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no evidence of acute disease.
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widespread opacification of the lungs has slightly progressed.
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no acute intrathoracic process.
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low lung volumes without definite pneumonia. chronic moderate cardiomegaly.
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in comparison with the earlier study of this date, there is no increase in the subcutaneous emphysema or evidence of pneumothorax following clamping of the right chest tube. overall, little change in the appearance of the heart and lungs.
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mild cardiomegaly without overt pulmonary edema.
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stable postoperative contours to the right paramedian and hilar region in this patient status post esophagectomy. the nasogastric tube is unchanged in position. a right chest tube remains in place. the right pleural effusion has decreased in size. there is a residual patchy opacity at the right medial lung base which may represent an area of partial middle and/or lower lobe atelectasis. also, patchy opacity at the left base is increased since the previous study, which could reflect worsening lower lobe atelectasis, although pneumonia or aspiration should also be considered. left-sided port-a-cath is unchanged in position. no pneumothorax. no pulmonary edema.
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no radiographic evidence of pneumonia.
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multifocal ill-defined opacities are new and consistent with atypical pneumonia. indistinct appearance of the pulmonary vasculature suggests concurrent early heart failure. findings were communicated via phone call by to on at pm.
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marked volume loss in right apex which could be old tb but is concerning for a neoplastic process.
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tracheostomy tube and left subclavian picc line remain in place. overall, cardiac and mediastinal contours are stable. there is a layering left effusion and persistent retrocardiac consolidation which may represent partial lower lobe atelectasis, although pneumonia cannot be excluded. no pulmonary edema. no pneumothorax. overall, cardiac and mediastinal contours are unchanged. multiple left lateral rib fractures are again seen. an incompletely visualized left mid clavicular fracture is also seen.
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comparison to. the severity of the pre-existing pulmonary edema has decreased. stable bilateral areas of atelectasis. no larger pleural effusions. moderate cardiomegaly persists.
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endotracheal tube ends <num> cm above the carina. enteric tube ends in the stomach in appropriate position. linear right basilar atelectasis. small left pleural effusion. left mediastinal widening with abnormally convex ap window contour. recommend further evaluation with pa and lateral views or ct of the chest.
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prominent apical scarring and emphysema. no focal consolidation. in light of the abdominal findings, a chest ct is recommended for staging purposes.
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no acute cardiopulmonary process. no radiographic findings to suggest pneumothorax.
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low lung volumes with bibasilar atelectasis and possible mild pulmonary vascular congestion.
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no radiographic evidence for acute cardiopulmonary process.
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no acute intrathoracic process.
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moderately well inflated lungs with bilateral small layering pleural effusions and bibasilar linear atelectasis. no pneumothorax. unchanged cardiomegaly.
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compared to a it chest radiographs through :<num>. a new right pigtail pleural drainage catheter projects over the lateral aspect of the right mid chest. there is new severe subcutaneous emphysema on both sides of the chest, right greater than left, passing into the neck. mild pulmonary edema is new. there is no appreciable pneumothorax or right pleural effusion. displaced right rib fractures noted. cardiomegaly is mild.
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no acute cardiopulmonary abnormality.
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worsening left lower lobe aspiration pneumonia.
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cardiomegaly is substantial, unchanged. ng tube tip is at the distal stomach. left retrocardiac consolidation is unchanged. upper lungs are essentially clear.
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in comparison with the study of , there is little change in the appearance of the bilateral pleural effusions with underlying compressive atelectasis. continued enlargement of the cardiac silhouette with some indistinctness of pulmonary vessels suggesting some elevated pulmonary venous pressure.
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no signs for acute cardiopulmonary process.
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improved interstitial edema. atelectasis or early consolidation of the left lower lobe, best appreciated on the lateral view.
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possible mild pulmonary vascular congestion with otherwise no acute intrathoracic process.
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left-sided port-a-cath remains in place. there has been interval removal of a right basilar chest tube. there is a catheter overlying the base of the heart, presumably related to a recently placed pericardial drain for a pericardial effusion. there continues to be a right pleural effusion and soft tissue opacity in the right hilar and paratracheal areas, which could represent fluid which is layering dependently given patient's positioning on the study as well as in combination with a decrease in right lung aeration. the medial opacities also could represent tumor progression or pneumonia. clinical correlation is advised. the left lung remains grossly clear with the exception of some streaky and patchy opacities at the base which likely reflect atelectasis. no evidence of pulmonary edema. assessment of the cardiac and mediastinal contours is difficult due to the right-sided opacities. no pneumothorax is appreciated.
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no significant interval change.
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no acute cardiopulmonary process. no displaced fracture is seen, however please note that this is not dedicated imaging of the back.
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no acute cardiopulmonary process.
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bibasilar opacities, which may represent atelectasis, aspiration or infection in the appropriate clinical setting. hiatal hernia.
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compared to chest radiograph :<num>. lung volumes have improved, previous mild pulmonary edema and cardiomegaly have resolved. no appreciable pleural abnormality. tip of the endotracheal tube at the upper margin of the clavicles is no less than <num> cm from the carina. it should not be withdrawn any further. nasogastric drainage tube ends in the midportion of the nondistended stomach.
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lung volumes are improving, and there is a decrease in linear atelectasis. there are no other focal pulmonary abnormalities. mild cardiomegaly is chronic. the dilatation of central pulmonary arteries seen on the chest cta has not been apparent on conventional chest radiographs, including today's, but the hila look smaller than on when the patient was probably in biventricular congestive heart failure and also had mild pulmonary edema.
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mild pulmonary vascular congestion, no pleural effusions or focal consolidation.
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ap chest compared to through : tip of the right pic line projects over the mid-to-low svc. bibasilar opacification could be atelectasis alone or atelectasis and pneumonia. it has improved since , but remains unchanged since. upper lungs are clear. heart size is top normal. pleural effusions are small if any. no pneumothorax.
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the lung volumes are low. mild cardiomegaly with atelectasis at the right lung basis and in the retrocardiac lung regions. no larger pleural effusions. no pneumonia, no pulmonary edema.
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increased small right apical pneumothorax after removal of the right-sided chest tube since. otherwise, no significant change.
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endotracheal tube is in standard position. bibasilar patchy opacities likely reflect atelectasis.
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no acute cardiopulmonary process.
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diffuse basilar predominant reticular opacities with progressive increased density in the right lower lobe, right middle lobe, and left lower lobe. in the absence of infectious symptoms, findings likely reflect progression of metastatic disease, correlate clinically. dr , communicated the above results to dr at on by telephone, three minutes after discovery.
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an intra-aortic balloon pump is seen with the tip <num> cm below the top of the aortic knob. no pulmonary edema. no focal airspace consolidation to suggest pneumonia. no pleural effusions or pneumothorax. overall cardiac and mediastinal contours are within normal limits given portable technique.
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moderate cardiomegaly with moderate pulmonary edema and moderate sized bilateral pleural effusions, left greater than right.
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there no prior chest radiographs available for review. lungs are severely hyperinflated due to emphysema. no focal pulmonary abnormality. vascular clips denote prior surgery in the right lower chest. heart size normal. thoracic aorta very tortuous but not clearly dilated. pulmonary arteries top- normal size. no mediastinal abnormality.
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no evidence of pneumonia or chf.
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comparison to. stable right pleural effusion, occupying approximately % of the right hemithorax. substantial decrease upright basilar atelectasis. increasing left retrocardiac atelectasis. no pneumothorax.
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moderate pulmonary edema and persistent cardiomegaly.
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compared to chest radiographs since , most recently. heart size normal. lungs grossly clear. hyperlucency projecting over the cardiac apex and left upper abdominal quadrant it could be due to anterior pneumothorax, although there has been no progression over more than <num> hr. upright view should be obtained when feasible. other pleural surfaces are normal in terms of pneumothorax or pleural effusion. lungs grossly clear. heart size normal. et tube and esophageal drainage tube in standard placements respectively. recommendation(s): repeat chest radiograph with patient upright, if feasible.
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interval decrease in size of the left pneumothorax status post left-sided chest tube placement.
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right suprahilar consolidation is new, probably pneumonia. extensive pulmonary metastases. lung volumes are lower, but this does not account for increase in both cardiac size and mediastinal caliber, suggesting cardiac decompensation although edema is mild if any. right pleural effusion is small if any. no pneumothorax. right subclavian infusion port
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no radiographic evidence of pneumonia or acute cardiopulmonary abnormality.
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no acute cardiopulmonary process, specifically no evidence of edema to explain the lower extremity edema.
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feeding tube, with a wire stylet fully advanced, ends in the upper portion of a mildly distended stomach. it has been withdrawn minimally from its position earlier at substantial lower lobe atelectasis and at least small pleural effusions persist, although there has been some improvement in the left lower lobe component of atelectasis over the past two hours. there is no pneumothorax. pulmonary vascular congestion and mild cardiac enlargement suggests borderline cardiac decompensation. no pneumothorax. left picc line ends in the mid svc. tracheostomy tube in standard placement.
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et tube tip is <num> cm above the carinal. ng tube tip is in the stomach. left central venous line tip is at the cavoatrial junction. heart size and mediastinum are stable. left basal consolidation and left pleural effusion are unchanged as compared to right basal opacities. there is no pneumothorax.
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ng tube terminates in the proximal stomach with the side port in the distal esophagus and must be advanced.
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faint medial right basilar opacity may represent developing infection, in the correct clinical setting. no pneumothorax or effusions detected.
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no evidence of acute intrathoracic injury. if clinical concern for rib fractures is high, ct is more sensitive.
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left basilar pneumonia. recommendation(s):follow up radiographs after treatment are recommended to ensure resolution of this finding.
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pa and lateral chest compared to : previous heterogeneous opacification in the right lung which improved from through has not improved subsequently, consistent with persistent multifocal pneumonia. additionally, mild pulmonary edema most readily detected in the left lung, continues to improve. heart is top normal size, decreased. small right pleural effusion remains. no pneumothorax. left picc line ends alongside a dual-channel right supraclavicular central venous catheter in the mid-to-low svc. no pneumothorax.
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as compared to the previous radiograph, the patient has received the new nasogastric tube. the course of the tube is unremarkable, the tip is not included on the image but the side-hole projects approximately <num> cm be low the gastroesophageal junction. no complications. borderline size of the cardiac silhouette without pulmonary edema.
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ap chest compared to : partial obscuration of the left lower lateral pleural sulcus could be due to a small region of abnormality in the left lower lobe or small left pleural effusion. there are no other findings to suggest pneumonia. heart is top normal size. upper lungs are clear. mediastinal caliber and contour at the level of the aortic arch and the mediastinal veins are mildly increased, but longstanding.
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in comparison with the study of , the cardiac silhouette is enlarged and there is some indistinctness of pulmonary vessels with b-lines, consistent with mild elevation of pulmonary venous pressure. no definite acute focal pneumonia.
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following removal of the left pleural drain present at , the small left pleural effusion is stable while left basal atelectasis has improved. a very small left apical pneumothorax is demonstrated on the expiration view. it may not be clinically significant. perhaps more important is the demonstration of new pneumoperitoneum, which might have been present, but not appreciated on semi erect prior radiographs. nasogastric tube ends in the stomach. cardiomediastinal silhouette is normal. cardiomediastinal and hilar silhouettes are normal.
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acute minimally displaced fracture of the left lateral <num>th rib. no pneumothorax.
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endotracheal tube tip is in standard position. left internal jugular central venous catheter tip terminates at the confluence of the brachiocephalic veins. low lung volumes with streaky bibasilar airspace opacities likely reflecting atelectasis though infection cannot be excluded. mild pulmonary vascular congestion. fracture of the two most superior sternotomy wires, with leftward displacement of the two most inferior sternotomy wires relative to the remaining sternotomy wires. this could suggest sternal dehiscence in the correct clinical setting, and clinical correlation is recommended.
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no acute cardiopulmonary abnormality.
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in comparison with the study of , there is little interval change. cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. single lead pacer again extends to the region of the apex of the right ventricle.
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no evidence of acute cardiopulmonary disease.
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no acute intrathoracic findings.
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no acute cardiopulmonary process. no opacity to correlate with the findings from the prior left shoulder radiograph.
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interval resolution of pneumonia. no current signs of pneumonia.
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no acute intrathoracic abnormality.
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no acute cardiopulmonary process.
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mild perihilar vascular congestion with opacities at the lung bases which could be secondary to mild pulmonary edema, however an acute infectious process cannot be excluded. nodular opacity at the right lateral lung base could be secondary to a lung nodule. once the patient's clinical condition improves, a dedicated pa and lateral chest radiograph would be recommended for further evaluation.
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no acute cardiopulmonary process.
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port-a-cath tip remains within the azygos vein. left lower lobe atelectasis.
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increase in cardiac size silhouette may be seen in pericardial effusion or dilated cardiomyopathy, correlation with echocardiogram is recommended.
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in comparison with the study of , the monitoring and support devices are unchanged. obliquity of the patient is somewhat limits the study. there is enlargement of the cardiac silhouette that appears stable and minimal elevation of pulmonary venous pressure.
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in comparison with the study of , there is little overall change. cardiac silhouette remains within normal limits and there is no appreciable vascular congestion. streaks of atelectasis are seen at the left base. right subclavian port-a-cath extends to the mid to lower portion of the svc.
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retrocardiac opacity worrisome for a left lower lobe infectious process.
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interval decrease in small, left pleural effusion without acute complications of thoracentesis.
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no acute findings in the chest.
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interval decrease in right pleural effusion.
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compared to prior chest radiographs since , most recently. lung volumes are lower, but the right lung is clear of any focal abnormality. moderate left pleural effusion may be larger or exaggerated by lower lung volumes. left lower lobe atelectasis is severe. the heart is not enlarged.
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no acute intrathoracic process.
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small to moderate right pleural effusion. additional regions of consolidation in the lungs seen in the region of prior metastatic disease. difficult to assess for interval change in these lesions given differences in technique.
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no convincing evidence for pneumonia. mild left basal atelectasis.
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left basilar atelectasis versus scarring, but no other acute cardiopulmonary process or evidence of failure.
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no pneumonia.
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no acute cardiopulmonary process. specifically, no evidence of pneumonia. results were discussed with at on via telephone by dr at the time the findings were discovered.
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no new focal consolidation to suggest pneumonia. persistent left base atelectasis. mild cardiomegaly. stat read was called to dr by dr at am, <num> minutes after the time of discovery, by telephone.
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elevated pulmonary venous pressures, improved since , still with small right and tiny left pleural effusions. no focal consolidation.
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no acute cardiopulmonary process. no free air below the diaphragm.
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chronic changes at the left lung base. no foreign body appreciated in the airways.
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interval intubation with endotracheal tube <num> cm above the carina. a right internal jugular port-a-cath is unchanged in position. interval development of diffuse bilateral airspace process which given the rapidity of development, likely reflects moderate pulmonary edema rather than an acute infectious process. clinical correlation is advised. heart remains upper limits of normal in size. no pneumothorax is seen, although the sensitivity to detect pneumothorax is diminished given semi-supine technique.
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no acute intrathoracic abnormality.
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no acute intrathoracic process.
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heart size and mediastinum are stable. the et tube tip is <num> cm above the carinal. bibasal consolidations appear to be more pronounced on the right and at a similar if not more pronounced on the left, the as concerning for infectious process superimposed on traumatic injury. aspiration is another possibility. ng tube passes below the diaphragm terminating in the stomach. left chest tube is in place. no definitive pneumothorax identified.
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heart size and mediastinum are stable. lungs are essentially clear with similar to previous study minimal chronic changes in the right upper lobe. no new consolidations or masses demonstrated. there is no pleural effusion or pneumothorax.
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small bilateral pleural effusions, possibly decreased from the prior exam, with mild bibasilar atelectasis.