mid lung. there may be kinking of the mid catheter, difficult to assess on this single view. there is a large right pleural effusion with associated compressive atelectasis, not significantly changed compared to the prior study from <unk>. the left lung is clear. the cardiomediastinal silhouette is difficult to assess secondary to obscuration of the right heart border by the pleural effusion. there is no pneumothorax.
<unk> year old man with pleural effusion s/p chest tube placement // ? pneumothorax
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heart size is normal. cardiomediastinal silhouette and hilar contours are unremarkable. compared to prior examination, the patient has been extubated. previously noted mild pulmonary edema has cleared. lungs are clear. there is no pleural effusion or pneumothorax.
alcoholic cirrhosis status post variceal bleeds now with o<num> requirements.
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portable semi-erect chest radiograph <unk> at <time>
<unk> year old man with seizures // eval ngt eval ngt
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heart size remains mildly enlarged. the mediastinal and hilar contours are unchanged and within normal limits. bibasilar interstitial opacities have minimally improved compared to the previous exam but persist. small bilateral pleural effusions have also nearly resolved. no new focal consolidation is present and there is no pneumothorax. there are no acute osseous abnormalities.
end-stage renal disease, chest pain.
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two views were obtained of the chest. the lungs are low in volume but clear without pleural effusion or pneumothorax. the heart is normal in size with normal cardiomediastinal contours. mild scoliosis is seen in the imaged spine.
chest pain. assess for pneumothorax.
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no focal consolidation, pleural effusion, or pneumothorax. cardiomediastinal hilar contours are normal. no rib fracture identified.
history: <unk>m with right rib pain s/p fall // r/o right rib fx, ptx
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a single ap view of the chest was reviewed. hilar contours are stable with multiple granulomatous calcifications found in mediastinal nodes as well. once again there is a lll mass or mass like consolidation (better seen on prior cxr and conforming to ct findings on <unk>). chronic, moderate cardiomegaly is exaggerated by ap projection compared to pa views. a small right pleural effusion is slightly larger than on the most recent prior study, and minimal pulmonary edema has developed. moderate left pleural abnormality is stable. there is no pneumothorax. scarring at the right apex and chain suture material in the right apex and right mid lateral lung are again seen.
history of sarcoid, presenting with hypoxia.
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cardiomediastinal silhouette and hilar contours are unremarkable. lungs are clear. pleural surfaces are clear without effusion or pneumothorax.
chest pain.
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. note is made of dense breast tissue.
<unk>f with fever // acute process?
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the endotracheal tube ends <num> cm above the level of the carina. an enteric catheter courses below the level of the diaphragm and out of the field of view inferiorly. dense retrocardiac opacification could reflect atelectasis versus a consolidation, not significantly changed. there is minimal right lower lung atelectasis. the degree of cardiac enlargement is not significantly changed. mediastinal contours are normal. no definite pleural effusions are seen. there is no pneumothorax.
neurologic changes, intubated. assess for change.
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cardiac, mediastinal, and hilar contours are normal. lungs are clear. pulmonary vasculature normal. no pleural effusion or pneumothorax is present. no acute osseous abnormalities.
shortness of breath.
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the cardiomediastinal and hilar contours are stable. the left costophrenic angle is not captured on the image, however there is no large pleural effusion. there is no pneumothorax. imaged portions of lung fields are clear. dobbhoff tube is coiled in the stomach with distal tip in the stomach but pointed towards the pylorus. right ij catheter is present in unchanged position with tip in the mid svc.
dobbhoff placement.
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single portable chest radiograph excluding portion of the right hemithorax from view. interval placement of the enteric catheter which reaches the mid-to-lower esophagus and turns cephalad to course out of view. there has been interval removal of the endotracheal tube. there is increased prominence of the central pulmonary vasculature suggesting underlying element of fluid overload though no overt pulmonary edema evident. no focal opacification concerning for pneumonia. cardiomediastinal and hilar contours are unremarkable.
patient with large subarachnoid hemorrhage, status post angio and coiling. please assess for nasogastric tube placement.
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there are low lung volumes without definite focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are stable with the cardiac silhouette top-normal to mildly enlarged..
history: <unk>f with left sided neck/chest/arm pain // evaluate for acs
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hd catheter is in standard position cardiomediastinal contours are normal. the lungs are clear. there is no pneumothorax or pleural effusion. the osseous structures are unremarkable
<unk> year old man with esrd here for hd initiation // hx of positive ppd, x-ray needed for initiation of outpatient hemodialysis
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there has been interval progression of previously visualized retrocardiac opacity which silhouettes the left hemidiaphragm and may be suggestive of pneumonia in this region. furthermore, there is now a new opacity silhouetting the right heart border suggestive of right middle lobe pneumonia. otherwise, there is no evidence of pneumothorax. while evaluation of the cardiomediastinal silhouette is limited due to silhouetting by opacities, the visualized cardiomediastinal silhouette appears stable. there is no evidence of pneumothorax.
evaluation of patient with hypoxia.
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essential resolution of previously seen the left lower lobe opacity, which is not seen on the current study. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with sob // infiltrate?
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mild cardiomegaly. the mediastinal and hilar contours are unchanged. low lung volumes are present with crowding of bronchovascular structures, but no overt pulmonary edema. hazy opacities in the bilateral, left greater than right, lower lobes with the left lower lobe opacity having a peripheral triangular appearance on the lateral view. blunting of the left costophrenic angle, likely representing a small pleural effusion. no right pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities. no subdiaphragmatic free air.
history: <unk>m with left lower quadrant pain starting earlier today. evaluate for ischemic colitis or abdominal perforation.
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>f with one episode of hemoptysis, weight loss
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platelike atelectasis is seen at the left lung base. a adjacent area of lingular airspace opacity may relate to atelectasis however, consolidation due to pneumonia is not excluded in the appropriate clinical setting. the right lung is clear. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. no pulmonary edema is seen.
history: <unk>m with hx renal xplant now rfank hematuria x <num> days, sob // eval ? edema
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a dialysis catheter has been removed. the cardiac, mediastinal and hilar contours appear stable. a mild interstitial abnormality is consistent with mild pulmonary edema. there is no definite pleural effusion or pneumothorax. irregularity is probably unchanged along the left humeral head; this appearance could be due to degenerative change but possibly avascular necrosis. the right humeral head is unremarkable.
chest pain.
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cervical and lumbar spinal hardware is visualized. the et tube tip is <num> cm above the carina. lung volumes are low. there is minimal pulmonary vascular redistribution but no overt pulmonary edema. there is crowding at the left base which could be due to volume loss or an early infiltrate. volume loss is also present at the right base.
question aspiration pneumonia.
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sternotomy wires are intact and the mitral and tricuspid prosthetic valves are unchanged. the cardiomediastinal and hilar contours are stable. the lungs are clear. small bilateral pleural effusions with minimal associated atelectasis are present.
<unk>-year-old female with new onset dizziness and ekg changes at outside hospital.
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frontal and lateral chest radiographs demonstrate well expanded and clear lungs. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.
<unk>-year-old male status post can surgery now with low fevers and oxygen saturation. evaluate for pneumonia.
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the lungs are clear of focal consolidation, pleural effusion or pneumothorax. no pulmonary edema. cardiomediastinal contours are normal. incidentally noted eventration of the right hemidiaphragm. on the lateral view, a few embolization coils are seen within the abdomen. mild loss of vertebral body height involving several thoracic vertebra it is unchanged in appearance.
history: <unk>m with cough, chills, homeless, "asthma symptoms" but no wheezing // evaluate for pneumonia, infection, acute process
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the patient is status post sternotomy and coronary artery bypass graft surgery. a single lead pacemaker device is present as well as a central venous catheter which is somewhat difficult to follow but probably unchanged, apparently terminating at the cavoatrial junction. there is no definite pleural effusion or pneumothorax. the lungs appear unchanged aside from patchy atelectasis associated with a prominent right-sided cardiac fat pad as well as streaky lingular atelectasis.
shortness of breath and fever.
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left-sided ijv cvp in situ with the tip in the proximal to mid svc. pulmonary hyperinflation with emphysematous changes seen in the upper lung zones. the heart size is normal. marked bibasilar (right more than left) airspace consolidation again visualized which shows mild progression compared to prior imaging. findings are concerning for aspiration pneumonia.
<unk> year old man with pmhx bladder prostate cancer. admitted with nausea, vomiting, and purulent drainage biliary tube drainage. // evaluate for interval change