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Generate impression based on findings.
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The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. Mild mucosal thickening in the left maxillary and sphenoid sinuses with small left maxillary mucous retention cyst/polyps. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Adenoids are prominent which may represent hypertrophic lymphoid tissue, correlation with direct inspection is recommended.
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No specific findings to explain patient's symptoms.
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Generate impression based on findings.
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A patient submitted outside study for review. Submitted for review are digital mammographic images (12/26/14, 1/12/15) and ultrasound images of right breast (1/12/15) performed at St. Anthony Hospital. For comparison, digital mammographic images (10/4/12, 3/26/10) are available. DIGITAL MAMMOGRAPHIC IMAGES (12/26/14, 1/12/15):The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A cluster of coarse calcifications has developed in benign fashion in the right breast at the central aspect.Stable benign small mass is present at anterior lower inner quadrant in the right breast.Previously seen a circumscribed mass in the upper outer quadrant in the left breast has become smaller and obscured.No suspicious masses, microcalcifications or areas of architectural distortion are noted in either breast. ULTRASOUND IMAGES OF RIGHT BREAST (1/12/15):A small cyst with internal hyper echoic spot, consistent with calcification, is seen at 3 o'clock position. No other lesions are present in the submitted images.
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No mammographic or sonographic evidence of malignancy. Benign calcifications and a benign mass in the right breast.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram.
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Generate impression based on findings.
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Reason: h/o bladder ca s/p TURBT and cystectomy POD #2, now with acute liver failure, hypotension, seizures. History: h/o bladder ca s/p TURBT and cystectomy POD #2, now with acute liver failure, hypotension, seizures. ABDOMEN:LUNG BASES: Small bilateral pleural effusions with overlying compressive atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesions.Apparent partial filling defect of the main portal vein on axial images is not seen on coronal reformatted images and is most likely artifactual in etiology, with no convincing evidence of portal venous thrombosis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral ureteral stents in place without hydronephrosis. Subcentimeter renal cysts.RETROPERITONEUM, LYMPH NODES: Amorphous fluid collection adjacent to the right iliac vessels measures up to 3.7 cm (series 3 image 118), and without loculation or gas foci most likely postsurgical.BOWEL, MESENTERY: Postoperative changes of ileal conduit formation. The cecum is abnormal morphology and adherent to the right lower quadrant pelvic sidewall, which may be chronic and or postsurgical in etiology. No discrete bowel wall thickening or free intraperitoneal air.BONES, SOFT TISSUES: Severe thoracolumbar levoscoliosis.Surgical drain with tip in the pelvis.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Status post cystectomy and ileal conduit formation.LYMPH NODES: Amorphous fluid collection adjacent to the right iliac vessels measures up to 3.7 cm (series 3 image 118), and without loculation or gas foci most likely postsurgical.BOWEL, MESENTERY: As aboveBONES, SOFT TISSUES: As aboveOTHER: Nonocclusive thrombus in the right common femoral and external iliac veins.
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1.Postoperative changes of cystectomy and ileal conduit formation without evidence of perforation, abscess, or other acute abnormalities to explain the patient's symptoms. The cecum is abnormal in morphology and adherent to the right lower quadrant pelvic sidewall, which may be chronic and or postsurgical in etiology and may be followed. 2.Nonocclusive thrombus of the right common femoral and external iliac veins.3.Fluid collection adjacent to the right iliac vessels likely represent a postoperative lymphocele or seroma. 4.Small pleural effusions and other findings as described above.These findings were discussed by phone with the referring clinical service at the time of dictation at 1/23/15 at 0930.
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Generate impression based on findings.
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57-year-old male with left groin pain. Evaluate for osteoarthritis. There is sclerosis and osteophyte formation in the left hip without significant joint space narrowing, compatible with moderate osteoarthritis. No evidence of acute fracture or alignment.
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Moderate left hip osteoarthritis.
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Generate impression based on findings.
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Bilateral breast pain and retroareolar burning sensation. Cysts seen previously in the right breast. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. The cluster of cysts in the mid lateral right breast seen on prior mammogram and ultrasound is stable.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable cluster of cysts in the right lateral breast. No findings to account for the patient's breast pain, and clinical correlation is recommended. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Male 41 years old; Reason: 41 yo male with melanoma to left arm; please do lymphoscintigraphy with mapping to identify sentinel lymph node History: MELANOMARADIOPHARMACEUTICAL: The left upper extremity was prepared in a sterile manner. The lesion corresponding to the melanoma site was identified and a total of 0.5 mCi Tc-99m filtered sulfur colloid was injected in four locations surrounding the lesion. A focus of increased activity is noted in the left axilla, representing the sentinel node. This region was marked with an indelible marker.
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Sentinel node identified in the left axilla.
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Generate impression based on findings.
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The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no residual abnormal density in the area of previously seen resolving left occipital subarachnoid hemorrhage. There is no new intracranial hemorrhage. There is subtle hyperdensity remaining along the mid body of the corpus callosum in the area of patchy diffusion restriction, but may be slightly less conspicuous than on the prior exam. There are no new areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is a persistent mild salt-and-pepper heterogeneous appearance of the calvarium, which appears slightly sclerotic overall, and may represent normal variation.
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1. No acute intracranial abnormality. Interval complete resolution of previously seen left occipital subarachnoid hemorrhage.2. Subtle hyperdensity remaining along the mid body of the corpus callosum in the area of patchy diffusion restriction.
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Generate impression based on findings.
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36 year old female with leg pain, evaluate for spondylolisthesis There is sacralization of the L5 vertebral body and numbering is performed per prior MRI. Vertebral body heights are intact. There is grade 1 anterolisthesis of L4 on L5 with 4 mm of displacement. Alignment is otherwise anatomic. Vertebral body heights and disk spaces are intact. There is a hemangioma within the T11 vertebral body. 7-mm filum lipoma. There is mild rightward curvature of the mid lumbar spine, possibly positional. T12-L1: No central or neuroforaminal stenosis.L1-L2: No central or neuroforaminal stenosis.L2-L3: No central or neuroforaminal stenosis.L3-L4: Minimal diffuse disk bulge. No central or neuroforaminal stenosis.L4-L5: Mild diffuse disk bulge with uncovering. Severe facet arthropathy. No central canal stenosis. Moderate to severe right and minimal left neural foraminal stenosis. No spondylolysis.L5-S1: No spinal or neuroforaminal stenosisBeam hardening artifact limits evaluation of the lower pelvis.
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1.Grade 1 anterolisthesis at L4-L5 with moderate right neuroforaminal stenosis, better characterized on recent MRI. No evidence of spondylolysis.2.Lipoma involving the filum terminale is again visualized. Correlate with clinical findings for possibility of tethered cord.
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Generate impression based on findings.
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Male 56 years old; Reason: rectal cancer local recurrence. Evaluate interval change History: rectal pain CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules including a calcified right middle lobe nodule and cluster of nodules near the right hilum unchanged from the prior study. No new suspicious pulmonary nodule or mass is seen. No consolidation or pleural effusion.MEDIASTINUM AND HILA: Right chest port is in place with its catheter tip at the cavoatrial junction. Residual thymic tissue is present. Multiple calcified lymph nodes are again seen, however no mediastinal or hilar lymphadenopathy is present. The heart is normal in size and there is no pericardial effusion. Mild coronary artery calcifications are present.CHEST WALL: No axillary lymphadenopathy is seen. Degenerative changes are seen throughout the thoracic spine.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted. Fatty infiltration.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left lower quadrant ileostomy is again noted with ileal prolapse. Fat containing umbilical hernia is again noted.BONES, SOFT TISSUES: Right lower anterior abdominal spinal stimulator generator is seen in place, stable.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Status post pelvic lymph node dissection without pelvic lymphadenopathy.BOWEL, MESENTERY: Status post colectomy.BONES, SOFT TISSUES: Enlarging presacral reference lesion currently measures 6.9 x 4.2 cm (image 24; series 3).Nonspecific S1 sclerosis is unchanged.
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1.Interval enlargement of presacral lesion.2.No change in S1 sclerosis which may be due to metastatic disease or from prior radiation.
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Generate impression based on findings.
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Female 37 years old; Reason: Level and specific location of uptake (diffuse vs nodular) History: Sub-clinical hyperthyroidism, nodular goiter by US , + antibodies The thyroid images demonstrate uniform increased activity in an asymmetrically enlarged thyroid gland, right greater the left. The 4-hour radioactive iodine uptake is 32.6% and the 24-hour uptake is 51.5% (normal range 10-30% at 24-hours).
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Findings consistent with grave's disease.
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Generate impression based on findings.
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Reason: 88 yo F with abdominal pain History: abdominal pain C diff+ Limited examination for solid organ pathology without intravenous contrast.ABDOMEN:LUNG BASES: Moderate bilateral pleural effusions with overlying compressive atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic right kidney with cortical parenchyma scarring. No hydronephrosis. Severe calcifications of the renal arteries.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: The portions of the colon opacified by oral contrast appear normal in caliber. Portions of the colon are collapsed and incompletely evaluated, however there is no specific evidence of colitis. A rectal tube is in place.The small bowel is normal in caliber without obstruction.BONES, SOFT TISSUES: Diffuse anasarca. Mild abdominal and pelvic ascites.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter in place.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Status post bilateral above the knee amputations.OTHER: No significant abnormality noted
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1. Limited study without intravenous contrast. No obvious colitis allowing for limitations.2. Mild abdominal and pelvic ascites and anasarca.3. Moderate bilateral pleural effusions.
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Generate impression based on findings.
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Male 71 years old; Reason: Follow CALGB 80803 Protocol History: Staging, T3N2 Esophageal Cancer, Clinical Trial PatientRADIOPHARMACEUTICAL: 11.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 106 mg/dL. Today's CT portion grossly demonstrates focus of soft tissue density in the distal left aspect of the esophagus with calcification or contrast media from prior swallow study. There is additional soft tissue density in the region of the gastric cardia. There is a subcentimeter nodular density in the left lower lobe. There is a sclerotic focus in the proximal left femur at the intertrochanteric region. There is atherosclerotic calcification of the aorta and peripheral branches. Today's PET examination demonstrates marked hypermetabolic activity in the gastric cardia with an SUV value of 9.2 corresponding to the soft tissue density on CT consistent with tumor. There is increased activity in the distal esophagus which is nonspecific and could represent tumor or esophagitis. There is mild activity in the region of the paraesophageal soft tissue density noted on CT. There is increased activity in the sclerotic focus in the left proximal femur at the intertrochanteric region noted on CT with SUV value of 4.1. There are two foci of hypermetabolic activity in the retroperitoneum at the level of the left renal vasculature is nonspecific.
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1. Hypermetabolic activity in the gastric cardia consistent with tumor. Increased activity in the distal esophagus is nonspecific and could represent tumor or esophagitis.2. Increased activity in the left proximal femur corresponds to the sclerotic focus CT, suspicious for metastatic disease.3. Low level activity in the region of the paraesophageal soft tissue density containing either calcification or contrast media from prior swallow study. This could represent either a benign calcified lymph node or an esophageal diverticulum.4. Two foci of hypermetabolic activity in the retroperitoneum at the level of the left renal vasculature is nonspecific, however could represent small tumor activity or tortuous ureter.
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Generate impression based on findings.
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Upon high contrast windowing, there is suggestion of asymmetric FLAIR hyperintensity in the mesial right temporal lobe on multiple sequences with possible mild expansion of the right amygdala. Hippocampal volume and contour are unremarkable and symmetric.The ventricles and sulci are prominent, consistent with mild age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are nonspecific but likely represent mild-moderate chronic small vessel ischemic changes. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. There is an incidental partially empty sella. The remainder of the midline structures and craniocervical junction are within normal limits.
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1. Subtle apparent asymmetric T2/FLAIR hyperintensity in the right mesial temporal lobe and possible mild expansion of the right amygdala. Please correlate with EEG findings.2. Probable mild-moderate chronic small vessel ischemic changes.
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Generate impression based on findings.
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There is no evidence of mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The airways are patent. The imaged intracranial structures are unremarkable. Severe degenerative changes of the visualized spine with anterior fusion of C4-C5 and minimal grade 1 retrolisthesis of C3 relative to C4. Degenerative changes are most severe at C4-C5 where there is moderate to severe bilateral foraminal narrowing. Moderate degenerative changes at the acromioclavicular joints bilaterally with chondrocalcinosis at the glenohumeral joints. Multiple granulomas seen within the visualized lungs. Atherosclerotic calcifications of the aorta and its branches. 1 mm hypodense left thyroid nodule. Multiple teeth are absent. Median sternotomy wires. Lenses are thin bilaterally, likely related to cataracts. Possible partially imaged AP window lymph node is seen on the most inferior slice of the study. The right maxillary sinus is hypoplastic.
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No CT findings to explain patient's symptoms.
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Generate impression based on findings.
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Reason: eval of sacral/pelvic mass History: pelvic mass ABDOMEN:LUNG BASES: Nonspecific patchy ground glass opacities. No consolidation. Questionable small pericardial effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Minimal left pelvicaliectasis likely due to compression by mass. Normal right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The bowel is normal in caliber without obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Displaced anteriorly and to the right by tumor. Scattered hyperattenuating foci incompletely evaluated, likely fibroids.BLADDER: Partially collapsed and displaced anteriorly by tumor.LYMPH NODES: Enlarged pelvic lymph nodes, with reference left iliac lymph node measuring 2.0 x 1.1 cm (series 6 image 120).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Again seen is a large destructive soft pelvic mass which measures up to 14.7 x 7.9 cm in maximum axial dimension (series 6 image 109) and demonstrates peripheral enhancement and calcification along its inferior aspect compatible with the patient's known Schwannoma. There is associated invasion and destruction of the left inferior ilium and sacrum. Postoperative changes of lumbosacral spine fusion and sacroiliac joint reconstruction are again noted, with metal artifact which limits evaluation of the pelvis.OTHER: No significant abnormality noted
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1. Large destructive pelvic soft tissue mass compatible with the patient's known Schwannoma as described above, with postoperative changes of lumbosacral spine fusion and sacroiliac joint reconstruction.2. Enlarged pelvic lymph nodes.3. Minimal left pelvicaliceal dilation likely due to left ureteral compression by the pelvic mass.4. Questionable small pericardial effusion and nonspecific basilar groundglass pulmonary opacities.
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Generate impression based on findings.
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Calcifications in the left breast 3 o'clock position. Short-term interval follow-up. No breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The tightly grouped cluster of amorphous calcifications in the left breast 3 o'clock position immediately adjacent to the calcified fibroadenoma is unchanged. No associated mass is identified. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable left breast calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually, which would resume in July 2015. Results and recommendation were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Female 36 years old Reason: fibrolamellar HCC restaging CT History: ascites, LE swelling CHEST:LUNGS AND PLEURA: The right lower lobe mixed density mass measures 11.5 x 10.4 cm (image 55; series 13), larger. As noted previously, there is associated compressive atelectasis adjacent to the mass. Pleural-based mass described in the prior report is also again noted roughly stable in size.MEDIASTINUM AND HILA: Massive enlargement of the azygos vein secondary to caval occlusion. There is no evidence of mediastinal lymphadenopathy on the basis of size criteria. Prominent right hilar node unchanged. Enlarged axillary nodes are stable; for reference purposes, left axillary node measures 1.9 x 1.0 cm (image 20; series 13) previously 1.9 x 1.0 cm (image 17; series 10; 10/13/2014 study).CHEST WALL: There are prominent collaterals in the musculature of the back.ABDOMEN:LIVER, BILIARY TRACT: The large hypervascular mass arising from the caudate lobe measures 7.2 x 4.9 cm (image 86; series 13) equivocally smaller. This lesion is compatible with the patient's known fibrolamellar HCC. There is heterogeneous geographic attenuation of the hepatic parenchyma during the arterial phase, likely perfusional in etiology as described previously.SPLEEN: The spleen is enlarged and there are extensive perisplenic venous collaterals. The mass at the splenic hilum measures 5.3 x 4.0 cm (image 82; series 13), larger. PANCREAS: The reference mass dorsal to the uncinate process has slightly increased in size, now measuring 2.6 x 2.1 cm (image number 104; series 13).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: : No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: There is extensive retroperitoneal lymphadenopathy, which overall appears to have slightly increased compared to the prior examination: Previously described peripancreatic lymph node now measures 2.4 x 2.0 cm (in image 107; series 13). The reference retrocrural node is not significantly changed, measuring 5.2 x 3.6 cm (image 70; series 13). The infrarenal IVC remains thrombosed and there is marked vascular collateralization.BOWEL, MESENTERY: Scattered hypervascular mediastinal mesenteric lymph nodes are again identified.BONES, SOFT TISSUES: There are prominent subcutaneous collaterals circumferentially affecting abdomen and pelvis.OTHER: Mild ascites, unchanged. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse body wall collaterals.OTHER: Mild ascites, unchanged.
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Overall interval progression of disease with reference measurements given above.
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Generate impression based on findings.
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Lung cancer, bone pain, restaging CHEST:LUNGS AND PLEURA: Nodule along along the right lower lobe suture line measures 2.6 x 2.0 cm (series 4, image 55), previously 2.5 x 1.7 cm. Scarring is noted along the right upper lobe suture line. No new suspicious pulmonary masses. MEDIASTINUM AND HILA: Right hilar node measures 1 cm in short axis (series 4, image 50), previously 1.1 cm. Surgical clips in the mediastinum. CHEST WALL: Worsening lytic lesions involving the T1, T2 vertebral bodies with new height loss of the superior endplate of T2. The T7, T8 lesions are stable.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypoattenuating hepatic lesions are unchanged overall. Posterior right hepatic lobe lesion measures 1.4 x 1.1 cm (series 4, image 81), unchanged. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Probable small left adenoma is unchanged.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Worsening lytic lesion of L4 with new fracture through the inferior endplate. Additionally there are new lytic lesions in the left ilium. OTHER: No significant abnormality noted.
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1. Progression of osseous metastases with increasing lytic lesions in T1, T2, L4, and left ilium with new fractures of T2 and L4.2. Stable hepatic metastases.3. Right hilar nodule has slightly increased in size since the prior exam. Although not FDG avid on an earlier PET scan, this lesion is somewhat suspicious for a metastatic lesion.
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Generate impression based on findings.
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2-year-old male for assessment of fractureVIEWS: Right first toe AP/lateral (two views) 01/23/15, 0947 hours. No periosteal reaction to suggest a healing fracture. Alignment is anatomic.
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Anatomic alignment without evidence of healing fracture.
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Generate impression based on findings.
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Reason: r/o appendicitis History: abdominal pain, anorexia ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix measures 9 mm in maximum diameter, larger than expected for normal. There is no obvious mesenteric fat stranding, periappendiceal fluid collections, or free intraperitoneal air. The bowel is otherwise normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No abdominal or pelvic free fluid.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Enlarged appendix measuring 9 mm in the clinical setting of right lower quadrant pain is suspicious for early appendicitis.
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Generate impression based on findings.
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78 year old female with a known right breast cancer treated with neoadjuvant chemotherapy presents for wire localization. On review of the prior studies, a marker cip surrounded by a focal asymmetry presents at posterior upper outer quadrant in the right breast. The procedure, risks including bleeding and infection, and benefits of needle-wire localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The right breast was placed in an alphanumeric grid using lateral to medial approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the grid, a 7 cm Kopans needle was placed adjacent to the clip. On orthogonal digital mammography, adequate positioning of the needle was confirmed after adjusting depth so the needle tip was approximately 2cm deep to the center of the target. A spring wire was then deployed. Repeat two view orthogonal digital mammograms reveal the spring wire to be in good position. The digital mammogram was annotated and reviewed with Dr. Chhablani prior to the patient's procedure. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Abe performed the procedure.Orthogonal digital specimen radiographs revealed the focal density and clip and spring wire to be within the specimen.
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Successful needle localization of the right breast clip.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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37 year old female with history of endometriosis s/p multiple abdominal surgeries, now complains of postprandial abdominal pain. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 15 minutes. Fluoroscopic evaluation demonstrated normal mucosa throughout the small bowel, without ulcers, sinus tracts, fistulae, or adhesions. No evidence of small bowel obstruction or stricture. No separation of bowel loops was present to suggest fibrofatty proliferation. The terminal ileum and ileocecal valve were normal in appearance. The ascending colon was grossly normal. TOTAL FLUOROSCOPY TIME: 3:24 mm:ss
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Normal examination of the small bowel and proximal colon, without specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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67 year old with proven right breast cancer presents for wire localization. On review of the prior studies, a small mass with a marker clip at the posterior portion. Target mass is located in the breast in the lower inner quadrant region located posteriorly at 5 o’clock. The procedure, risks including bleeding and infection, and benefits of needle-wire localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The right breast was placed in an alphanumeric grid using inferior to superior approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the grid, a 7 cm Kopans needle was placed adjacent to the lesion. On orthogonal digital mammography, adequate positioning of the needle was confirmed after adjusting depth so the needle tip was approximately 2cm deep to the center of the target. A spring wire was then deployed. Repeat two view orthogonal digital mammograms reveal the spring wire to be in good position. The digital mammogram was annotated and reviewed with Dr. Jaskowiak prior to the patient's procedure. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Abe performed the procedure.Orthogonal digital specimen radiographs revealed the mass and clip and spring wire to be within the specimen.
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Successful needle localization of the right breast malignancy.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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Reason: r/o SBO, hx of met colon CA History: persistent N/V, abd distention ABDOMEN:LUNG BASES: Patchy ground glass and tree in bud opacities in the right middle lobe, right lower lobe, lingula, and left lower lobe are new since the prior study. No pleural effusions.LIVER, BILIARY TRACT: Percutaneous biliary catheter in place with associated pneumobilia. Numerous hypoattenuating foci in the liver are again noted suspicious for metastatic disease. Mild perihepatic ascites.SPLEEN: No significant abnormality notedPANCREAS: Two lesions in the pancreatic body are again visualized. The more anterior fluid density lesion measures 1.1 x 1.0 cm (series 3 image 59) unchanged. The adjacent more solid lesion is somewhat more ill-defined and this lesion but grossly unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy. Reference lymph nodes in the left periaortic area measure 1.4 x 1.1 cm (series 3 image 83) unchanged.BOWEL, MESENTERY: Interval development of a high-grade small bowel obstruction with dilation of bowel loops up to 3.2 cm, with transition point near the ileocecal valve, where there is increased wall thickening and enhancement of the distal ileum, in addition to cecal wall thickening and fat stranding which was seen previously. There is some interloop fluid in this region which may indicate ischemia, however there is no pneumoperitoneum or portal venous gas.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Large uterine mass is unchanged and most likely a fibroid uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Thin curvilinear radiopacity in the pelvis appears interposed between the bladder and uterus but its exact location difficult to determine, is of unknown etiology and significance. Surgical service was notified of this finding at the time of dictation.
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1. Acute high grade bowel obstruction with transition point near the ileocecal valve where there is wall thickening and enhancement of the distal ileum, in addition to cecal wall thickening and fat stranding seen previously. Differential considerations include neoplastic, inflammatory, and ischemic etiologies. 2. Thin curvilinear foreign body in the pelvis of unknown etiology or clinical significance. This was discussed with the surgical service at the time of dictation. 3. New basilar pulmonary opacities are most compatible with aspiration or infection. 4. Pancreatic/hepatic lesions and lymphadenopathy are not significantly changed since the recent prior study.
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Generate impression based on findings.
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22 year old female with trismus and fever. There is tonsilar enlargement and resultant near complete effacement of the superior oropharynx. There is bilateral cervical lymphadenopathy measuring up to 1.8 cm in short axis. There is no evidence of abscess. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. There is minimal nonspecific fluid within the left mastoid air cells and mild maxillary sinus mucosal thickening. There is a midline mandibular bony cleft that likely represents an incisive canal. The osseous structures are otherwise unremarkable.
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Non-specific lymphadenopathy and tonsillar enlargement resulting in oropharyngeal airway narrowing without evidence for abscess.
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Generate impression based on findings.
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Patient with hypertension and arthralgias. KIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 1 Left: 0 Length*** Right: 8.1 cm Left: 7.7 cm Mean for age: 9.0 cm Range for age: 7.1 - 10.8 cmADDITIONAL OBSERVATIONS: Small volume ascites. Bilateral simple pleural effusions. Right junctional parenchymal defect noted.
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1.Grade 1 right hydronephrosis.2.Small volume ascites and bilateral simple pleural effusions.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning.Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469
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Generate impression based on findings.
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Asymptomatic female for diagnostic mammogram. History of left lumpectomy with radiation treatment in 1991. History of a right cyst aspiration. Family history of breast cancer in a maternal aunt. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A scar marker was placed on the left breast. Dystrophic calcifications, volume loss and postsurgical architectural distortion are present in the lumpectomy bed and unchanged.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Reason: h/o tonsil ca and CRT, compare to previous, measurements pls History: NONE LUNGS AND PLEURA: Small calcified granulomata, but no evidence of pulmonary or pleural metastases.Previously reported right basilar subsegmental atelectasis has resolved.MEDIASTINUM AND HILA: There is no evidence of mediastinal or hilar lymphadenopathy.Mild coronary artery calcification is present, the heart and pericardium otherwise unremarkable.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Previously noted hepatic cystlike hypodensities are unchanged, likely benign.
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No evidence of metastases, or other significant abnormality.
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Generate impression based on findings.
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Male 72 years old; Reason: hx of bladder cancer, evaluate for metastatic disease History: see above The following observations are made given limitations of an unenhanced study.ABDOMEN:LUNG BASES: Nonspecific pulmonary micronodules in the lung bases are unchanged.LIVER, BILIARY TRACT: Cholelithiasis without complication.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Chronic left hydronephrosis and hydroureter with atrophy of the left kidney appears similar to the prior study. Probable right renal cyst is unchanged. RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Colonic diverticulosis without complication. Peri-umbilical hernia containing small bowel is nonobstructive. Diverticula. Parastomal hernia contains colon is also nonobstructive.BONES, SOFT TISSUES: Degenerative changes are seen in the lumbar spine with anterolisthesis of L4 and L5.PELVIS:PROSTATE/SEMINAL VESICLES: Status post prostatectomy.BLADDER: Status post cystectomy.LYMPH NODES: Status post pelvic lymph node dissection.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
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No evidence of metastatic disease. Moderate to severe chronic left hydronephrosis is unchanged. Two nonobstructive ventral hernias: periumbilical hernia, containing small bowel and upper abdominal peri-stomal hernia, containing colon.
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Generate impression based on findings.
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51 year old female presents for annual diagnostic mammogram as recommended. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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Female 61 years old; Reason: metastatic breast cancer - evaluate response to treatment, compare with previous CT scan with measurements per recist 1.1 History: pulmonary mets CHEST:LUNGS AND PLEURA: The reference right lower lobe pulmonary nodule measures 3 x 3 mm (image 72; series 5), unchanged and possibly representing scarring. The reference left lower lobe pulmonary nodule adjacent to the left major fissure measures 0.8 x 0.8 cm (image 46; series 5), equivocally larger. Post radiation changes in the anterior aspect of the left upper lobe.MEDIASTINUM AND HILA: Reference mediastinal lymph node measures 0.7 x 0.6 cm (image 31; series 3), unchanged.CHEST WALL: Postsurgical changes in the left breast and left chest wall.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensities in the liver unchanged. The hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Status post right TRAM flap reconstruction of the left breast.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Equivocal enlargement of left pulmonary nodule with measurements given above.
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Generate impression based on findings.
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History of head and neck cancer and chemoradiation therapy, compare previous with measurements CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, some calcified in the right upper lobe. No suspicious nodules or masses.MEDIASTINUM AND HILA: No lymphadenopathy. Heart size is normal. No coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Accessory splenule noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small left periaortic lymph node is unchanged.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastatic disease or other significant abnormality.
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Generate impression based on findings.
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Syncope, distended neck veins, evaluate for obstructing mass LUNGS AND PLEURA: Basilar atelectasis without suspicious nodules or masses. Interval resolution of pleural based right lower lobe nodule.MEDIASTINUM AND HILA: The SVC is markedly narrowed without contrast opacification. There is no evidence of extrinsic compression by a mass lesion upon the SVC. The azygos vein is normal in size. Severe coronary artery calcifications. Heart size normal. No pericardial effusion.CHEST WALL: Distended venous collaterals are noted within the subcutaneous soft tissues.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy.
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The SVC is markedly narrowed without evidence of extrinsic compression by a mass lesion. This finding may represent a sequela of scarring from prior catheter placement. Distended venous collaterals are noted within the superficial soft tissues of the chest.
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Generate impression based on findings.
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Male 68 years old; Reason: restaging kidney cancer History: restaging kidney cancer, on bevacizumab CHEST:LUNGS AND PLEURA: Previously described pulmonary nodules have regressed and the reference nodule in the right lung has resolved completely. No consolidation or pleural effusion is seen.MEDIASTINUM AND HILA: Superior mediastinal lymphadenopathy has regressed. The reference prevascular lymph node measures 0.8 x 0.8 cm (image 20; series 10). Previously referenced left para-aortic lymph node has decreased in size now measuring 1.8 x 1.8 cm (image 64; series 10). Calcified subcarinal and right hilar lymph nodes are again seen. The heart is normal in size and a trace pericardial effusion is again noted. No coronary artery calcifications are present.CHEST WALL: Soft tissue metastasis adjacent to the right scapula now measures 2.5 x 1.6 cm (image 32; series 10), unchanged. However multiple additional intramuscular and subcutaneous enhancing nodules have decreased in size (for example, 3 subcentimeter lesions on image 59; series 10 are all smaller). Lytic lesion in the T7 vertebral body is stable. ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodense foci in the liver unchanged and remain too small to characterize. No new suspicious liver lesion is seen.SPLEEN: Calcified splenic granulomas are seen. 1 cm calcified splenic artery aneurysm is unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left upper pole renal mass extends towards the renal hilum and measures 7.5 x 6.6 cm (image 110; series 10) not significantly changed from the prior study with comparable measurements.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Colonic diverticulosis is present without complication.BONES, SOFT TISSUES: Multiple enhancing nodules in the paraspinal musculature and subcutaneous fat appear roughly stable (for example image 163 series 10 -- gluteal musculature). Multiple peritoneal nodules regressed slightly.Degenerative changes are seen throughout the spine with grade 1 anterolisthesis of L5 on S1 as noted previously.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis is present without complication.BONES, SOFT TISSUES: Multiple peritoneal, intramuscular, and subcutaneous metastases are roughly stable.
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Overall slight interval regression of disease with reference measurements given above.
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Generate impression based on findings.
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Elevated d-dimer, evaluate left upper lobe nodule LUNGS AND PLEURA: 7-mm left upper lobe solid nodule (series 6, image 34) with a surrounding cluster of micronodules. No additional pulmonary nodules or masses. These are similar in appearance to the prior exam.MEDIASTINUM AND HILA: Prevascular lymph node measures 1.2 centers in short axis (series 4, image 32), previously 8 mm. Left hilar lymph node appears similar to prior, but is difficult to measure in the absence of intravenous contrast. Mild coronary artery calcifications. Heart size is normal.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy.
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1.Left upper lobe nodule with surrounding cluster of micronodules. Infectious / inflammatory etiologies such as granulomatous or atypical infection are favored; increasing adenopathy is suggestive of malignancy, however. 2.Increasing prevascular lymph node and stable left hilar lymph node.
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Generate impression based on findings.
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Patient with recurrent epididymitis, evaluate for prosthetic utricle.EXAMINATION: MRI pelvis without IV contrast 01/23/15 A vertically oriented T2 hyperintense structure is seen arising off the posterior aspect of the prostatic urethra measuring 3 x 4 mm in cross-sectional dimension (image 26, series 501) and approximately 28 mm in cranial caudal dimension (image 13, series 1201). This finding is most consistent with a prostatic utricle. The utricle diameter is less than the urethra. The testicles are normally positioned within the scrotum, and a small left hydrocele is seen. Trace free fluid is noted in the pelvis.
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1.Prostatic utricle, which although small in appearance, may be much larger during voiding and voiding cystourethrogram may be helpful.2.Normally positioned testicles, with a small left hydrocele present.
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Generate impression based on findings.
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50 year old male with history of fistulizing Crohn's disease, s/p ileocecectomy. Now presents with RLQ abdominal pain. Scout radiograph showed a nonobstructive bowel gas pattern. Postsurgical changes compatible with prior ileocecectomy and neoterminal ileum creation were noted.Transit time to the colon was 15 minutes, with contrast readily flowing through the small bowel and ileocolonic anastomosis. Fluoroscopic evaluation demonstrated some tethering of distal small bowel loops in the right lower quadrant with areas of residual narrowing; findings are indicative of prior/chronic inflammation. However, there were no ulcers, sinus tracts, fistulae, strictures, or other signs of active inflammation. The neoterminal ileum and colonic anastomosis were patent, although slight narrowing of the neoterminal ileum likely indicates chronic inflammation. Atypical appearance of the distal descending colon, which resembles that of small bowel. TOTAL FLUOROSCOPY TIME: 5:03 mm:ss
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1.Postsurgical changes and findings compatible with chronic neoterminal ileum/distal small bowel inflammation as described above. However, there is no evidence of active Crohn's disease or intestinal obstruction.2.Atypical appearance of the distal descending colon which is likely secondary to underdistention. However, dedicated evaluation of the colon can be considered if there is clinical concern for colonic pathology at this site.
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Generate impression based on findings.
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History of right breast DCIS status post right lumpectomy in 03/12. No current breast complaints. Three standard views of both breasts were performed digitally with a lateral exaggerated right CC view and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Linear scar marker overlies the upper outer quadrant of the right breast. Stable surgical clips and post-surgical architectural distortion are present in the right breast upper outer quadrant. Benign intramammary lymph node in the posterior right breast is again noted. Scattered calcifications are present bilaterally and progressing in a benign fashion. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable right breast post-surgical changes. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Reason: eval for extension of known dissection History: left flank and upper quadrant pain in distribution of blood flow from known dissection location VASCULATURE: Redemonstration of a type B dissection extending from about the level of the left subclavian artery proximally to about the level of the renal arteries distally appearing similar in extent to the prior study. An intimal flap is noted with fenestration. The amount of flow seen in both lumens appear similar. The celiac axis arises from the true lumen. The superior mesenteric axis arises along the fenestration. The left renal artery arises from the true lumen, and the right renal artery arises from the false lumen. The inferior mesenteric artery, common iliac, external iliac, and common femoral arteries are patent.CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Please see vasculature section for description of type B dissection. Heart size is normal. No pericardial effusion or mediastinal adenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Type B aortic dissection with a fenestrated flap appearing similar to the prior study. No acute abnormalities to account for the patient's pain.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications and bilateral focal asymmetries are stable.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two sisters (diagnosed at the age of 54 and 61). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered calcifications have progressed in a benign fashion bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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47-year-old female with hip pain. Right hip: There is sclerosis, osteophyte formation, and medial joint space narrowing in the right hip, compatible with marked osteoarthritis.Pelvis: No fracture or malalignment is evident in the pelvis. Sacroiliac joints appear normal. Bilateral hip osteoarthritis, right greater than left.
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Bilateral hip osteoarthritis, right greater than left.
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Generate impression based on findings.
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Tachycardia, evaluate for pulmonary embolism PULMONARY ARTERIES: Exam limited by patient motion. Within this limitation there is no evidence of acute pulmonary embolism to the lobar pulmonary arterial distribution. The pulmonary artery is enlarged with mosaic perfusion abnormality suggestive of pulmonary arterial hypertension.LUNGS AND PLEURA: Small bilateral pleural effusions, left greater than right, with overlying compressive atelectasis.MEDIASTINUM AND HILA: No evidence of right heart strain. Heart size is normal.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.Limited examination without evidence of pulmonary embolism through the lobar pulmonary ateries. 2.Small pleural effusions.3.Findings consistent with pulmonary arterial hypertension, unchanged.PULMONARY EMBOLISM: PE: NoChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: No.
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Generate impression based on findings.
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53-year-old male with foot ulcer. Rule out osteomyelitis. Transmetatarsal amputation is noted. Soft tissue irregularity of the distal foot adjacent to the amputated first and second metatarsals is compatible with stated history of foot ulceration. The osteotomy lines are distinct. No underlying osteolysis is evident to suggest osteomyelitis. No evidence of acute fracture or malalignment.
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No evidence of osteomyelitis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister, diagnosed at the age of 39. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. There has been a symmetric increase in volume of both breasts.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Extensive susceptibility artifact is noted along the anterior aspect of the images, likely related to dental hardware. This limits evaluation of surrounding structures. The ventricles are within normal limits. The sulci are slightly prominent for patient's stated age which may indicate mild volume loss. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
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Mild nonspecific prominence of the sulci for patient's age which may relate to mild global volume loss. Otherwise, unremarkable contrast enhanced MRI of brain although evaluation somewhat limited due to extensive susceptibility artifact from dental hardware.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Focal asymmetries are present in each medial breast. No suspicious microcalcifications or areas of architectural distortion are present.
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Bilateral focal asymmetries. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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17 year-old female with ankle pain, evaluate for fractureVIEWS: Left ankle AP/oblique/lateral, right knee AP/oblique/lateral, pelvis AP/frog (8 views) 01/23/15 No acute fracture or malalignment is evident. Phleboliths are incidentally noted in the left hemipelvis.
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Normal examination.
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Generate impression based on findings.
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A patient submitted outside study for review. Submitted for review are digital mammographic images (12/30/14) and ultrasound images of left breast (12/30/14) performed at High Tech Medica Park. digital mammographic images (12/30/14):The breast parenchyma is heterogeneously dense, which limits the sensitivity of the mammogram. No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in either breast. ULTRASOUND IMAGES OF LEFT BREAST (12/30/14):Following lesions are detected;1. A round hypo/anechoic lesion measuring 4 x 4 x 4 mm at 12 o'clock position, 2-3 cm from the nipple2. An oval hypo/anechoic lesion measuring 4 x 3 x 5 mm at 2 o'clock position, 5-6 cm from the nipple3. An oval hypoechoic lesion measuring 7 x 4 x 7 mm at 2 o'clock position, 2-3 cm from the nipple4. A round hypo/anechoic lesion measuring 5 x 3 x 5 mm at 3 o'clock position, 3-4 cm from the nippleAll lesions are benign appearing, likey to be cysts.
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No mammographic evidence of malignancy. Ultrasound detected 4 benign appearing masses in left breast, likely cysts. Follow up ultrasound in 6 moths is recommended.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months).
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Generate impression based on findings.
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Malignant neoplasm of the stomach, unspecified site. CHEST:LUNGS AND PLEURA: Stable large right pleural effusion and associated right middle lobe atelectasis. Motion artifact.MEDIASTINUM AND HILA: No significant abnormality noted. Multiple small thyroid nodules. Subcentimeter lymph node adjacent to the great vessels (image 18; series 3) is unchanged and can be followed. Ascending aorta measures 3.9 cm in diameter, unchangedCHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Index hepatic/perihepatic hypodense lesion in the left lobe of the liver measures 1.4 x 0.8 cm (image 80; series 3), stable. Perihepatic ascites, stable. Other subcentimeter hypodense lesions in the liver are stable.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Index left paraortic lymph node measures 7-mm in diameter (image 95; series 3), stable.BOWEL, MESENTERY: Again noted diffuse wall thickening of the entire stomach with moderate amount of distention.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No substantial interval change in the ill-defined, infiltrative pelvic mass extending to both adnexa and invading the uterus. Reference left adnexal component of the mass measures 12 x 9.5 cm (image 159; series 3), stable. Right adnexal component measures 7.8 x 5.4 cm (image 175; series 3), stable.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Unchanged pelvic mass. Stable right pleural effusion with associated atelectasis. No significant change in the gastric wall thickening, ascites and hepatic lesions.
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Generate impression based on findings.
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57-year-old female with ankle pain status post fall. Evaluate for fracture. There is medial soft tissue swelling about the ankle. Degenerative changes are noted. Vascular calcifications are present. No evidence of fracture or malalignment in the right ankle.
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Soft tissue swelling without evidence of fracture or malalignment.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of right cyst aspiration. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable bilobed mass in the inferior right breast, which has previously been documented to be a cyst via ultrasound. Scattered benign calcifications, including arterial, are seen bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views, additional bilateral MLO views, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Ovoid, partially obscured mass present in the left upper outer breast. Possible additional adjacent mass anterior to the main lesion. No suspicious masses, microcalcifications or areas of architectural distortion are present in the right breast. Scattered benign calcifications are seen bilaterally.
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Partially obscured ovoid mass in the left upper outer breast. Additional imaging, including spot compression views and possible ultrasound, is recommended for further evaluation. Additionally, an attempt to obtain patient's prior mammogram should be made.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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44-year-old male with abdominal pain. History of drainage of pancreatic fluid collection. Prior Fry procedure. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is mild heterogeneity in the posterior right lobe of the liver, likely unchanged from the prior exam, which may represent flow abnormality. There is now complete thrombosis of the portal vein and its branches with nonocclusive thrombus in the superior mesenteric vein. There is cavernous transformation of the portal vein.SPLEEN: Splenomegaly without focal abnormality is unchanged.PANCREAS: Calcifications consistent with chronic pancreatitis. Multiple clips obscure portions of the region of the pancreatic head. Postoperative changes as previously noted without change.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst identified. Mild, focal parenchymal loss lower pole of the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is borderline to mild, and relatively diffuse small bowel dilatation with some degree of fold thickening. There are less distended loops of small bowel identified in the ileum where there also appears to be perhaps mild wall thickening. The appearance is not specific but could be inflammatory/infectious in nature, and less likely ischemic.BONES, SOFT TISSUES: No significant abnormality notedOTHER: There is moderate abdominal and pelvic ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is borderline to mild, and relatively diffuse small bowel dilatation with some degree of fold thickening. There are less distended loops of small bowel identified in the ileum where there also appears to be perhaps mild wall thickening. The appearance is not specific but could be inflammatory/infectious in nature, and less likely ischemic.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate abdominal and pelvic ascites.
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1. Complete portal venous thrombus with cavernous transformation. 2. Diffuse ascites.3. Borderline to mild small bowel dilatation with fold thickening particularly in the ileum as noted above4. Stable splenomegaly.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of two benign left breast biopsies. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications and stable focal asymmetries are seen bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Neoplasm of uncertain behavior in the stomach, intestines and rectum. Assess extent of disease with peritoneal carcinomatosis and ascites. CHEST:LUNGS AND PLEURA: Scattered micronodules can be followed. These are too small to measure currently.MEDIASTINUM AND HILA: Thyroid nodules. No significant adenopathy in the mediastinum.CHEST WALL: Right internal jugular vein chest port.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted. Presumed splenule (image 71; series 3) should be followed.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: 12-mm right adrenal nodule can be followed (image 73; series 3)KIDNEYS, URETERS: Probable left renal cysts.RETROPERITONEUM, LYMPH NODES: Small mesenteric lymph nodes mostly at the base of the mesentery.BOWEL, MESENTERY: Moderate ascites with areas of ill-defined calcification, presumably representing known carcinomatosis (image 144; series 3; right lower quadrant); no discrete measurable lesions are identified.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate pelvic ascites.
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Ascites and presumed carcinomatosis with no measurable disease. Right adrenal nodule.
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Generate impression based on findings.
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Evaluate lung nodules seen on prior CT, dyspnea LUNGS AND PLEURA: Increasing spiculated nodule in the left lower lobe measures 18 x 11 mm (series 4, image 52), previously 12 x 7 mm. Additional bilateral pulmonary nodules previously measured appear stable or smaller as follows:1. Posterior left upper lobe nodule measures 6 mm (series 4, image 35), previously 6 mm.2. Inferior left upper lobe nodule measures 5 x 5 mm (series 4, image 42), previously 9 x 8 mm. No3. Posterior right upper lobe nodule measures 9 x 5 mm (series 4, image 33), previously 10 x 7 mm.There are multiple new left upper lobe pulmonary nodules measuring up to 8 mm at the left apex.Severe emphysema.MEDIASTINUM AND HILA: No lymphadenopathy. Mild coronary artery calcifications. Heart size is normal. Aberrant right subclavian artery.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Increasing left lower lobe nodule with several new left upper lobe nodules on a background of stable to decreasing bilateral upper lobe pulmonary nodules. The morphology of the left lower lobe nodule and left apical nodule are suspicious for primary lung cancers. The additional nodules may may represent inflammatory lesions. The fact that they are decreasing in size in the absence of treatment for underlying malignancy makes metastatic disease much less likely.
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Generate impression based on findings.
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High probability benign focal asymmetry in the right posterior lower outer quadrant. Short-term follow-up. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The focal asymmetry in the right posterior outer breast is unchanged. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually, which would resume in July 2015. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views (total of 7 images) and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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NSCLC status post hyperfractionated RT two years prior. Assess for recurrence. CHEST:LUNGS AND PLEURA: Centrilobular and paraseptal emphysema. No pleural fluid or pneumothorax. No new or suspicious nodules or masses.Post therapeutic changes in the right upper lobe consistent with history of radiation therapy, measuring 2.3-cm at the reference level, previously 2.4-cm (4/27).MEDIASTINUM AND HILA: Thyroid gland is enlarged and contains multiple nodules, consistent with goiter. Small calcified and partially calcified mediastinal lymph nodes appear unchanged. Main pulmonary artery enlarged, unchanged. Atherosclerotic calcification of the thoracic aorta and its branches, including the coronary arteries. Leadless pacemaker implant in the anterior right ventricle.CHEST WALL: Heterogeneous mineralization the skeleton, appearing mixed lytic/sclerotic, unchanged. Sclerotic lesion in T11 unchanged.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Granulomas.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Kidneys appear atrophic. Nonspecific hyperattenuating cortical lesions incompletely characterized.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Calcification abutting the lateral wall of the stomach unchanged.BONES, SOFT TISSUES: Heterogeneous mineralization pattern.OTHER: No significant abnormality noted.
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Stable post therapeutic appearance of right upper lobe reference area. No signs of recurrent or metastatic disease. Abnormal skeletal mineralization pattern chronic and unchanged
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. Family history of breast cancer in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Biopsy clip is present in the left upper outer breast, at site of prior benign biopsy. Scattered benign calcifications are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Reason: r/o abscess, SBO, hx of uterine CA History: abd pain, N/V/D, gap acidosis Evaluation of solid organ pathology is limited by the lack of IV contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral percutaneous nephrostomy tubes in place. Focus of air in the collecting systems likely postprocedural.RETROPERITONEUM, LYMPH NODES: Infrarenal IVC filter in place. Retroperitoneal lymphadenopathy increased since the prior study, with reference left periaortic lymph node measuring 2.0 x 1.8 cm (series 3 image 57) previously 2.0 x 1.3 cm.BOWEL, MESENTERY: As belowBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomyBLADDER: As belowLYMPH NODES: Increased pelvic lymphadenopathy. Left obturator lymph nodes measure 3.8 x 1.7 cm (series 3 image 103).BOWEL, MESENTERY: Marked interval increase in size of ill-defined pelvic soft tissue mass, which is now indistinguishable from both the bladder and the sigmoid colon highly suspicious for tumor invasion. Bubbly foci of gas within this infiltrative mass may represent stool, air in the urinary bladder, fistulous connections, or possibly infection in the appropriate context. The percutaneous nephrostomy tubes terminate in the region of this conglomerate mass as well.BONES, SOFT TISSUES: Degenerative changes affect the thoracolumbar spine. No suspicious osseous lesions.OTHER: No significant abnormality noted
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1.Marked interval increase in size of ill-defined pelvic mass, evaluation of which is limited without IV contrast, now with invasion of the colon and bladder as described above. 2.Increased pelvic and retroperitoneal lymphadenopathy.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother, diagnosed at the age of 42. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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77 year old with history of benign right breast biopsy (04/14) presents for follow up exam. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A cluster of calcifications is again seen at 9 o'clock position in the right breast with a marker clip. There have been no significant changes with these calcifications. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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38-year-old male with right anterior hip pain, pain with right hip abduction. For avascular necrosis. The femoral heads are regularly shaped and normally seated within the acetabula bilaterally without evidence of avascular necrosis. No significant degenerative changes of the hip or sacroiliac joints are present. No fracture or malalignment in the pelvis.
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No evidence of avascular necrosis.
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Generate impression based on findings.
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The colon is adequately cleansed of stool. There is a small amount of residual fluid which is well type of oral contrast. Prone view is well distended probably due to rapid manual insufflation of room air despite the poor rectal tone. The supine view is somewhat suboptimally distended. Comparison the views from this exam on the prior exam provided diagnostic study.In the distal rectosigmoid there is a short segment of narrowing abutting the left aspect of the uterus without evidence of significant wall thickening most likely representing an benign stricture. There is no pericolonic fat stranding or shelf to suggest mass. Some diverticula are seen in the region.The remainder of the colon is adequately distended and shows no evidence of polyps or masses. Note: CT colonography is not intended for the detection of diminutive colonic polyps (i.e., tiny polyps < 5 mm), the presence or absence of which will not change management of the patient.EXTRACOLONIC
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Short segment stricture distal sigmoid colon strongly benign stricture. No significant size polyps masses anywhere else in the colon.Short segment, non obstructive ileal thickening near terminal ielum.As noted previously the adrenal gland lesion nonspecific although statistically likely benign. Recommend routine 5-year follow-up exam for colorectal cancer screening. At that time I suggest noting recommendation for supplemental manual room air insufflation and use of 80 mAs technique.*OPTIONAL C-RADS CLASSIFICATION:C-1E-3*(see full definitions in: Zalis et al. CT Colonography reporting and data system: a consensus proposal. Radiology 2005;236:3-9)C1: Normal or benign lesions (no polyps > 6mm). Continue routine screening.C2: Intermediate polyp (less than three 6-9mm polyps or can't exclude >6mm in technically adequate study. Surveillance CTC or colonoscopy recommended.C3: Polyp, possibly advanced adenoma. (polyp >10mm or >three 6-9mm). Colonoscopy recommended.C4: Colonic mass, likely malignant.
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Generate impression based on findings.
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66-year-old male with spinal fusion. Bilateral rods and pedicular screws are present at L4-L5, as well as a L4-5 intervertebral spacer device without evidence of hardware complication. Alignment, intervertebral disk spaces, and vertebral body heights are maintained. No evidence of fracture or malalignment in the lumbar spine. Vascular calcifications are noted in the abdomen.
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Lumbar orthopedic hardware as above without evidence of hardware complication.
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Generate impression based on findings.
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Non-small cell lung cancer. Pre-chemo. CHEST:LUNGS AND PLEURA: Large loculated right pleural fluid collection with an enhancing rind which now appears nodular in the costophrenic angle (3/100). Volume of pleural fluid has increased in the interim.Suture line consistent with previous wedge resection along the inferomedial margin of the now heterogeneously consolidated right lung.Index right lower lobe nodule is now centrally necrotic. The now masslike lesion contained within consolidated lung measures 3 x 2.9 cm while the necrotic portion of the lesion measures 12 x 18 mm (3/54, 3/56). Numerous additional nodules are no longer distinguishable from the now consolidated adjacent lung. Scattered micronodules in the left lung too small to characterize however the largest lesion in the upper lobe appears decreased in size, 5-mm previously, currently 3-mm (4/38).MEDIASTINUM AND HILA: Rightward mediastinal shift. The large airways of the right lung are smoothly thickened. Mild mass effect upon the right mediastinum by adjacent consolidation/tumor though vascular structures are grossly patent. Numerous small enhancing lymph nodes throughout the mediastinum bilaterally, some of which are new or larger, though they remain less than 1 cm in size. For example, a left hilar lymph node has increased from 6 to 9-mm (3/44).CHEST WALL: Small subcentimeter right internal mammary and cardiophrenic lymph nodes are new. Right subpectoral lymph node enlargement is new, for example a 13-mm lymph node is seen on series 3 image 32.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes, a least one of which has increased in size but remains less than 1 cm in short axis (3/124), an aortocaval lymph node measuring 7 mm, previously 3-mm.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Thickening of the gastric antrum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Interval worsening of consolidation throughout the right lung, enlargement of right pleural fluid collection and small but enlarging lymph nodes. Reference lesion provided in the body of the report.
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Generate impression based on findings.
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27-year-old female status post finger injury (slammed in door), evaluate for fracture. Mild soft tissue swelling about thumb without evidence of underlying fracture or malalignment.
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Mild soft tissue swelling without fracture.
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Generate impression based on findings.
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Reason: perihepatic bleeding History: R flank pain, ablation for perihepatic hematoma 1/14 ABDOMEN:LUNG BASES: Basilar subsegmental atelectasis/scarring.LIVER, BILIARY TRACT: Postprocedural changes of radiofrequency ablation of the previously described segment 6/7 hypoattenuating lesion, with hypoattenuation extending linearly along the ablation tract through the right hepatic lobe. There is no evidence of acute hemorrhage. A wedge-shaped area of low attenuation in the right hepatic lobe has continued to decrease in size, with stable foci of increased attenuation peripherally on series 3 image 20. A hypoattenuating focus adjacent to the hepatic veins also appears unchanged on series 3 image 18. There is a small amount of perihepatic ascites without evidence of perihepatic hematoma. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Postprocedural changes of radiofrequency ablation as described above without evidence of acute hemorrhage.
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Generate impression based on findings.
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Reason: follow up lymphadenopathy, s/p bronch which was negative History: none LUNGS AND PLEURA: Scattered small scarlike opacities without significant interval change.Mild bronchial wall thickening.No suspicious nodules and no pleural effusions.MEDIASTINUM AND HILA: Moderately enlarged mediastinal lymph nodes, particularly in the lower paratracheal areas, unchanged from previous scans.Moderate coronary artery calcification.No pericardial effusion.CHEST WALL: Degenerative disease in the spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Moderate nonspecific mediastinal lymphadenopathy, unchanged since 6/19/2013. This degree of stability is consistent with a benign etiology such as sarcoidosis, and no further CT follow-up is recommended for this finding in the absence of change in the patient's clinical status.
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Generate impression based on findings.
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33-year-old male with lumbar pain. Alignment, vertebral body heights, and intervertebral disk spaces are maintained. No evidence of fracture or malalignment in the lumbar spine.
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No findings to account for lumbar pain.
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Generate impression based on findings.
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Female, 40 years old.Laps in the abdomen during surgery, counts correct. Surgical drain overlies right abdomen. Enteric tube tip overlies gastric antrum. Scattered surgical clips. Surgical clamps overlying right femur is outside of the patient. No unexpected RFO.
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No unexpected RFO. Findings discussed with Dr. Millis p8217 at 11:41 AM 1/23/2015
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Generate impression based on findings.
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70 year old male. Recurrent prostate cancer with rising PSA. CHEST:LUNGS AND PLEURA: Equivocal interval enlargement of right lower lobe pulmonary nodule which measures 1.0 x 1.0 cm (image 78; series 5). A second subpleural nodule in the right upper lobe (image 25; series 5) appears stable compared to prior chest CT of 10/31/2014 and measures 2.4 x 1.0 cm. No additional new or suspicious pulmonary nodules.MEDIASTINUM AND HILA: Presumed adenopathy (versus a subpleural mass) anterior to the right pulmonary artery at the right hilum measures 3.5 x 1.7 cm (image 44; series 3). This previously measured less than 1 cm in diameter on the study dated 6/20/2014 and was indistinguishable from the mediastinum on the prior unenhanced chest CT. Trace pericardial effusion. Hiatal hernia.CHEST WALL: Severe left glenohumeral osteoarthritis.ABDOMEN:LIVER, BILIARY TRACT: No focal parenchymal lesion. Cholelithiasis without CT evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Unchanged chronic severe right hydro-nephrosis/hydroureter. Mild prominence of the left renal collecting system is also unchanged. Status post cystoprostatectomy with ileal conduit formation.RETROPERITONEUM, LYMPH NODES: Scattered mildly prominent retroperitoneal lymph nodes.BOWEL, MESENTERY: New soft tissue implants near the ostomy site interposed between bowel loops measures 2.6 x 1.9 cm (image 125; series 3) and presumably represents a metastasis. A second, smaller implant is also noted inferiorly (image 136). Surgical changes from ileal conduit formation.BONES, SOFT TISSUES: Multilevel degenerative changes within the spine. No suspicious focal osseous lesion.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy. Penile prosthesis is partially visualized. Device reservoir within the left pelvis.BLADDER: Status post cystectomy.LYMPH NODES: Surgical clips from pelvic lymph node dissection. No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Post surgical changes from right acetabuloplasty. No suspicious focal osseous lesion.OTHER: No significant abnormality noted
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Interval progression of disease in both the chest and abdomen with reference measurements given above.
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Generate impression based on findings.
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Male 44 years old with history of neutropenia CHEST:LUNGS AND PLEURA: Scattered, bilateral micronodules, unchanged.MEDIASTINUM AND HILA: Punctate thrombus in the SVC. Interval removal of the previous porch.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Previously described subcentimeter hypodense lesion in the left lobe of the liver is no longer visualized.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephrolithiasis without evidence of hydronephrosis. Bilateral small cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Significant interval increase in the right inguinal soft tissue mass, which now measures 5.2 x 2.4 cm image number 189, series number 3. This mass compresses and possibly invades the right external iliac vein.Complicated fluid collection within the right scrotum. Further evaluation with scrotal ultrasound is recommended.OTHER: No significant abnormality noted
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Significant interval increase in the size of the right inguinal soft tissue mass now encasing and possibly invading the right external iliac vein.Scrotal ultrasound is recommended for further evaluation of the right scrotum.Interval removal of the port. Punctate thrombus in the SVC.Right nephrolithiasis without evidence of hydronephrosis.
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Generate impression based on findings.
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Male 34 years old Reason: kidney stones History: stones ABDOMEN:LUNG BASES: Subcentimeter bilateral lower lobe nodules are unchanged.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple nonobstructing left renal calculus. There is a 3 mm stone at the right renal pelvis. Mild caliectasis involving the right renal collecting system.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild wall thickening of the entire colon with submucosal fat deposition. This maybe secondary to ulcerative colitis. Clinical correlation is recommended.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Left nonobstructing renal calculi.Single stone in the right renal pelvis causing mild right renal caliectasis.Diffuse wall thickening of the colon with submucosal fat deposition. These findings are suspicious for ulcerative colitis. Clinical correlation is recommended.
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Generate impression based on findings.
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Reason: h/o nasopharyngeal ca - thin cuts through the nasopharynx/base of skull/orbits, s/p induction chemo, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: No sign of pulmonary or pleural metastases.Mild basilar bronchiectasis is seen, without bronchial wall thickening. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen.The esophagus is patulous, unknown etiology.Moderate coronary artery calcifications are present.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable small benign-appearing cystlike hypodensities, as well as a hemangioma verified by MRI.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Subtle adrenal nodularity is unchanged.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. No evidence metastases or other significant abnormality.2. The esophagus is patulous, which can be a cause of reflux esophagitis.
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Generate impression based on findings.
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59 year old who had been called back on screening mammogram performed on March 2013. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A small circumscribed mass at left upper outer quadrant is unchanged, consistent with intramammary lymph nodes. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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Female 27 years old Reason: fever , tachycardia History: as above ABDOMEN:LUNG BASES: Bilateral small pleural effusions and dependent atelectasis, new from previous CT.LIVER, BILIARY TRACT: Hepatomegaly, unchanged.SPLEEN: Splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Bilateral physiologic cysts in the ovaries.BLADDER: No significant abnormality notedLYMPH NODES: Probably reactive bilateral inguinal adenopathy.BOWEL, MESENTERY: Rectum is dilated. There is a fistulous communication extending from the posterior rectum to the perianal region. There is bilateral perianal fistula tracts and collections containing oral contrast. These are incompletely imaged. Right-sided collection measures 3.2 x 2 cm on image number 151. These collections are significantly smaller compared to previous study.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Chest CT portion of the study will be dictated separately. Interval development of bilateral pleural effusions and dependent atelectasis.Patient's known perianal collections have decreased in size within the interval. These collections are incompletely imaged. Perianal fistula tract is again noted.
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Generate impression based on findings.
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Male 82 years old Reason: evaluate for disease progression, hx of metatstatic prostate cancer with rising PSA level on lupron History: bone pain CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter lesion in the segment 4 is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: Interval decrease in the size of the previously described right retrocrural node. This node now measures 1 x 0.8 cm on image number 92, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerosis vertebral body with mild compression fracture compatible with metastatic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: Significantly distended bladder.LYMPH NODES: Internal iliac node is significantly smaller measuring 7 x 6 mm image number 161, series number 3. Index right inguinal lymph node measures 2.2 x 1.8 cm on image number 198 on series number 3, not significantly changed compared to previous study.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Subcentimeter sclerotic lesion in left iliac wing is unchanged.OTHER: No significant abnormality noted
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Interval decrease in the size of the most of the index lymph nodes. T12 vertebral body metastatic lesion appears more sclerotic on today's study.
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Generate impression based on findings.
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Reason: RUL cavitary lesion History: cough. LUNGS AND PLEURA: A right upper lobe thickwalled cavity has resolved with interval obliteration of the cavity, with a residual masslike lesion measuring 14 x 43 mm, corresponding to the collapsed walls of the previous cavitary lesion, with a small internal focus of calcification.A solid left upper lobe subpleural nodule is unchanged, compatible with a granuloma.Severe paraseptal and centrilobular emphysema, mainly in the upper lobes.Micronodules and focal scars also unchanged.MEDIASTINUM AND HILA: No significant lymphadenopathy.Moderate coronary artery calcifications.Large sliding hiatal hernia.CHEST WALL: Degenerative disease in the spine and healed seventh left rib fracture.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Interval resolution of a right upper lobe cavity, with a residual soft tissue mass, most consistent with resolving granulomatous infection, but continued follow-up is recommended.
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Generate impression based on findings.
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Female 68 years old Reason: restaging cholangiocarcinoma after 3 months of therapy History: persistent hyperbilirubinemia CHEST:LUNGS AND PLEURA: Interstitial reticular thickening unchanged.MEDIASTINUM AND HILA: Left supraclavicular index lymph node measures 10 by 8 mm on image number 8, series number 13, not significantly changed from previous study. Index AP window node now measures 10 by 8 mm on image number 27, series number 13, not significantly changed from previous study.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Again noted significant intrahepatic biliary dilatation despite two metallic stents. Previously measured index mass now measures 2.5 x 2.5 cm on image number 94, series number 13, slightly smaller compared to previous study. There is also an infiltrative mass in the right lobe of the liver, grossly unchanged compared to previous study.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral small renal hypodense lesions are unchanged.RETROPERITONEUM, LYMPH NODES: Index periportal lymph node is stable measuring 1.7 by 1 cm image number 101, series number 13.Stable index aortocaval lymph node measures 1.4 x 0.6 cm image number 105, series number 13. Index para-aortic node measures 1.3 x 1 cm, not significant changed from previous study, best seen on image number 96, series number 13.BOWEL, MESENTERY: Interval development of peritoneal fat stranding , most prominent being adjacent to the descending colon. This may represent ascites, however, peritoneal carcinomatosis cannot be excluded.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of new ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Slight interval decrease in the size of the patient's known common bile duct mass. Index lymph nodes are grossly stable. Significant biliary dilatation persists despite interval placement of metallic stents.Interval development of peritoneal fat stranding , most prominent being adjacent to the descending colon. This may represent ascites, however, peritoneal carcinomatosis cannot be excluded.
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Generate impression based on findings.
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Reason: CVA History: CVA The CSF spaces are appropriate for the patient's stated age with no midline shift. A small hypodense focus is present in the right basal ganglia which was present on the prior exam likely represent an old lacunar infarct.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular and subcortical white matter hypodensities of a moderate degree are present. Compared to the prior exam subcortical hypodensities adjacent to the right middle frontal gyrus have mildly progressedThe visualized portions of the paranasal sinuses demonstrate a small air-fluid level in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact..Incidental note is made of partial empty sella.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. Atherosclerotic calcifications have progressed since the prior exam.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of nonhemorrhagic CVA.3.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. These have mildly progressed since the prior exam4.old right basal ganglia lacunar infarct
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Generate impression based on findings.
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Pain Shoulder: Improved alignment of the AC joint, interval correction of suspected dislocation. Diffuse remodeling of the clavicular head is again observed without evidence of interval change or distinct fracture. Mild degenerative changes of the shoulder otherwise identified without evidence of interval new lesions. Shoulder alignment is otherwise preservedClavicle: No additional clavicular abnormality
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Realignment of the acromioclavicular joint
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Generate impression based on findings.
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Reason: R/o stroke. Pt w/ cognitive changes, no other frank focal deficits. Possible septic emboli on CT History: Cognitive changes The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate some mucosal thickening in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.There is a 22 x 12 mm actual dimension cystic lesion in the velum interpositum compared unchanged when compared to the prior examAtherosclerotic calcifications are present along the distal internal carotid arteries.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of nonhemorrhagic CVA3.stable velum interpositum cyst.
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Generate impression based on findings.
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Possible elbow fracture. Trauma to left arm and wrist Wrist: Spelled prior distal wrist fixation without evidence of complication or change in alignment. Fracture planes remain relatively distinct and correlation with prior outside imaging if available would be helpful. Ulnar styloid fractureForearm: Minimal heterotopic bone observed along the volar aspect of the distal radius. No additional radiographic abnormalitiesElbow: Questionable minimal stranding in the soft tissues and swelling without additional underlying osseous abnormality. No effusions
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Questionable soft tissue swelling an old repaired ORIF of the distal radius with underlying comminuted intra-articular fracture
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Generate impression based on findings.
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Pain Redemonstration of a fragmented and collapsed femoral head with superior migration of the entire femur. Fracture fragments remain within the acetabular fossa and specifically the femoral neck and fragments are close to abutting the superior lateral rim of the acetabulum. No change in alignment when compared to prior plain films. Soft tissues are unremarkable. No appreciable abnormality within the partially visualized lower pelvis.
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Extensive AVN with fragmentation of the right femoral head
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Generate impression based on findings.
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Male 73 years old Reason: 73 yo male with borderline resectable pancreatic cancer s/p chemo/RT please evaluate for extent of disease and vessel involvement with pancreatic protocol History: pancreatic cancer ABDOMEN:LUNG BASES: Thrombus in the left ventricular apex, again noted without a significant change.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Patient's known primary tumor of the pancreas now measures 2.6 x 2.9 cm on image number 53, series number 11, slightly smaller compared to previous study. About 90 degree abutment of the superior mesenteric vein is again noted. No evidence of occlusion of the veins. No evidence of arterial involvement other than the gastroduodenal artery. This is unchanged from previous study.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Slight interval decrease in the size of the pancreatic head mass, otherwise no significant change from previous study.
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Generate impression based on findings.
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Male 54 years old Reason: Concern for sacral fluid collection/abscess. Area of sacrum is indurated and warm History: Fever, warm skin, indurated There is diffuse edema of the skin and subcutaneous tissues on the right side of the sacrum where the skin is indurated and warm. No definite collection suspicious for abscess.
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Diffuse edema of the skin and subcutaneous tissues suggestive of cellulitis without evidence of abscess.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother, diagnosed at the age of 73. Personal history of benign breast biopsy. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally. Ovoid benign morphology fat-containing mass in the right retroareolar breast has an appearance compatible with a hamartoma.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect subtle changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 2 - Benign finding.RECOMMENDATION: NSD - Screening Mammogram.
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Generate impression based on findings.
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Male 64 years old Reason: HCV cirrhosis with prior bleeding History: HCV cirrhosis LIMITED ABDOMENLIVER: Liver is enlarged and cirrhotic with coarse echotexture. There is a 3.4 x 3 cm hypoechoic, ill-defined mass in the right lobe of the liver suspicious for hepatocellular carcinoma.BILIARY TRACT: Cholelithiasis without evidence of intro or extrahepatic biliary dilatation.PANCREAS: Not well-visualized due to overlying bowel gas.SPLEEN: Spleen is enlarged measuring 14 cm. RIGHT KIDNEY: Bilateral slightly echogenic kidneys.OTHER: No significant abnormalities noted.
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Cirrhosis and portal hypertension. Focal liver mass suspicious for hepatocellular carcinoma. Portal venous thrombus. MRI is recommended for further evaluation.Dr. Reau was notified and acknowledged about the above findings at the time of dictation.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Bilateral focal asymmetries and bilateral incompletely characterized calcifications are identified.
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Bilateral focal asymmetries and incompletely characterized calcifications are identified. An attempt should be made to obtain prior mammograms for comparison purposes to confirm stability of these findings. If not possible, then additional imaging is recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison.
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Generate impression based on findings.
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Pain following fall playing football Small benign-appearing cyst in the lunate aspect of the triquetrum without evidence of a line abnormality. Remainder the wrist is otherwise unremarkable. No malalignment or new abnormality observed on deviation views given positioning. Specifically no evidence of a fracture.
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Small benign appearing cyst without evidence of an acute abnormality such as fracture.
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Generate impression based on findings.
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Female 75 years old Reason: r/o pancreatic mass History: none ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: There is a 2.2 x 0.9 cm cystic lesion in the uncinate process of the pancreas communicating with the pancreatic duct and likely representing a branch type I PMN. Pancreatic duct is normal in size. No definite solid component of this lesion.ADRENAL GLANDS: Nodular left adrenal gland.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Cystic lesion in the pons may process of the pancreas likely representing a branch type I PMN. Follow-up MRI in one year may be helpful. Cholelithiasis.Nonspecific nodular thickening of the left adrenal gland.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Focal asymmetry in the central right breast is stable.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Right shoulder fracture Minimally impacted and largely unchanged alignment of a comminuted right humeral head fracture and fracture distinctly extending through the tuberosity. Mild interval healingModerate osteoarthritic changes
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Mild continued interval healing of a comminuted right humeral head fracture without interval change in alignment
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Generate impression based on findings.
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Male 57 years old Reason: prostate ca History: ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Again noted focal sclerosis of the left posterior aspect of the L1 vertebral body and posterior elements of the L1 vertebral body. Sclerosis of the spinous process of T9 vertebral body is also noted. No significant change.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Please see discussion aboveOTHER: No significant abnormality noted
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No significant change in the CT appearance of the sclerotic spine lesions as described above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign intramammary lymph node identified in the right upper outer breast. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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