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Generate impression based on findings.
28 year old female. Septic, bilateral low abdominal pain, right greater than left. Evaluate for PID, appendicitis, colitis. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The right kidney enhances inhomogeneously with several focal wedge-shaped hypoattenuating areas extending to the periphery. Findings likely represent pyelonephritis with early phlegmon formation. No hydronephrosis or obvious renal calculi. No significant abnormality the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Foley catheter is noted in a distended bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Findings suggestive of right-sided pyelonephritis with phlegmon formation.
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CVA. There is no intracranial mass, hemorrhage, edema or hydrocephalus. There is focal prominence of CSF space along the left frontal convexity without scalloping of the overlying frontal bone most likely representing a prominent sulcus. The left insular ribbon is somewhat indistinct on this exam, although note is made of a normal appearance on subsequent MRI exam. The midline is intact. The partial opacification of the inferior left mastoid air cells. Orbits and paranasal sinuses are unremarkable.
No acute intracranial abnormality demonstrated on unenhanced CT. If there is persistent concern regarding acute ischemia, MRI could be considered.
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63 year old male. Reason: Assess for cause of ileus such as fluid collection or for mechanical bowel obstruction, s/p cystectomy/neobladder. History: Nausea, vomiting, distention ABDOMEN:LUNG BASES: Coronary artery calcifications. LIVER, BILIARY TRACT: Numerous hepatic cysts. Calcified hepatic granulomata. SPLEEN: Calcified splenic granulomata. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Air in both renal collecting systems / pelves. Bilateral percutaneous small diameter ureteral stents, one extends from the right distal ureter and another from the left proximal ureter. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel obstruction with transition point near the anastomosis in the right pelvis. Numerous fluid filled proximal loops are dilated. Transition is in the distal ileum. NG tube tip in the gastric body. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy. BLADDER: Status post cystoprostatectomy. Foley catheter in a decompressed neobladder. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colon and rectum are decompressed by small bowel obstruction. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Surgical drains in pelvis exit in both lower quadrants. Midline surgical skin staples. Left fat-containing umbilical hernia.
Small bowel obstruction at or near the anastomosis in the pelvis, right lower quadrant. Post-op changes of cystoprostatectomy and neobladder formation.
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Vertigo, left-sided numbness, weakness. Possible posterior circulation stroke Unenhanced head: There is focal prominence of CSF density along the left frontal lobe convexity without adjacent bony scalloping likely representing prominent sulcus or arachnoid cyst. There are a few areas of hypoattenuation within the periventricular/subcortical white matter most likely representing sequela of age indeterminate small vessel ischemic disease. There is no intracranial mass, hemorrhage, edema or hydrocephalus. The midline is intact. Bones and paranasal sinuses are unremarkable. There scattered opacification of the more inferior left mastoid air cells. Orbits and extracranial soft tissues are unremarkable.CT angiogram neck: There is a normal 3 vessel arch. There is intraluminal hypodensity most likely representing eccentric plaque at the left subclavian/axillary artery junction with mild narrowing. There is an eccentric atherosclerotic plaque which is partially calcified along the medial wall of the mid left common carotid. There is no significant stenosis at the carotid bifurcations according to NASCET criteria. Note is made of irregularity and calcification within the distal cavernous and supraclinoid ICAs bilaterally. There is a right dominant posterior circulation with no aneurysm or steno-occlusive lesion demonstrated along the extracranial portions of vertebral arteries bilaterally.CT angiogram head: There is irregularity and atherosclerotic plaque associated with the distal ICAs. MCAs and ACAs are normal bilaterally including a patent anterior communicating artery. There is no aneurysm or steno-occlusive lesion. There is a focus of irregularity and mild narrowing associated with focal calcification in the V4 segment of the right (dominant) vertebral artery. The distal left vertebral artery is congenitally diminutive. The basilar artery is normal with a normal pattern of branching. PCAs are patent bilaterally without steno-occlusive lesion or aneurysm. There is a questionable small right posterior communicating artery without a visualized left PCOM.Incidental findings: Heterogeneous attenuation including at least one focal nodule within the right thyroid. This could be assessed sonographically if clinically indicated. There is ill-defined sclerosis anteriorly at the right mandibular angle most likely representing osteitis condensans.
1.Hypoattenuating lesion likely representing plaque at the left subclavian/axillary arterial junction with mild narrowing.2.Irregular partially calcified plaque along the proximal aspect of the left common carotid artery.3.No significant stenosis at the carotid bifurcation by NASCET criteria.4.Right-dominant posterior circulation with irregular calcification along the distal right vertebral artery.5.Calcification and irregularity of the cavernous/supraclinoid ICAs bilaterally.6.No intracranial steno-occlusive lesion or aneurysm.Incidental note of heterogeneous thyroid with probable focal lesion. Correlation with thyroid function tests is recommended and thyroid ultrasound may be obtained as clinically indicated.
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60 year old female. Reason: 60yoF with ICM and CAD presents with 10/10 sharp left-sided chest pain for 10 hours, possible STEMI on EKG in ED, cardiac cath negative for lesions, CEs neg x 3, possible drug use. Please rule out aortic dissection. CHEST:LUNGS AND PLEURA: Bibasilar atelectasis/scarring noted. No pleural effusions.Several, noncalcified, pulmonary micronodules are again noted and are unchanged from prior examination. Previously measured lingula nodule (image 49 series 10) continues to measure 4 mm.MEDIASTINUM AND HILA: No lymphadenopathy. No pericardial effusion. Severe coronary artery calcifications. Left ventricular enlargement with marked thinning of the left ventricular free wall. The main pulmonary artery is normal in diameter. No aortic dissection or aneurysm. The aorta has normal caliber and taper. CHEST WALL: Small lipoma noted in the left pectoral muscle. Diffuse bony demineralization, suggestive of osteopenia/osteoporosis.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. SPLEEN: Calcifications in the spleen, suggestive of prior granulomatous disease.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: No significant abnormality noted.OTHER: Fat containing umbilical hernia. No aortic aneurysm or dissection. Normal aortic caliber and taper. All major aortic branches are patent. PELVIS:UTERUS, ADNEXA: Status post hysterectomy. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral total hip replacements with metallic prostheses and associated artifact obscure details of mid-pelvic structures. OTHER: Patent iliac and femoral arteries bilaterally with no aneurysm or dissection.
Left ventricular enlargement with thinning of the free wall. Marked coronary artery calcifications. No aortic aneurysm or dissection.
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72-year-old male with shortness of breath and possible paraneoplastic syndrome. CHEST:LUNGS AND PLEURA: Continued improvement in basilar predominant bilateral consolidation, left more than right, and bronchial thickening. Previously seen tree in bud nodular opacities in the right middle lobe are also improved. Persistent subsegmental consolidation in left lower lobe and along the left major fissure.The previously measured mass like area of consolidation in the left upper lobe along the major fissure currently measures 2.3 x 2.2 cm, previously measured 2.4 x 2.0 cm (series 5, image 43).Chronic appearing subpleural interstitial opacities are not significantly changed, and may represent underlying chronic interstitial lung disease such as fibrosing NSIP.No new focal opacities or consolidation. No pleural effusions.MEDIASTINUM AND HILA: No lymphadenopathy. Heart is normal size without pericardial effusion. Mild coronary artery calcifications.CHEST WALL: Degenerative changes affect the thoracic spine, with mild collapse of T12 vertebral body, unchanged.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: Hypoattenuating lesion in tail of pancreas measures 2.9 x 2.7 cm, not specific but may represent a cystic pancreatic neoplasm such as IPMN or serous cystadenoma (series 3, image 109).ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple lesions are seen arising from both kidneys; while many of these are hypodense and compatible with cysts, several are higher in attenuation than expected for benign cysts and cannot be completely characterized on this exam (series 3, image 119, 124). Atrophy and scarring of kidneys bilaterally. Extrarenal pelvis bilaterally but no hydronephrosis. 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: Left hip prosthesis.OTHER: No significant abnormality noted
1.Continued improvement in bilateral basilar predominant lung consolidation, likely resolving organizing pneumonia. Persistent subsegmental consolidation is seen in the left lower and upper lobes. 2.Basilar predominant chronic appearing interstitial opacities are not significantly changed and may represent chronic interstitial lung disease such as fibrosing NSIP.3.Nonspecific cystic lesion in tail of pancreas may represent IPMN or serous cystadenoma; follow-up with pancreas protocol MRI is recommended for better characterization.4.Multiple lesions arising from both kidneys, most of which are hypoattenuating and consistent with cysts. However, several of these measure above water density and are not completely characterized on this exam. Dedicated renal protocol CT or MRI for better characterization is recommended.
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24-year-old female patient with chest pain and shortness of breath. Evaluate for a pulmonary embolus. PULMONARY ARTERIES: Technically adequate study. No pulmonary embolus. Pulmonary artery size within normal limits.LUNGS AND PLEURA: No focal air space opacity, pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Scattered bilateral axillary lymphadenopathy. No significant osseous abnormalities.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Splenomegaly, stable compared to prior examination. Nonspecific hypoattenuating lesion within the spleen.Retroperitoneal lymphadenopathy.
No evidence of a pulmonary embolus.No acute cardiopulmonary abnormality.Nonspecific retroperitoneal and axillary lymphadenopathy with splenomegaly, possibly representing inflammatory/infectious process.
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36 year old female. Reason: bowel obstruction s/p ileostomy takedown w/ rectal EUA, anal dilation 10/30/13. History: Abdominal pain above umbilicus. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenomegaly. The spleen measures 14 cm in length. 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. Patent ileostomy anastomosis at image 116, series 3. No bowel obstruction. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Post-operative changes after ileostomy takedown in the right lower quadrant (image 110, series 3) without abscess or hernia. The subcutaneous fat is infiltrated and this may be due to post-operative fibrosis or cellulitis. No abscess or fistula. No associated intra-peritoneal changes. PELVIS: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
No bowel obstruction. Post-op changes in RLQ abdominal wall subcutaneous tissues after ileostomy takedown, without abscess, hernia or fistula.
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60 year-old female with history of chronic sinusitis as was undergoing functional endoscopic sinus surgery Redemonstrated are postoperative changes including medial antrostomies, uncinectomies, partial middle turbinectomies, sphenoidotomies, and partial ethmoidectomies. In this context, the major paranasal sinus ostia/ostomies are patent. There is no significant mucosal thickening or air-fluid level. There is mild rightward nasal septum deviation with laterally projecting osseous spur. Mastoid air cells and middle ear cavities are also clear. Visualized intracranial contents are unremarkable. Visualized orbital contents are also clear.
Clear paranasal sinuses status post functional endoscopic sinus surgery.
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63-year-old female with history of left parietal glioma and headache, evaluate for postop hemorrhage There is been interval left parieto-occipital craniotomy with associated postsurgical changes. There is a small amount of pneumocephalus.. Hypodensity is noted in the left parietal lobe at the site of prior tumor, which likely represents edema however residual tumor cannot be excluded. There are small hyperdensities in this region which likely represents hemorrhage. There is no significant extra-axial fluid collections. There is minimal effacement of the left lateral ventricle without midline shift. Ventricular size is normal. The basal cisterns are normal in size and configuration. Bilateral basal ganglia calcifications are noted. Scattered periventricular and subcortical white matter hypodensities are stable and likely represent mild to moderate chronic small vessel ischemic disease. The paranasal sinuses are hypoplastic but clear. The ethmoid air cells are clear.
1.Expected postsurgical changes of left parieto-occipital craniotomy with a small amount of acute hemorrhage in the surgical bed. No midline shift or significant mass effect.2.Recommend MRI for further evaluation of residual tumor.
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Altered mental status. There is streak artifact associated with metal hardware in the region of the left anterior temporal lobe where there is a small area of encephalomalacia underlying a temporal craniotomy defect. Operative note could not be located within the patient's EMR, however this most likely represents craniotomy relating to prior aneurysm clipping.There is mild sulcal prominence in keeping with patient's age. There is a few unchanged areas of ill-defined hypoattenuation within white matter, including the left corona radiata which most likely represent stable sequela of chronic small vessel ischemic disease. There is atherosclerotic calcification of the supraclinoid ICAs bilaterally. There is no intra-cranial mass, hemorrhage or CT evidence of acute hydrocephalus. The midline is intact. Sinuses and mastoids are unremarkable. Orbits and extracranial soft tissues are unremarkable.
Postoperative and chronic changes without acute intracranial abnormality. Stable sequela of chronic small vessel ischemic disease.
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65-year-old female with HCV, concern for cirrhosis. Hypoechoic lesion seen in segment 7 on ultrasound. ABDOMEN:LUNG BASES: Stable severe cardiomegaly. Pacer wires are partially visualized in the right atrium.LIVER, BILIARY TRACT: Nodular liver contour consistent with cirrhosis.Corresponding to lesion seen on US, ill-defined area of arterial enhancement is seen in segment 7 which measures 1.7 x 1.5 cm, and demonstrates washout on venous phase (series 9, image 37; series 11, image 37). Several other subcentimeter foci of arterial enhancement do not demonstrate washout and may represent perfusion abnormalities or dysplastic nodules (series 9, image 50, 32, 41).Hepatic veins, portal veins, and hepatic artery are patent.Cholelithiasis. Pericholecystic fluid and periportal edema most likely due to cirrhosis. No ascites fluid.SPLEEN: Splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: Again seen nonspecific left adrenal nodule which measures 2.7 x 2.1 cm, previously measured 3.0 x 2.4 cm (series 11, image 27).KIDNEYS, URETERS: Atrophy of right kidney. Hypoattenuating lesions in both kidneys, some of which are too small to characterize, but most consistent with cysts.RETROPERITONEUM, LYMPH NODES: Multiple prominent lymph nodes in the upper retroperitoneum. Atherosclerotic calcifications throughout aorta and its branches.BOWEL, MESENTERY: Diverticulosis.BONES, SOFT TISSUES: Degenerative changes in lower lumbar spine.OTHER: No significant abnormality noted
1.Hepatic segment 7 lesion measuring 1.7 cm in maximal dimension demonstrates arterial enhancement and washout, consistent with hepatocellular carcinoma.2.Cirrhotic liver morphology.3.Stable size of nonspecific left adrenal nodule.
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History of atrial fibrillation with anticoagulation. Known tumor. Rule out intracranial hemorrhage. There is right-sided temporo-occipital encephalomalacia associated with ex vacuo dilatation of the right ventricular atrium and an overlying craniotomy defect. There is no associated hemorrhage. There is no acute hydrocephalus or edema. There is ill-defined patchy hypoattenuation of the periventricular and subcortical white matter which most likely represents age indeterminate sequela of chronic small vessel ischemic disease. The midline is intact. Orbits, sinuses mastoid air cells are unremarkable. Extracranial soft tissues are unremarkable.
Chronic postoperative changes within the right temporal occipital region without acute intracranial pathology including hemorrhage. Findings suggesting age indeterminate sequela of small vessel ischemic disease.
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43-year-old female with subarachnoid hemorrhage Brain CTA: Two small outpouchings in the distal right internal carotid artery likely represent infundibula. No definitive aneurysms are identified.There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The anterior communicating and right posterior communicating arteries are hypoplastic. CT head:There is been near resolution of subarachnoid hemorrhage seen on prior exams with a minimal residual focus of blood in the right suprasellar cistern, decreased from the prior exam. No new foci of hemorrhage are evident. No extra-axial fluid collections. The ventricular size is appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.No definitive evidence for aneurysm. 2.Continuing evolution of minimal blood products within the suprasellar cistern. No evidence of acute hemorrhage.
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70 year-old male being treated for CLL. Evaluate disease. CHEST:LUNGS AND PLEURA: Bilateral scattered micronodules, several new from prior exam.MEDIASTINUM AND HILA: The mediastinal and hilar lymphadenopathy is redemonstrated. Reference right hilar node measures 2.6 x 2.1 cm (image 45, series #3), unchanged. Reference pretracheal lymph nodal conglomerate measures 1.5 x 1.0 cm, smaller and less conglomerate from prior study. CHEST WALL: Bilateral axillary lymphadenopathy is redemonstrated. Reference right axillary lymph node measures 3.0 x 1.5 cm, smaller from previous measurement 3.6 x 1.6 cm. OTHER: No other significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Few scattered bilobar subcentimeter hypodensities are redemonstrated, stable, too small to characterize though favor benign etiology.SPLEEN: The spleen remains enlarged at 15.4 cm, grossly unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral cystic lesions are unchanged, likely simple cysts.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy involves the periportal, periaortic, caval, and mesenteric lymph nodes. Reference left periaortic lymph node measures 2.7 x 3.9 cm (image 129, series #3), smaller from previous measurement of 4.8 x 3.3 cm.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: Diffuse bilateral pelvic and inguinal lymphadenopathy is redemonstrated. Reference right common iliac lymph node measures 2.9 x 2 .2 cm (image 163, series #3), unchanged. Reference left inguinal lymph node measures 2.6 x 1.4 cm, smaller from previous measurement of 2.8 x 1.8 cmBOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1.Slightly improved diffuse lymphadenopathy.2.New pulmonary micronodules.3.Moderate splenomegaly, unchanged.
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27 year-old female with concern for CVA due to decreased responsiveness and elevated blood pressure Interval development of a small amount of hemorrhage within the posterior aspect of the left caudate head. Interval development of a small amount of subarachnoid blood in the parasagittal right occipital lobe adjacent to the sinus confluence. No additional foci of hemorrhage are present.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Interval development of a small amount of left caudate head hemorrhage and a small right parasagittal occipital subarachnoid bleed.MRI may be obtained for further characterization of these findings.These findings were discussed with Dr. DiMaggio at 9:45 am on 11/27/2013
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Right foot pain. Abnormal ankle radiographs. History of ankle injury.EXAMINATION: CT right ankle without IV contrast 11/27/13 The talonavicular joint is abnormal. It is narrowed. The articular surfaces are flattened and broadened. There are erosions medially in both the navicular and talus. Osteophyte formation is present both laterally and medially.Minimal heel valgus is noted. No subtalar coalition is present.
Narrowing, flattening, and erosions of the right talonavicular joint. Juvenile arthritis is likely however a fibrous coalition cannot be excluded.
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59-year-old male with non-small cell lung cancer status post neoadjuvant RT CHEST:LUNGS AND PLEURA: Interval reexpansion of the right lower lobe. Nonspecific patchy ground glass and interstitial opacities in the right lower lobe. An underlying mass is now visualized extending along the minor fissure, measuring 2.6 x 2.9 cm (image 67, series 5). Mass also extends around the right hilum and lower lobe bronchi. No other suspicious nodules.MEDIASTINUM AND HILA: Reference prevascular lymph node measures 6 mm and previous measured 8 mm (image 37, series 3), decreased in size. Reference partially necrotic right hilar lymph node measures 9 mm and previous measured 9 mm (image 57, series 3).Reference subcarinal lymph node measures 1.0 cm and previously measured 1.6 cm (image 58, series 3), decreased in size.Distal esophageal varices are again noted. Small hiatal hernia. Unchanged coronary arterial calcifications.CHEST WALL: No axillary lymphadenopathy. Mild gynecomastia. Sclerosis of the C6 and C7 vertebral bodies is unchanged. Degenerative changes of the thoracolumbar spine. No discrete lytic or blastic lesions of the spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Nodular cirrhotic morphology, and evidence of portal hypertension including recanalized umbilical vein. Prominent porta hepatis lymph nodes may relate to chronic liver disease, unchanged.SPLEEN: Splenomegaly.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Diaphragmatic lymph node measures 9 mm and previously measured 9 mm (image 85, series 3).BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastric varices. Ascites.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. No discrete lytic or blastic lesions of the spine.OTHER: Moderate ascites.
1. Interval reexpansion of the right lower lobe with underlying mass now visualized and measured for future reference. Patchy ground glass and interstitial opacities in the right lower lobe are nonspecific.2. Reference mediastinal and right hilar lymphadenopathy, mildly decreased in size.3. Cirrhotic liver morphology with evidence of portal hypertension and moderate abdominal ascites.
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65-year-old female patient with lung cancer status post 12 cycles of chemotherapy. Please evaluate for disease and compare with previous scans using the same reference lesions. CHEST:LUNGS AND PLEURA: Left lower lobe nodule adjacent to the descending thoracic aorta measures 11 x 17 mm (series 5 image 54), unchanged. Unchanged adjacent mild minimal subsegmental atelectasis within the superior segment of the left lower lobe.Nonspecific scattered micronodules, stable.Minimal right basilar atelectasis.No new suspicious nodules or masses.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.Minimal atherosclerotic changes in the thoracic aorta.No mediastinal or hilar lymphadenopathy.CHEST WALL: Mild multilevel degenerative changes in the thoracic spine. No suspicious osseous lesions.No axillary lymphadenopathy. Small sub-centimeter nodule in the right breast is stable compared to examinations in 2012.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left-sided duplicated collecting system. No hydronephrosis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Stable left lower lobe nodule. No new abnormalities suspicious for metastatic disease.
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38-year-old male with mesothelioma status post 6 doses of treatment. ABDOMEN:LUNG BASES: Left pleural effusion and postsurgical changes in the right lung. Please see dedicated chest CT report for chest findings.LIVER, BILIARY TRACT: Liver is only partially visualized due to severe elevation of right hemidiaphragm. Mild periportal edema but otherwise no significant abnormality is identified.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Multiple surgical staples are seen in the upper abdomen.Interval increase in bulky, confluent retroperitoneal lymphadenopathy. The reference periaortic node measures 4.9 x 2.7 cm; this measured 3.0 x 1.8 cm on 10/2/2013 exam and approximately 3.3 x 1.8 cm on 10/13/2013 exam (series 9, image 37). Reference caval node measures 5.4 x 3.8 cm; this measured 4.3 x 3.0 cm on 10/2/2013 exam and 4.6 x 3.0 on 10/13/2013 exam (series 9, image 69). Lymphadenopathy encases majority of retroperitoneal vasculature, including renal arteries and veins, celiac axis, portal vein, and SMV. There is compression and narrowing of the inferior vena cava, left renal vein, and portal vein (series 9, image 36, 49, 58); the IVC appears nearly completely compressed below level of renal veins (series 9, image 58).BOWEL, MESENTERY: Interval increase in large amount of ascites fluid. Significant increase in size of multiple mesenteric lymph nodes. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Increased pelvic lymphadenopathy.BOWEL, MESENTERY: Increase in large amount of ascites fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1.Interval increase in bulky retroperitoneal and mesenteric lymphadenopathy as well is significant increase in large amount of ascites fluid. Retroperitoneal lymphadenopathy encases and narrows multiple abdominal vessels, as described above.2.Please see dedicated chest CT report for chest findings.
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88-year-old female with altered mental status evaluate for intracranial hemorrhage Patchy hypoattenuation in the periventricular and subcortical white matter likely represents the sequela of small vessel ischemic disease of indeterminate age. Chronic right paramedian cerebellar hemisphere stroke. Probable right basal ganglia lacunar infarct.The CSF spaces are appropriate for the patient's stated age with no midline shift. No intracranial hemorrhage is identified. No edema or mass effect is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1. No acute intracranial abnormalities. Please note CT is insensitive for the detection of acute ischemia.2. Small vessel ischemic disease of indeterminate age. Chronic right paramedian right cerebellar hemisphere stroke. Probable chronic right basal ganglia lacunar infarct.
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16-year-old male. History of pectus excavatum, evaluate anatomy and calculate Haller index. Pectus excavatum deformity is seen. Haller index measures 3.8. Otherwise, the limited view of the chest is normal.
Pectus excavatum deformity with Haller index of 3.8.
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40 year-old female patient with history of thymoma status post chemotherapy, radiation and resection. Please compare with previous examination and evaluate disease status. CHEST:LUNGS AND PLEURA: Stable elevated left hemidiaphragm suggestive of phrenic nerve paralysis.No significant change in distortion of the left paramediastinal pulmonary parenchyma and mild bronchiectasis in the left upper lobe, consistent with post radiation changes.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.Soft tissue mass in the anterior mediastinum with sutures and coarse calcifications measures 22 x 46 mm (series 3 image 30), unchanged. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Median sternotomy hardware in place without abnormality.Mild multilevel degenerative changes of the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypoattenuating subcentimeter lesions in the right lobe of the liver unchanged from prior examination and likely represent cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left duplicated collecting system. No hydronephrosis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Moderately large stool burden in the colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Stable residual anterior mediastinal mass. No specific evidence of metastatic disease or new sites of disease.
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73 year-old female with metastatic lung cancer, reevaluate disease CHEST:LUNGS AND PLEURA: Partially solid nodule in the right lower lobe measures 1.4 x 1.4 cm (image 65, series 5) and previously measured 1.2 x 1.0 cm, increased in size with increasing solid component and associated pleural thickening. Multiple additional bilateral groundglass nodules have been stable since 2009. Calcified micronodules consistent with prior granulomatous disease.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes compatible with prior granulomatous disease. Mild coronary arterial calcifications.CHEST WALL: Degenerative changes of the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Small unchanged hypoattenuating right hepatic lesion, not fully characterized on this nondedicated exam, but likely benign.SPLEEN: Scattered granulomata.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Hiatal hernia.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.
Increased size of reference right lower lobe partially solid nodule with increasing solid component and adjacent pleural thickening highly suspicious for a primary adenocarcinoma. Multiple additional small groundglass nodules are not significantly changed since 2006.
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26 year old female with left flank pain and abdominal pain. 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: Two small nonobstructing stones are seen in calyces of right kidney; the larger stone in inferior calix measures 3 mm (series 3, image 49). No stones identified in left kidney. No hydronephrosis.3 mm calcific density is seen at expected location of right UVJ, consistent with stone. No significant hydroureter. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes are noted in the lumbar spine, with posterior disk osteophyte complex at L1-2.OTHER: 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: Punctate calcifications in the pelvis are not located along course of ureter and most consistent with phleboliths (series 3, image 117, 127).
1.There is a 3 mm calcific density is seen at expected location of right UVJ, consistent with stone. No significant hydroureter or hydronephrosis. 2.Two nonobstructing stones in right kidney, largest measuring 3 mm.
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Reason: metastatic thryoid ca, on therap, eval for dz progression with measurements History: as above CHEST:LUNGS AND PLEURA: Multiple small pulmonary nodules with reference measurements as follows:1. Apical right upper lobe nodule (series 5/25) 5 x 3 mm, previously 4 x 4 mm, not significantly changed.2. Anterior right upper lobe nodule (series 5/29) 5 x 4 mm, previously 7 x 3 mm, not significantly changed.3. Peripheral left upper lobe nodule (series 5/32) 6 x 5 mm, unchanged.4. Right lower lobe nodule (series 5/79) 7 x 7 mm, previously 8 x 5 mm, not significantly changed.MEDIASTINUM AND HILA: Surgical clips in the thyroid bed. Poorly defined soft tissue posterior to the trachea at the level of the thyroid gland is poorly visualized and appears unchanged.No significant lymphadenopathy.CHEST WALL: Previously described abnormalities in the distal right clavicle and right glenoid, possibly related to previous trauma or metastatic disease. Healed right rib fractures.Small hemangioma in the T10 vertebra.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hepatic cysts and dilated gallbladder.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral suspicious renal masses, may represent primary or metastatic tumor, unchanged from previous.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Lytic lesion in the left transverse process of the L4 vertebra, consistent with a metastasis, unchanged.OTHER: No significant abnormality noted.
Pulmonary nodules, renal masses and skeletal metastases with no significant change. .
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80 year-old female with AML, assess for pneumonia. LUNGS AND PLEURA: Interval increase in nodular and ground glass pulmonary opacities and extensive new right lower lobe lobe airspace disease. Left upper lobe masslike lesion measures 3.7 cm and previous measured 3.7 cm (image 22, series 4). New small left pleural effusion.MEDIASTINUM AND HILA: Unchanged mediastinal lymphadenopathy with reference subcarinal lymph node measuring 1.5 cm and previously measuring 1.4 cm (image 36 series 3). Coronary arterial calcifications are unchanged. No pericardial effusion. Superior mediastinal nodule likely extending from the thyroid is again noted, not significant changed.CHEST WALL: Degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
1. Increased pulmonary ground glass and air space opacities with several nodules and masslike lesions suspicious for atypical infection, although follow-up imaging should be obtained to exclude underlying malignancy. Mediastinal and hilar lymphadenopathy.
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64 year old female with metastatic thyroid cancer on therapy, evaluate Limited intracranial and orbital views are unremarkable. Visualized paranasal sinuses and mastoid air cells are clear. Mottled lucency is again seen involving the right parietal bone, squamous right temporal bone, and a small portion of the right retromastoid occipital bone. The right sphenoid wing is also mottled and irregular lucent with involvement of the lateral orbital wall, floor of the middle cranial fossa, and pterygoid plates. These findings are similar to the prior examination. No definite new destructive calvarial lesions are present.Similar to the prior, subtle areas of dural thickening and enhancement are present along the right parietal bone and right squamous temporal bone. Also redemonstrated is epidural thickening and enhancement along the floor of the right middle cranial fossa which extends through the permeated skull base to involve the infratemporal fossa. No significant interval change in infiltration of abnormal soft tissue into the right pterygopalatine fossa.Interval decrease in the size of a centrally hypoattenuating right level IIb reference lymph node which measures 1.1 x 0.8 cm (series 6 image 24), previously measured 1.7 x 1.3 cm. An additional reference node, slightly more inferiorly, has undergone an interval decrease in size and is no longer centrally hypoattenuating measuring 0.5 x 0.6 cm (series 6 image 33), previously measured 0.9 x 0.8 cm.Interval decrease in the size of the left submandibular reference lymph node which measures 1.0 x 0.8 cm (series 6 image 36), previously measured 1.4 x 1.1 cm. Enhancing tissue, too ill-defined to accurately measure, is again present along the left posterolateral aspect of the cricoid cartilage and appears somewhat less prominent than on the prior study.Status post thyroidectomy. No significant interval change in small soft tissue nodules within or adjacent to the thyroid bed. The aerodigestive tract is otherwise unremarkable without exophytic masses or focal effacement. The major cervical vessels are patent.Lytic change involving the posterior elements at C2, C3, C4 and C6 is not significantly changed. The vertebral body heights are maintained without pathological fracture. Chronic fracture of the T1 spinous process. The partially visualized right scapula is also demonstrates mottled lucency similar to the prior.Pulmonary micronodules some of which are calcified are present within the visualized lung apices. Please see dedicated chest CT from today's date for further details.
1. Interval decrease in size of cervical reference lymph nodes.2. No significant interval change in osseous lytic disease involving the right aspect of the calvarium and floor of the right middle cranial fossa.3. Within the limits of CT, the epidural tumor along the right parietal and temporal bones, the floor of the right middle cranial fossa, and extending into the infratemporal fossa has not significantly changed. If clinically indicated, MRI may be obtained for further evaluation of this finding.4. No significant interval change in lytic lesions of the cervical spine without interval development of new lesions.
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Mesothelioma CHEST:LUNGS AND PLEURA: Stable right hemithorax pleural thickening and nodularity with associated body and loss. Appearance remains consistent with provided history of mesothelioma. Reference measurements are as follows:1. At the level of the aortic arch (image 28 series 3), the one o'clock lesion remains unchanged measuring 1 mm2. At the level of the right main pulmonary artery (image 43 series 3), the 12 o'clock position remains 4 mm unchanged3. At the level of the left atrium (image 62 series 3), the 6 o'clock position remains 4 mm unchangedThe right paravertebral lesion also is unchanged measuring 3.6 x 2.8 cm (image 75 series 3). The adjacent non-index pleural lesions in the 7 and 5 o'clock positions are also stable in size.Small loculated anterior pleural effusion on the right is unchangedMEDIASTINUM AND HILA: Reference subcarinal lymph node remains 20 millimeters (image 50 series 3).Coronary calcifications with extension into the right atrial appendage unchanged. Cardiac and pericardium otherwise remains unremarkable.Small hiatal herniaCHEST WALL: Right internal mammary chain node is unchanged measuring 1.2 cm in short axis (image 45 series 3). Stable unchanged hyperattenuating soft tissue nodules, most prominent in the right lateral chest wall (image 67 series 3).ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable left renal cysts PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable aortocaval or right para-aortic lymph node adjacent to the right diaphragmatic crus, unchanged measuring 2.0 cm (image 91 series 3).BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Lesion adjacent to the origin of the right 12th rib (image 99 series 3) remains unchanged. Scattered degenerative changes in L3 deformity stable in appearance.OTHER: No significant abnormality noted.
Right hemithorax mesothelioma without interval change. Reference measurements provided
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Reason: R/O bicuspid aortic valve History: Dilated ascending aorta LUNGS AND PLEURA: Scattered stable micronodules. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal adenopathy can be identified.Cardiac size is normal without evidence of pericardial effusion.No evidence of aortic dilatation.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
No cardiopulmonary abnormalities identified. Specifically no evidence of aortic dilatation.
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Reason: s/p 6 doses of treatment please evaluate for disease and compare to previous scans History: mesothelioma LUNGS AND PLEURA: Status post right pneumonectomy with a fluid-filled right pleural cavity.Nodular right pleural thickening again observed with the following measurements:1.At the level of the aortic arch at 7 o'clock ( image 32 series 6) 12 mm previously 12 mm. 2.At the level of the main pulmonary artery (image 36 series 6) 12 mm at the 8 o'clock position previously 11 mm, and 3 mm at the 3 o'clock position previously 3 mm.3. At the level of the left atrial appendage (image 44 series 6) 5 mm at the 3 o'clock position previously 5 mm. Left lower lobe nodule (image 68 series 8 measures 7 mm previously measuring 8 mm.New upper lobe 4-mm nodule (image 49 series 8) and left paramediastinal upper lobe nodule measuring 10 mm (image 42 series 8).Stable left apical nodules (images 19 and 20 series 8)interval increase in left pleural effusion.Interval increase in left pleural effusionMEDIASTINUM AND HILA: Enlarging left cardiophrenic mass (image 72 series 6) now measuring 3.9 cm x 4.7 cm and previously measured 3 cm x 3.8 cm.Prevascular lymph nodes demonstrate interval increase in size (image 30 series 6) now measuring 10 mm in short axis previously measuring 6 mm.Additional pericardial lymph nodes are mildly increased in size.Cardiac size is normal without evidence of a pericardial effusionCHEST WALL: Left internal mammary lymph node (image 24 series 6 is unchanged.Stable deformity of the left scapular tip less likely represent an exostosis.Tumor involving the deep gutter on the right (image 88 series 6) is unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Interval increase in ascites and mesenteric and retroperitoneal lymphadenopathy and peritoneal tumor burden.
1.Interval increase in left lung pulmonary nodules and left pleural effusion.2.Interval increase in mediastinal and pericardial lymph nodes with interval increase in left cardiophrenic mass.3.Right pneumonectomy with stable right pleural thickening in reference measurements. 4.Increasing ascites with increase in mesenteric, retroperitoneal, and peritoneal tumor burden.
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72-year-old male patient presents with shortness of breath with hypoxia and history of advanced lung cancer, progressive disease, now on B-RAF inhibitor x 2 months common dust reduced. Please compare to prior. CHEST:LUNGS AND PLEURA: Marked interval increase in bilateral pleural effusions, right greater than left. Right middle lobe consolidation with underlying mass is not significantly changed.Interval increase in nonspecific mixed groundglass and solid opacities in the bilateral lungs.Interval decrease in intralobular septal thickening.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Moderate to severe coronary artery calcifications.Mildly prominent mediastinal lymph nodes, not significant changed. Reference right paratracheal lymph node measures 11 mm (series 3 image 36), stable. Prominent prevascular lymph node measures 7 mm (series 3 image 36), previously 10 mm.CHEST WALL: New osseous sclerotic lesions in the T3, T12, L2, L3, and L4 vertebral bodies, consistent with metastatic disease.Surgical clips in the right axilla. No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Interval decrease in numerous hypoattenuating liver lesions compatible with metastatic disease. Largest lesion is in the left lobe of the liver and measures 2.7 x 2.5 cm (3 image 89), previously 2.7 x 3.6 cm.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: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Spinal canal narrowing at the L4 and L3 level is unchanged compared to prior. Multilevel degenerative changes in the lumbar spine with sclerotic lesions, as above.OTHER: No significant abnormality noted.
Increased pleural effusions, bilateral air space opacities and sclerotic osseous lesions with interval decrease in liver lesions.
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70 year-old male with CLL, reevaluate Limited intracranial views are unremarkable. Mucosal thickening and bubbly secretions within the maxillary sinuses suggestive of acute sinusitis.Diffuse bilateral cervical lymphadenopathy at all nodal stations without significant interval change in distribution and appearance. Reference left level 5 lymph node measures 2.1 x 0.9 cm (series 6 image 23), previously measured 2.1 x 0.9 cm. Additional right submandibular reference lymph node measures 1.2 x 0.8 cm (series 6 image 28), previously measured 1.3 x 0.8 cm. Lymphadenopathy is also present in the supraclavicular, axillary and retropectoral regions bilaterally.Prominence of asymmetric enhancing soft tissue along the left palatine tonsil with asymmetric effacement of the left glossotonsillar suclus. Similar to the prior, no discrete mass is present and this finding is likely secondary to the hypertrophied lymphoid tissue within the left palatine tonsil. Redemonstration of asymmetric prominence of enhancing soft tissue along the left lingual tonsil, unchanged and likely hypertrophied lymphoid tissue. A similar appearance is seen on the right, although to a lesser degree.No exophytic mass or focal effacement of the aerodigestive tract. There is no abnormal soft tissue mass or pathologic enhancement.The parotid, submandibular and thyroid glands are free of focal lesions. The cervical vasculature is patent. Mild bilateral atherosclerotic carotid bifurcation calcifications. Multilevel degenerative changes of the visualized cervicothoracic spine without suspicious osseous lesions.Right upper lobe pulmonary nodule, please see dedicated chest CT from today's date for further details.
1. No significant interval change in amount or extent of bilateral cervical lymphadenopathy at all nodal stations.2. Bubbly secretions in the maxillary sinuses suggestive of acute sinusitis.
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66-year-old male with history of prostate cancer. Rising PSA. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Unchanged mild left adrenal nodularity.KIDNEYS, URETERS: Multiple bilateral subcentimeter hypodensities are too small to characterize, though stable from prior exam and likely represent benign cysts.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Status-post prostatectomy. Postsurgical changes are redemonstrated. A soft tissue focus left surgical bed, likely in the area of the removed left seminal vesicle, is more prominent than the previous exam and measures 1.4 cm (image 121, series #3).BLADDER: No significant abnormality noted.LYMPH NODES: A left external iliac lymph node measures 0.9 x 1 .1 cm, remains unchanged. The previously measured right ischio anal fossa lymph node is not identified on this exam.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the rectal lumbar spine are redemonstrated. Sclerotic focus in the right ilium remains unchanged and likely represents a bony island.OTHER: Small right inguinal hernia containing only mesenteric fat.
1.Interval increased prominence of small soft tissue focus in the left surgical bed is nonspecific though raises question of local recurrence.2.No CT evidence of metastatic disease.
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74 year old female. Reason: Rule out CAD. GLOBAL trial. History: Chest discomfort. Height: 61 inWeight: 136 lbsBSA: 1.6 m^2BMI: 25.7 kg/m^2Calcium Score:LM: 0LAD: 103LCx: 0RCA: 4.3Total: 208. This represents the 67% for this patient's age and gender.Cardiac Function and Morphology:Left Ventricle:EDV: 92 ml The left ventricle is normal in size, shape, volume and wall thickness. Right Ventricle:EDV: 87 ml The right ventricle is normal in size, shape, volume and wall thickness. Left Atrium: The left atrial volume minus the pulmonary veins is 75 ml. There are four distinct pulmonary veins which drain normally into the left atrium.Right Atrium: The right atrial volume is 69 ml. The right atrium is structurally normal. Cardiac Veins: The coronary sinus is normal.Cardiac Valves: There are diffuse mural calcifications at the aortic root. There is no mitral annular calcification.Great Vessels:Aorta: The aortic arch is left sided. The brachiocephalic vessels branch normally from the arch. Visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. Largest dimensions of the thoracic aorta are as follows:Sinuses of Valsalva: 34 mm Ascending: 30 mm Sinotubular junction: 27 mm Descending 20 mmPulmonary Artery: Main PA 22 mmRight PA 20 mm Left PA 19 mmVena Cavae: The SVC is normal in size and without structural abnormality. The IVC is normal in size and without structural abnormality.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary Artery Anatomy:LM: The left main coronary artery arises normally from the left sinus of valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. The left main is very short. There is no significant plaque in the left main.LAD: The LAD gives rise to the diagonal and septal branches. There is dense eccentric calcification in the proximal LAD. There is focal calcification at the 1st diagonal branch origin. There is no significant plaque in the LAD or its branches.LCx: The left circumflex artery gives rise to the obtuse marginal branches. There is no significant plaque in the LCx or its branches.RCA: The RCA arises normally from the right sinus of valsalva. It is the dominant coronary artery giving rise to the posterior descending artery and a posterolateral branch. A small amount of focal calcification is located in the proximal RCA. There is no significant plaque in the RCA or its branches.EXTRACARDIAC CHEST
1. Normal ventricular volume and morphology.2. Calcium Score total: 208. This represents the 67%tile for this patient's age and gender.3. No significant coronary artery stenoses. .
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21-year-old female with intractable seizures status post occipital and parietal resections in 2004. Stable postoperative changes of right-sided craniotomies, right occipital and anterior temporal lobe resections with associated encephalomalacia. Right-sided dural thickening is decreased with an improving underlying small chronic subdural collection measuring 4 mm, previously 6 mm. A small extra axial fluid collection adjacent to the right ex vacuo dilated right occipital horn is unchanged in size measuring 2.3 x 1 .1 cm, previously 2.3 x 1.1 cm. No acute hemorrhage or midline shift is evident. Hemorrhage within the right temporalis muscle is decreased.The ventricles are stable in size. No intracranial masses are evident. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
Postsurgical changes of right craniotomies and occipital and temporal lobe resections without acute abnormalities. A chronic right subdural fluid collection is decreased in size. An occipital extra axial collection is stable.
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72 year old female status post right nephrectomy. Evaluate for hematoma. ABDOMEN:LUNG BASES: Small bilateral pleural effusions, right more than left.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post right nephrectomy with postsurgical changes in right flank/nephrectomy bed, including multiple foci of gas, fat stranding, and small amount of fluid. No evidence of hematoma.Left kidney unremarkable.RETROPERITONEUM, LYMPH NODES: As above, status post right nephrectomy with post-surgical changes in nephrectomy bed, but no evidence of a hematoma. No lymphadenopathy.BOWEL, MESENTERY: No bowel obstruction or wall thickening. Multiple foci of free intraperitoneal air, consistent with recent surgery. Ventral hernia in lower abdomen containing fat and foci of free air.Postsurgical changes around GE junction.BONES, SOFT TISSUES: Postsurgical changes in anterior abdominal fascia. Subcutaneous emphysema in the lower abdominal wall, consistent with recent surgery.Metallic stimulator device in the subcutaneous fat of right flank with metallic lead entering central spinal canal. Dystrophic appearing calcifications in the left flank, likely result of prior trauma.Severe degenerative changes affect the lumbar spine, worst at L1-2 and L2-3.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter in place. Air in bladder consistent with recent instrumentation.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Metallic clips in right pelvis.
Postsurgical changes in the right nephrectomy bed and flank without evidence of hematoma.
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Male; 19 years old. Reason: history of metastatic osteosarcoma s/p thoracotomy and chemotherapy History: on therapy evaluation Lack of intravenous contrast limits evaluation for lymphadenopathy, solid organ, and bowel pathology.LUNGS AND PLEURA: Status post multiple bilateral wedge resections. A staple line in the right upper lobe extends superolaterally to the periphery where there is associated linear and somewhat nodular opacity, which is unchanged in appearance and most compatible with postsurgical scarring. New faint and somewhat linear nodular opacity in the superior segment of left upper lobe is nonspecific and may be post infectious or inflammatory (series 4 image 34). Otherwise, there are no suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is evident. The heart is normal in size without pericardial effusion.CHEST WALL: A left upper wall chest port is present with the catheter tip at the superior cavoatrial junction. Stable subcutaneous linear fat stranding in the right posterolateral chest wall compatible with post surgical change. No axillary lymphadenopathy. No suspicious osseous lesions.UPPER ABDOMEN: Limited evaluation of the upper abdomen is normal.
1. New nonspecific nodular opacity in the left upper lobe, for which attention at follow-up is recommended.2. Right upper lobe surgical suture row with unchanged linear and nodular opacity, most compatible with postsurgical change.
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27 year-old female with intracranial hemorrhage. Limited portable technique CT images redemonstrate a small amount of hemorrhage within the posterior aspect of the left caudate head as well as subarachnoid blood in the parasagittal right occipital lobe adjacent to the sinus confluence. No additional foci of hemorrhage are present.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Limited portable technique CT images redemonstrate a small amount of hemorrhage within the posterior aspect of the left caudate head as well as subarachnoid blood in the parasagittal right occipital lobe adjacent to the sinus confluence. Given differences in technique, no significant interval change.
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15-year-old patient with history of infection at halo pin placement sites. Evaluate for osteomyelitis. Several postoperative findings are demonstrated including a suboccipital craniectomy for foreman magnum decompression, resection of the posterior arch of C1, and shunt placement with catheter tip crossing the dura at the level of the CC junction. There is residual hardware associated with the craniotomy which has not changed in position over multiple prior exams.At the site of the previous focal parietal fracture immediately superior to the left mastoid air cells, there has been interval healing with no comminuted fragments remaining. There is no associated soft tissue density, emphysema, pneumocephalus or underlying extra-axial fluid collection. The most recent pin sites, one of which is just medial to this lesion, are unremarkable and have demonstrated interval healing. There is no acute intra-axial abnormality including mass, edema, hemorrhage or hydrocephalus. Orbits and paranasal sinuses are unremarkable. Mastoids are clear.
Findings related to the prior suboccipital craniectomy for decompression of foreman magnum. Interval resolution of air with no bone fragments left at the site of the previously described focal left parietal comminuted fracture. No lytic lesions of bone, soft tissue stranding or extra-axial fluid collections at this site. No abnormalities of the more recent sites of pin insertion within the posterior skull.
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Metastatic uterine carcinoma on therapy, restaging CHEST:LUNGS AND PLEURA: Stable right upper lobe spiculated nodule (image 28; series 4) measuring 1.1 x 1.3 cm. Relatively stable right lower lobe referenced nodule (image 55; series 4) measuring 0.6 cm in diameter. Increasing right pleural effusion. Presumed lymphangitic spread of tumor at the left lung base again noted. Emphysema again noted.MEDIASTINUM AND HILA: Stable enlarged and heterogeneous thyroid. Stable mediastinal lymph nodes. Reference right hilar lymph node (image 39; series 3) is larger measuring 2.3 x 1.7 cm. Replaced right subclavian artery. Pericardial effusion slightly larger. Enlarging left axillary lymph nodes.CHEST WALL: Extensive sclerotic bony metastatic lesions unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.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: No change in extensive sclerotic bony metastatic lesionsOTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus absentBLADDER: 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.
Increasing adenopathy. Reference measurements are given above. Enlarging right pleural effusion.
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48 year old female. Reason: kidney stone History: right flank pain rad to rlq with hematuria ABDOMEN:LUNG BASES: No significant abnormality noted. Breast implants. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild right hydronephrosis. 5 mm calcification in the pelvis may be located in the distal right ureter. Mild right ureteral dilation. RETROPERITONEUM, 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: Moderately distended bladder is otherwise unremarkable. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right buttock calcifications, probably injection granulomata. OTHER: Right ureteral calculus.
Distal right ureteral 5 mm calcification and mild right hydronephrosis.
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Reason: h/o HNC, CRT, lung nodules, compare to previous, measurements pls History: none LUNGS AND PLEURA: Right lower lobe small nodule (image 47 series 5) now demonstrates increased interval cavitation and measures 8 mm previously measuring 2 mm.Additional right lower lobe cavitary nodule (image 47 series 5) now measures 11 mm previously measuring 7 mm.Right subpleural lower lobe nodule (image 51 series 5) is stable a 4 mm.Right basilar subpleural nodule (image 69 series 5) is no longer cavitary and has increased in size measuring 10 mm previously measuring 6 mm mmPost radiation changes in the apices.Scattered stable pulmonary cysts.No pleural effusions.MEDIASTINUM AND HILA: Significant amount of debris within the mainstem bronchi.No mediastinal or hilar lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. New large cystic lesion within the right lobe of the liver (image 97 series 3) measuring 8.5 cm x 6.8 cm.Increasing smaller cystic lesions in the right lobe of the liver compatible with metastatic disease.Interval increase in left periaortic lymph node (image 103 series 3).
1.Interval progression in pulmonary solid and cavitary nodules.2.New hepatic metastases
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78 year old male. Reason: restaging scans, s/p 4 cycles of investigational systemic immunotherapy. History: hx of metastatic bladder cancer. CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged in size since prior examination.MEDIASTINUM AND HILA: There is old granulomatous disease. There is minimal dependent basilar atelectasis. There is evidence of atherosclerotic calcifications of the thoracic aorta. There is no mediastinal or hilar lymphadenopathy.CHEST WALL: Right-sided Port-A-Cath is again noted with the tip ending in the distal SVC.ABDOMEN:LIVER, BILIARY TRACT: No intrahepatic biliary ductal dilatation or focal mass lesion within the hepatic parenchyma. There is no cholelithiasis or choledocholithiasis. SPLEEN: Multiple calcific foci are seen within the splenic parenchyma consistent with prior granulomatous disease.PANCREAS: The previously described masslike fullness in the head of the pancreas is unchanged, measuring 1.9 x 3.4 cm (image 116 series 3). No other significant change. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The left kidney is atrophic, and the previously seen hydronephrosis and hydroureter have resolved. Status post cystectomy and ileal conduit in the right lower quadrant. RETROPERITONEUM, LYMPH NODES: Stable borderline retroperitoneal lymph nodes are present.BOWEL, MESENTERY: Right lower quadrant ileal conduit. Normal appendix in the right lower quadrant. BONES, SOFT TISSUES: Left posterior lateral chest wall lipoma is unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Patient is status post cystoprostatectomy.BLADDER: Patient status post cystoprostatectomy. There is no recurrent disease within the cystectomy bed.LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1.Resolved left hydroureter and hydronephrosis.2.No evidence of local recurrence or metastatic disease.
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Spontaneous pneumothorax and chest tube placement. Please check underlying lung anatomy for pleural blebs and possible causes. LUNGS AND PLEURA: Left chest tube is observed extending towards posterior wall and upper lobe within the major fissure. A small underlying residual pneumothorax, however a small anterior gas collection is observed inferiorly and adjacent to the right cardiac border occupying the lingular region. No intra-pulmonary underlying abnormalities observed other than minimal atelectasis adjacent to the chest tube. Specifically no nodules or masses. No effusions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Mild left lower chest wall emphysema adjacent to the chest tubeUPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
Left chest tube with a small associated anterior pneumothorax. No underlying intrapulmonary abnormality
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Bronchiectasis with out acute exacerbation. Patient had left lower lobe resection LUNGS AND PLEURA: Asymmetric lung volumes with decreased on the left with hilar clips compatible with patient's left lower lobe resection. No underlying intrapulmonary focal abnormalities, specifically no nodules or masses. No effusions. Interval resolution of the previous fluid collection observed 7/6/13MEDIASTINUM AND HILA: No lymphadenopathy.The cardiac and paracardial are within normal limits. Mild right to left midline shift.CHEST WALL: Bilateral unchanged breast augmentationUPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted in this limited non-augmented exam.
Status post left lower lobe resection without evidence of recurrence or new complication. Previously identified left pleural effusion resolved
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64-year-old male with history of CLL. Reason: relapsed CLL on treatment regimen. History: Evaluation of disease status CHEST:LUNGS AND PLEURA: Diffuse, bilateral miliary pattern is unchanged from previous study.MEDIASTINUM AND HILA: Stable enlarged mediastinal lymph nodes. CHEST WALL: Index left axillary lymph node is stable measuring 1.5 x 1 cm on image 23, series 3. Other bilateral axillary lymph nodes are stable.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenomegaly, unchanged. Spleen measures 18 cm.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index retroperitoneal lymph node measures 1.2 x 0.8 cm image 117, series 3. This lymph node and other retroperitoneal lymph nodes are stable compared to previous study.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: Stable size of the pelvic adenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
No significant change. No new lesions.
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46 showed female with metastatic thyroid cancer, on therapy. A previously demonstrated extra-axial, homogeneously enhancing lesion situated along the left sphenoid wing adjacent to the anterior left temporal lobe has not been included within the field of view on today's acquisition.Lytic changes in the clivus, particularly affecting the right inferior aspect, are unchanged. A dominant lucent lesion again measures 20 x 10 mm (series 4, image 16). Lytic change is also present within the left lateral mass of C1 and questionably is in the right occipital condyle. These findings are stable. Elsewhere, no definite new or concerning bony lesions are demonstrated. There is straightening of the cervical spine, positional.Scattered small lymph nodes are demonstrated in the neck. None of these is pathologically enlarged. Evidence of thyroidectomy is redemonstrated. No concerning the soft tissue or enhancing abnormalities are seen in the resection bed to suggest recurrent disease.The right internal jugular vein does not opacify, a stable finding. Otherwise, cervical vessels are unremarkable. Lung apices are clear.
1.Stable lytic lesions involving the clivus, right occipital condyle and left lateral mass of C1. No new bony lesions are detected.2. No pathologic adenopathy in the neck.3. Status post thyroidectomy with no suspicious lesions in the operative bed.
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Malignant neoplasm of the head face and neck. Currently on therapy, follow CHEST:LUNGS AND PLEURA: Upper lobe predominant centrilobular emphysema with new extensive patchy opacities largely involving the right lower lobe with minimal sparing of the periphery consistent with small blebs. A small effusion. The remaining visualized lung including the entire left lung is otherwise are clear.Small focal 3 or 4-mm soft tissue nodule along the right lateral tracheal wall (image 28 series 3) unchanged. Possible tracheal polyp or metastatic focus is of concern.Tracheostomy tube unchangedMEDIASTINUM AND HILA: No lymphadenopathy.The cardiac and pericardium are within limits other than extensive coronary calcificationsCHEST WALL: Left chest wall port unchanged. Extensive degenerative changes throughout the thoracic and visualized lumbar spine more pronounced inferiorly.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small stable right renal cystPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.G-tubeBONES, SOFT TISSUES: See aboveOTHER: No significant abnormality noted.
1. Focal nonspecific consolidation suspicious for pneumonia in the appropriate clinical setting and no superimposed findings two suggest intrapulmonary metastatic disease.2. A small fixed nodular density in the trachea also concerning for possible polyp or less likely metastatic disease.
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Female 82 years old; Reason: Cause of abd pain, n/v History: Nausea, vomiting abd pain; negative EGD ABDOMEN:LUNGS BASES: Post operative changes from median sternotomy.LIVER, BILIARY TRACT: Hepatic contour is smooth. Nonspecific subcentimeter hypodense lesion possibly a cyst in segment two of the liver. The hepatic and portal veins are patent. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No nephrolithiasis or hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Severe calcific arteriosclerotic disease of the aorta. Abdominal aorta is normal in caliber. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Small bowel is normal in caliber. Large periampullary duodenal diverticulum.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 pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Post operative changes in the left inguinal canal.OTHER: No significant abnormality noted.
1.No evident inflammatory changes in the abdomen or pelvis.
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Prostate cancer. Evaluate for progression of disease. CHEST:LUNGS AND PLEURA: Scattered micronodules again seen unchanged, some of which are calcified and likely all represent granulomatous changes. No new infiltrates or masses seen. No effusions.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN: Within the limits of a non-IV contrast enhanced examination limiting evaluation of parenchymal solid organs and vascular structures, the following observations can be made:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic left kidney with percutaneous nephrostomy catheter again seen in expected position. No hydronephrosis. No parenchymal mass is seen or foci of abnormal calcification in either kidney.RETROPERITONEUM, LYMPH NODES: No enlarged retroperitoneal lymph nodes seen with scattered small normal sized lymph nodes unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate with soft tissue extending from posterior lateral aspect to the left pelvic sidewall. Size and appearance of this soft tissue extension is unchanged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right inguinal hernia containing only mesenteric fat again seen. Diffuse degenerative bony changes seen throughout without focal abnormality seen to suggest metastatic disease. Bone scan would be more sensitive to detect skeletal metastases.OTHER: No significant abnormality noted
No change compared to previous. Enlarged prostate with soft tissue extending to the left posterolateral pelvic sidewall.
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Benign neoplasm of the thymus. Cough CHEST:LUNGS AND PLEURA: Multiple left pleural based masses are again observed and grossly unchanged. The reference. Visual nodule is currently not well appreciated and or partially resolved. Currently this reference lesion measures 5 mm in short axis and appears flatter, previously 8 mm (image 85 series 4) and round. The reference left pleural-based nodule or thickening in the lower lobe posteriorly is unchanged at 4.6 x 1.3 cm (image 79 series 4).Interval improvement with decrease changes and focal consolidation in the right lower lobe in left apex, both with with persistent air bronchograms. Suspected recurrent aspiration superimposed on scarring and postradiation change.MEDIASTINUM AND HILA: The left superior paramediastinal mass again measures 3.6 by 11.4 cm (image 38 series 3). The reference right superior paratracheal node (image 17 series 3) remains 9 mm. The reference cardiophrenic lymph node is also unchanged measuring 1.4 cm in short axis (image 78 series 3).The reference left infrahilar lymph node (image 63 series 3) remains 2.2 cm. scattered supraclavicular lymph nodes, mildly improved although the two larger lymph nodes (image 15 series 3) remain essentially unchangedThe cardiac and pericardial marked otherwise within limits other than the moderate pericardial effusion.CHEST WALL: Borderline left hilar lymph nodes again measuring 1 cm in short axis.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Small suspected subcentimeter cysts. Punctate gas is observed in the gallbladder similar to the prior exam end of uncertain significance.SPLEEN: Mild splenomegalyADRENAL GLANDS: Unchanged nodularity of the right adrenal glandKIDNEYS, URETERS: No significant abnormality noted. Small stable left renal cystsPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Borderline lymph nodes without distinct lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Scattered degenerative changes unchangedOTHER: No significant abnormality noted.
Stable pulmonary and thoracic reference measurements
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Female 50 years old; Reason: left breast IDC; s/p left lumpectomy, SNBx with 5 LN involved. CT scan for metastatic work-up History: none CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. No pleural effusions. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Common trunk for the inferior pulmonary veins, an anatomical variant.CHEST WALL: Post operative changes in the left breast. Fluid cavity measures 7.6 x 2.3 cm on image 49/series 3.Post operative changes in the left axilla. Small but hyper enhancing left axillary lymph node measures 1.1 x 0.9 cm (image 33/series 3). ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small fat-containing hypodense lesions in the right kidney likely represent small AMLs . No hydronephrosis either kidney.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.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: No significant abnormality noted.
1.Post operative changes in the left breast with small left axillary lymph node.
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74 year old male. Reason: wt loss and microscopic hematuria CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Left thyroid lobe small cyst. Right hilar calcifications compatible with old granulomatous disease. CHEST WALL: Multiple metallic pellets in the right lateral chest wall and lung base from old gunshot wound. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. 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. Normal appendix in the right lower quadrant. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small fat-containing umbilical hernia. PELVIS:PROSTATE, SEMINAL VESICLES: Brachytherapy seeds in the prostate. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Fat-containing right inguinal hernia.
No acute abnormality to explain weight loss and hematuria. Brachytherapy seeds in the prostate. Cholelithiasis.
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56-year-old male with history of nasopharyngeal carcinoma, chemoradiation therapy, lung nodules, reevaluate Limited intracranial and orbital views are unremarkable. Opacification of the visualized right mastoid air cells. The left mastoid air cells are clear. Mucosal thickening with obliques regions in the right maxillary sinus. Scattered mucosal thickening of the ethmoid air cells.Interval development of a hypoattenuating rim enhancing collection/lesion with suggestion of enhancing septations along the prevertebral space, left greater than right, which extends from C5 to approximately T1-T2. At C6-C7, where the collection is centered, there has been interval development of lucencies within the C6 and C7 vertebral bodies, C7 greater than C6, with interval endplate erosive changes. Additionally, there is a soft tissue density posterior epidural component at these levels which results in some narrowing of the central spinal canal and may extend through the neural foramen.Posttreatment changes are again present including mild anatomic distortion in the nasopharynx and oropharynx as well as effacement of mucosal features and fascial planes. No lymphadenopathy by CT size criteria. No interval change in prominence of the right piriform sinus and right laryngeal ventricle. The salivary glands and thyroid are free of focal lesions. The cervical arterial structures are patent. Similar to the prior, the right IJ vein is not identified above the level of the retromandibular vein.Biapical scarring of the visualized lungs. Please see dedicated chest CT report from today's date for further details.
1. Interval development of a rim enhancing hypoattenuating prevertebral space collection/lesion extending from C5 to T1-T2 and permeative changes and endplate erosion of the C6-C7 vertebral bodies with a posterior epidural soft tissue component resulting in some narrowing of the central spinal canal and probable neuroforaminal involvement. These findings are most likely secondary to metastatic disease. However, cannot definitively exclude osteomyelitis-diskitis with a prevertebral abscess. Recommend MRI of the cervical spine with contrast for further evaluation.2. No cervical lymphadenopathy or soft tissue masses within the suprahyoid neck.
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79-year-old patient with history of recurrent buccal cancer on therapy. Evaluate for disease progression. Head: Stable changes associated with left parietal craniotomy including bony defect and left sided dural thickening. There is stable patchy hypoattenuation within a periventricular and subcortical distribution most likely representing sequelae of chronic small vessel ischemic disease. There are no acute intracranial lesions including mass, edema, hemorrhage or hydrocephalus. The midline is intact. Orbits and mastoids are normal.Neck: There is a left-sided Port-A-Cath with marked narrowing of the left internal jugular vein. Postoperative findings include right hemiglossectomy and hemimandibulectomy with resection of the submandibular gland and the multiple flap reconstructions in addition to tracheostomy placement. There is significant artifact related to metallic hardware. There has been closure of the previously described defect overlying the mandible at the site of osteotomy with associated alteration of soft tissue configuration deep to this, including subcutaneous stranding and distortion of graft fat. There is a soft tissue mass centered within the right retromaxillary fissure, eroding the posterolateral wall of the right maxillary sinus and involving the inferior aspect of the maxillary sinus (series 80229 image 63). This likely invades the pterygopalatine fossa where there is less distinct soft tissue stranding and results in erosion of the right maxillary alveolar ridge. This is inseparable from adjacent buccal thickening and it is difficult to differentiate what represents tumor versus thickened mucosa versus granulation tissue. The soft tissue within the inferior aspect of the right maxillary sinus most likely represents a combination of tumor mucosal thickening.The tongue demonstrates an unchanged configuration including postoperative changes. Mucosa of the hypopharynx, larynx and proximal trachea are unremarkable. Small scattered nodes are demonstrated throughout the neck including one note anterior to the manubrium which measures 12 x 9 mm today (previously 9 x 8 mm - series 80229 image 418). No other nodes have increased in size or are significant by size criteria. The left submandibular and parotids are unremarkable. There is extremely dense atherosclerotic calcification of carotid bifurcations bilaterally. Exact quantification of stenosis is difficult secondary to the dense calcification, though right sided calcification/plaque is more pronounced than left and there is likely a significant stenosis at this level. There is progressed degenerative change of the cervical spine which is straightened and demonstrates intervertebral disk height loss most prominent at C5-6 and C6-T1 as well as antrolisthesis of C4 on 5 (3.5 mm) and C7 on T1 (4.4 mm) on the basis of degenerative change. There are endplate changes and vacuum phenomena C6-7 and C7-T1. New airspace opacity within the peripheral aspect of the right posterior lobe and a small pleural effusion in addition to stable emphysematous changes of the lungs.
1.Soft tissue density in centered in the right retromaxillary fossa eroding the posterior lateral wall of the maxillary sinus and alveolar ridge representing tumor recurrence. Exact margins are difficult to differentiate from mucosal thickening and granulation tissue given treatment and reconstruction.2.Slight increase in the size of a lymph node anterior to the manubrium as described. No other obvious lymphadenopathy demonstrated. 3.Progressed degenerative disease of the cervical spine. No obvious aggressive lesion demonstrated.4.Progressed atherosclerotic disease and calcification at the carotid bifurcations, more so on the right than left.5.Interval interval covering of the defect overlying the right mandible at the site of osteotomy.
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Head and neck cancer, follow-up CHEST:LUNGS AND PLEURA: A stable irregular left lower lobe mass posteriorly with changes suggesting internal necrosis again measures 3.9 x 2.3 cm (image 16 series 5). Basilar scarring and atelectasis essentially unchanged. No superimposed new acute focal air space abnormality. No effusions.MEDIASTINUM AND HILA: Hypodense right thyroid nodule (image 6 series 3)No lymphadenopathyExtensive coronary calcifications without additional cardiac or pericardial abnormalityCHEST WALL: Right chest port and old healed rib fracturesABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Unchanged nodular thickening of the left adrenal glandKIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Dense aortic and branch calcifications.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Stable left basilar pulmonary mass representing presumed metastatic disease
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Reason: evaluate for sternal/xyphoid process abnormality History: chest wall pain, protruberance in region of xyphoid process LUNGS AND PLEURA: Diffuse bronchial thickening suggestive of bronchitis or asthma.4 mm subpleural solid nodule in the left lower lobe, unchanged since 2/28/2013, and presumably benign.MEDIASTINUM AND HILA: Residual thymic tissue in the anterior mediastinum.Marked coronary artery calcification and/or a stent in the left anterior descending branch.Mildly enlarged nonspecific lymph nodes in the lower para-aortic and gastrohepatic regions.Moderately dilated and thickened esophagus.CHEST WALL: Slightly prominent and irregularly mineralized xiphoid process, unchanged since 2/28/2013.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
1. Prominent xiphoid process without any significant pathology or interval change.2. Thickened and mildly dilated esophagus of uncertain etiology.3. Diffuse bronchial thickening suggestive of bronchitis or asthma.
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Male 72 years old; Reason: Hx of Bladder Cancer s/p cystectomy with ileal conduit. Eval for recurrent/metastatic disease. History: See above ABDOMEN:LUNGS BASES: Well healed left posteriomedial rib fractures.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst. Mildly prominent left renal collecting system.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta.No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right lower abdominal ileal conduit.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomyLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Status post cystoprostatectomy and ileal conduit; No evident metastatic disease
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Head and neck cancer CHEST:LUNGS AND PLEURA: Diffuse and largely centrilobular emphysema. A stable right upper lobe pleural thickening with associated loculated small fluid collection unchanged mild volume loss as expected post radiation change with left to right mediastinal shift. Essentially resolved left basilar changes suggesting prior aspirationMEDIASTINUM AND HILA: No lymphadenopathyMild coronary calcifications without superimposed additional pericardial or cardiac abnormality. Moderate aortic tortuosity and more pronounced atherosclerotic diseaseCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small suspected renal cyst unchanged bilaterallyPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.G-Tube with a jejunostomy tube with redundancy observed in the stomach unchangedBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Largely resolved aspiration and diffuse underlying emphysema and post radiation changes. No suspicious new findings to suggest recurrent or metastatic disease
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68-year-old female with chest heaviness and abnormal chest radiograph LUNGS AND PLEURA: Multiple bilateral pulmonary cysts and scattered bullae. Basilar predominant interlobular and intralobular septal thickening. Small centrilobular nodules. No suspicious nodules or masses.MEDIASTINUM AND HILA: Atherosclerotic calcifications of the aorta and moderate coronary arterial calcification. The heart size is size is normal.CHEST WALL: Degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
1. Cystic/bullous disease. 2. Basilar predominant interstitial disease with centrilobular nodules and intralobular septal thickening. Correlate with history of smoking. Differential may include LIP, LAM or small airways disease.
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36-year-old female concern for ureteral injury. Reason: rule out ureteral injury History: CS with extension low into uterus concern for ureteral injury ABDOMEN:LUNG BASES: Small bilateral pleural effusions and subsegmental basilar consolidation/atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted. No evidence of extravasation of contrast outside the collecting system on delayed images to suggest ureteral injury. There is no opacification of the distal right ureter due to mass effect/compression by the large uterus with resultant mild right hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Several foci of free intraperitoneal air consistent with recent surgery.PELVIS:UTERUS, ADNEXA: Large, postpartum uterus, with fluid, blood, and foci of gas in the endometrial cavity. Postoperative changes consistent with history of cesarean section.BLADDER: Foley catheter noted. No evidence of contrast extravasation to suggest collecting system injury.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes in the anterior lower abdominal wall, with multiple foci of gas in the soft tissues.OTHER: No significant abnormality noted
Changes status post cesarean section without evidence of collecting system injury.
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Reason: 65 yr old male with h/o MDS, pre-SCT evaluation History: evaluate LUNGS AND PLEURA: Mild apical paraseptal emphysema.Scattered nonspecific micronodules.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Mildly prominent scattered mediastinal lymph nodes without definite lymphadenopathy.Mild cardiac enlargement without evidence of pericardial effusion.Severe coronary artery calcification.Hypoattenuating blood pool compatible with anemia.CHEST WALL: Changes of degenerative disk disease at T11- T12 and mild anterior wedging of T12 of indeterminate age.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy.Mild perinephric stranding. Splenule. A
No significant pulmonary or pleural abnormalities.
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46-year-old female patient with history of metastatic thyroid cancer, on therapy. Evaluate for disease and compare to previous examinations with measurements. CHEST:LUNGS AND PLEURA: Interval decrease in the size and number of pulmonary nodules. Right lower lobe reference nodule measures 11 x 11 mm (series 5 image 162), previously 12 x 8 mm.No focal air space opacity or pleural effusion.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion.Interval decrease in size of mediastinal and hilar lymph nodes. Reference right hilar lymph node measures 11 mm (series 3 image 42), previously 19 mm.Superior mediastinal soft tissue mass is compatible with residual thymic tissue and is stable.Status post thyroidectomy with surgical clips at the thyroid bed.CHEST WALL: Lucent lesions in the manubrium, bilateral humeral heads, right iliac wing, T12 and L3 vertebral bodies are unchanged compared to prior examination and are compatible with metastatic disease.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Stable right adrenal nodule measures 1.3 x 1.9 cm (series 3 image 88) and is consistent with metastatic disease.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 markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Slight interval decrease in the dimensions of pulmonary and mediastinal metastases.Stable adrenal metastases and osseous metastatic lesions.
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82-year-old female patient with AML and history of fungal pneumonia. Present with worsening cough. Evaluate for worsening pneumonia versus other process. LUNGS AND PLEURA: Two focal irregularly shaped opacities in the left upper lobe, each approximately 1 cm in size (series 5 images 11 and 18), are new and are suggestive of fungal infection.Right major fissure nodule is stable compared to prior examination and likely represents an intrapulmonary lymph node.Minimal bibasilar scarring.Scattered nonspecific micronodules, unchanged.MEDIASTINUM AND HILA: Mild cardiomegaly without pericardial effusion. Moderate coronary artery calcifications. Mild atherosclerotic changes in the thoracic aorta.Left-sided central venous catheter with tip in the superior vena cava.Stable scattered prominent mediastinal lymph nodes. No significant hilar lymphadenopathy.CHEST WALL: Stable moderate multilevel degenerative in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
Two new small irregularly shaped nodular opacities in the left upper lobe suggestive of fungal infection.
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70 year-old male with history of head and neck cancer CHEST:LUNGS AND PLEURA: Reference left lower lobe perimediastinal pulmonary nodule measures 2.8 x 2.0 cm and previously measured 2.8 x 2.3 cm (image 8, series 4). No significant pleural effusion. Multiple bilateral pulmonary and subpleural metastases, many are mildly decreased in size.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Coronary arterial calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypoattenuating left hepatic lesions are unchanged and likely represent cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Numerous bilateral renal cysts are not significantly changed.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Unchanged nonspecific L3 sclerotic vertebral body focus.OTHER: No significant abnormality noted.
Numerous pulmonary metastases, many which are mildly decreased in size. No new metastases.
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52-year-old female with metastatic melanoma status post 4 cycles Taxol/CArbo/AVastin. Please assess response to therapy and compare to previous imaging. CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules are redemonstrated. The reference lesion in the right lower lobe measures 1.7 x 1 .5 cm, previously 1.9 x 1.7 cm. This lesion is questioned on the current study to represent consolidation versus loculated fluid in the horizontal fissure rather than a true nodule. Other non-reference lesions, likely representing true nodules, are reduced in size. The largest of these non-reference lesions is located in the right middle lobe and measures 1.2 x 0.9 cm from 1.6 x 1.2 cm previously.MEDIASTINUM AND HILA: Mediastinal adenopathy is redemonstrated. Reference subcarinal lymph node measures 2.3 x 1.7 cm, from previously 2.8 x 2.0 cm. Right hilar adenopathy is stable.CHEST WALL: Left anterior chest wall lesion measures 1.3 x 0.8 cm, unchanged. Left axillary lesions are grossly stable in size and morphology. Multiple subcutaneous nodules are redemonstrated in the soft tissues of the chest wall, shoulder, and back and are grossly stable in size and number.ABDOMEN:LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. Cholelithiasis without evidence of cholecystitis.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 pathologically enlarged retroperitoneal nodes.BOWEL, MESENTERY: Mesenteric adenopathy redemonstrated, reference lesion measuring 1.1 x 0.6 cm (image 125, series #3), unchanged.BONES, SOFT TISSUES: Reference subcutaneous soft tissue nodule measures 1.4 x 1.0 cm (image 132, series #3), slightly decreased from previously 1.6 x 1.3 cm.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.
1.Stable to slight improvement in metastatic disease, as indicated by pulmonary nodules, mediastinal adenopathy, subcutaneous nodules, and mesenteric adenopathy.2.Cholelithiasis.
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Reason: Pt with laryngeal CA s/p CRT completed 11/2012. please re-eval for recurrence and compare to prior scans History: as above CHEST:LUNGS AND PLEURA: Biapical scarring, slightly increased compared to previous scans.Interval clearing of right upper lobe ground glass opacity compatible with aspiration.Subpleural right lower lobe scars, unchanged.Interval clearing of focal left lower lobe air space opacity.Motion artifact degrades diagnostic detail at the lung bases.MEDIASTINUM AND HILA: Tracheostomy tube and voice prosthesis in place.Increased secretions are present in the central airways.Mildly enlarged lymph nodes in the lower paratracheal and precarinal regions, unchanged.Large sliding hiatal hernia.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral hypodensities compatible with cysts and multiple nonobstructing calculi bilaterally.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
No sign of metastases.
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Shortness of breath. Previous diffuse interstitial opacities, check for change LUNGS AND PLEURA: Diffuse new diffuse patchy groundglass opacities greater in the bases and on the right. No discrete effusions however these findings are superimposed upon previously described moderate interstitial changes and emphysema. Mild bronchiectasis in the discrete superimposed focal masses in this limited evaluation.MEDIASTINUM AND HILA: No lymphadenopathy.Borderline to mildly enlarged cardiac silhouette unchanged. Please note prior discussion above the intra-atrial septum currently is not reevaluated given lack of intravenous contrast. Pericardium unremarkable.Small hiatal herniaCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Marked abdominal ascites, essentially unchanged. Partially visualized sclerotic morphology of the liver incompletely visualized. Consider dedicated imaging if further characterization is needed
Interval increased airspace opacities throughout the lungs suggesting edema given the mildly enlarged silhouette however the appearance is non-specific and infection or less likely pneumonitis cannot be excluded.
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70 year-old female, history of head and neck cancer, restaging scan CHEST:LUNGS AND PLEURA: Decrease in size of cavitary right middle lobe nodule which now measures 1.6 x 1.4 cm and previously measured 2.1 x 2.4 cm (image 59, series 5). Right upper lobe ground glass opacities are not significantly changed. Scattered nonspecific micronodules appear similar to the prior study.MEDIASTINUM AND HILA: Right central venous catheter tip extends to the SVC. The heart size is normal. No mediastinal or hilar lymphadenopathy.CHEST WALL: Pathologic fracture at the site of the sternal metastasis with decreasing soft tissue component.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholecystectomy clips. Bilateral hypodense lesions are not significantly changed, likely representing cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Interval decrease in size of peripancreatic soft tissue mass which now measures 4.0 x 2.8 cm and previously measured 5.3 x 4.6 cm (image 22, series 3).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Previously noted soft tissue mass in the right pericolic gutter is not visualized on this exam.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.
1. Interval decrease in size of cavitary right middle lobe nodule and peripancreatic soft tissue mass. No new metastases.2. Pathologic fracture at the site of the sternal metastasis with decreasing soft tissue component.3. Unchanged right apical ground glass nodules, which may represent indolent adenocarcinoma.
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30 year-old female with recently diagnosed with stage IIB cervical cancer. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.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: Multiple prominent lower retroperitoneal lymph nodes; for reference, left para-aortic node measures 1.2 x 1.4 cm (series 401, image 133).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted. The known cervical carcinoma is not well visualized on this exam.BLADDER: No significant abnormality noted.LYMPH NODES: Several enlarged pelvic lymph nodes; reference left pelvic sidewall node measures 1.2 x 2.3 cm (series 401, image 165).BOWEL, MESENTERY: Small amount of free fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.No evidence of intrathoracic metastatic disease.2.Multiple prominent retroperitoneal and pelvic lymph nodes.
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63-year-old female with malignant neoplasm of the mouth of unspecified site, restaging status post 4 cycles of investigational systemic immunotherapy Head:The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement.The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Neck:No cervical lymphadenopathy by CT size criteria. No soft tissue masses or abnormal enhancement is present within the neck. No exophytic mass or focal effacement of the aerodigestive tract. Within the limitations of dental streak artifact, no oral cavity lesions are present. The salivary glands are free of focal lesions. Small hypoattenuating thyroid nodules. The major cervical vasculature is patent bilaterally.Destructive mixed sclerotic and lytic manubrial lesion appears similar to the prior. No additional suspicious osseous lesions are identified.Partially visualized right chest port catheter. The visualized portions of the lung apices demonstrate centrilobular emphysema and a persistent mixed groundglass and solid right apical opacity. Please see dedicated chest CT from today's date for further details.
1. No cervical lymphadenopathy or soft tissue masses in the neck.2. No significant interval change in destructive osseous manubrial lesion.3. Right apical part solid, part groundglass nodule which remains suspicious for indolent adenocarcinoma. Please see dedicated chest CT from today's date for further details.
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58-year-old male with right neck swelling Within the visualized brain, there is no edema, masses or acute hemorrhage.The orbits are unremarkable. There is a right maxillary mucus retention cyst/polyp. The mastoid air cells are clear. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The parotid, thyroid and submandibular glands are unremarkable. Punctate tonsillar calcifications are noted. Soft tissues of the neck are symmetric without masses evident. There is scattered nonspecific small cervical lymph nodes some of which are borderline enlarged by CT criteria. There atherosclerotic calcifications of the carotid arteries at the bifurcation, however they are patent without significant stenosis. The jugular veins are patent. There is mild degenerative changes of the cervical spine with posterior disk osteophyte complex at C5-C6. A left subclavian ICD is noted.
No findings to explain patient's symptoms, specifically no significant lymphadenopathy or soft tissue masses.
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62 year old female with laryngeal cancer status post CRT. Right neck pain radiating to right ear. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. Redemonstrated is change related to total laryngectomy with a soft tissue flap placement as well as tracheostomy and thyroidectomy. A tracheostomy tube and voice prosthesis are in stable position.The appearance of the surgical change is stable relative to prior exams. No focal soft tissue mass or pathologic adenopathy is detected. A soft tissue nodule along the right tracheoesophageal groove, referenced on prior examinations, is no longer discretely visible.Salivary glands are unremarkable. Cervical vasculature remains patent with the exception of the left IJ vein which does not opacify, a stable finding. Mild scarring in the lung apices. No concerning bony lesions. A sclerotic focus in the T3 vertebral body has been stable over multiple prior examinations and is probably benign.
No evidence of locally recurrent disease or new neck lymphadenopathy.
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39-year-old female presents with right lower quadrant pain x 1 day, nausea, vomiting, diarrhea, not tolerating p.o. Rule out appendicitis. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.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: Dilated appendix with periappendiceal fat stranding and edema. Appendicolith identified. Adjacent cecal wall thickening. Findings are consistent with appendicitis. No loculated fluid collection or evidence of intraperitoneal free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Myomatous uterus. 4-cm left thin-walled homogeneous adnexal cystic structure with no internal septation favors benign/physiologic etiology.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: Small amount of free fluid in the pelvis.
1.Findings consistent with acute appendicitis.Findings were discussed with Dr. Munitz of the emergency department at 2:28 p.m. on November 27, 2013 via telephone.
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65 year old patient with metastatic CA. Evaluate for disease with measurement. Head: There is no acute intracranial abnormality including mass, hemorrhage, hydrocephalus or edema. Gray-white differentiation is unremarkable and the midline is intact. Orbits and paranasal sinuses, mastoid air cells and bony structures are unremarkable.Neck: There are no visualized masses. Mucosa of the nasopharynx, oropharynx and hypopharynx is unremarkable. Epiglottis, larynx and puriform sinus is normal. Proximal trachea is unremarkable. There is no pathologic lymphadenopathy and the submandibular and parotid glands are unremarkable. Vasculature is unremarkable with the exception of atherosclerotic calcification at the carotid artery bifurcations bilaterally.There are two unchanged 5-mm hypoattenuating thyroid nodules, one within each lobe. There is an unchanged pattern of linear densities demonstrated at the posterior aspect of the right pulmonary apex which could be in keeping with airspace disease or radiation pneumonitis.
No suspicious lesion demonstrated within the head and neck. Stable from previous.
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77-year-old female with metastatic breast cancer. Persistent nausea and back pain. Evaluate for GI involvement. CHEST:LUNGS AND PLEURA: Stable right apical scarring. Stable tubular/branching opacity in right apex, which may represent a bronchocele (series 6, image 26). Basilar predominant dependent atelectasis.No suspicious nodules.MEDIASTINUM AND HILA: Large heterogeneous right thyroid lobe unchanged. Multiple calcified mediastinal and hilar lymph nodes consistent with prior granulomatous infection. Moderate coronary artery calcifications.No pathologically enlarged mediastinal lymph nodes. Heart size normal. Small hiatal hernia.CHEST WALL: Multiple scattered sclerotic foci throughout osseous structures not significantly changed and consistent with skeletal metastases. Vertebral body heights are maintained.ABDOMEN:LIVER, BILIARY TRACT: Fat infiltration of the liver. Status post cholecystectomy. No suspicious liver lesions.SPLEEN: Multiple splenic granulomas.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuating lesions in both kidneys, most likely benign cysts. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple scattered sclerotic foci throughout osseous structures not significantly changed and consistent with skeletal metastases. Vertebral body heights are maintained.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.
1.No abnormality to explain patient's nausea.2.No significant change in multiple sclerotic foci throughout osseous structures, presumably reflecting treated metastases. No evidence of fracture or vertebral body height loss.
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48-year-old female with persistent abdominal pain. Concern for hernia. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Multiple hypoattenuating lesions throughout the liver, many of which are too small to characterize. While most of these likely represent cysts, there is a cluster of ill-defined hypodense foci in segment 4B, which is of unclear etiology (series 3, image 37).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 notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Bony protuberance arising from right pubic bone, likely an osteochondroma/exostosis. OTHER: No significant abnormality noted
1.No hernia. 2.Multiple hypoattenuating lesions throughout the liver, many of which are too small to characterize. While most of these likely represent cysts, there is a cluster of ill-defined hypodense foci in segment 4B, which is of unclear etiology. Dedicated liver MRI may be helpful in further characterization. 3.Bony protuberance arising from right pubic bone, most consistent with benign osteochondroma/exostosis.
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82-year-old male with new onset shortness of breath and pain in right upper chest near medial scapula, evaluate for osseous disease. LUNGS AND PLEURA: Mild diffuse emphysema. Scattered micronodules some of which are calcified compatible with prior granulomatous disease. Mild bronchial wall thickening. No suspicious nodules or masses.MEDIASTINUM AND HILA: Prominent aortic root. Moderate coronary arterial calcification and atherosclerotic calcifications of the aorta. The heart size is normal.CHEST WALL: Moderate loss of height of the T6 vertebral body and mild loss of height of the T4 vertebral body appearing similar to the prior exam. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Atherosclerotic calcifications of the abdominal aorta and its branches.
1. Compression deformity of the T6 and T4 vertebral bodies. The T6 vertebral body compression fracture appears similar to the prior radiograph in 2012. The T4 vertebral body may also be chronic although mild interval progression cannot be excluded.2. Mild diffuse emphysema.3. No discrete lytic or blastic osseous lesions, however, MRI would be more sensitive for further evaluation if there remains high clinical concern for osseous disease.
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Reason: pt with metastatic melanoma s/p 4 cycles Taxol/CArbo/AVastin please assess response to therapy and compare to previous imaging History: metastatic melanoma Please note that the measurements may be affected by differences in patient positioning from the prior study.Multiple nodules and masses throughout the left extremity are again seen compatible with patient's history metastatic melanoma. Beginning distally multiple reference nodules measure:Along the dorsal radial aspect of the carpus: 27 x 15 mm (series 6, image 180) previously measuring 24 x 28 mm.Along the radial aspect of the distal forearm: 30 x 20 mm (series 6, image 155) previously measuring 31 x 24 mm. Low-density located centrally likely reflects necrosis.Largest mass in a conglomerate of nodules within the medial soft tissues just proximal to the medial epicondyle of the humerus: 24 x 29 mm (series 6, image 98) previously measuring 32 x 39 mm.In the subcutaneous fat posterior to the mid humeral diaphysis: 6 x 7 mm (series 6, image 71) previously measuring 13 x 9 mm.Subcutaneous lesion in the axillary fold measures 12 x 11 mm (series 6, image 50) previously measuring 14 x 12 mm.There is an additional axillary node located more deeply now measuring 20 x 18 mm (series 6, image 44) previously measuring 16 x 16 mm, although this may reflect differences in patient positioning. Additional masses and nodules subjectively appear slightly smaller on the current study compared to the prior study.Surgical clips again noted in the left axilla. Mild heterogeneity of the marrow of the humerus may represent reconverted red marrow although it is impossible to exclude metastatic disease. This may be further evaluated with MRI if clinically warranted.
Multiple nodules and masses compatible with metastatic melanoma, nearly all of which have decreased in size. One axillary node appears to have increased very slightly in size although this may reflect differences in patient positioning rather than a true increase in size.
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64 year old male. Reason: Mass noted on TTE believed to arise from pulmonary veins. Please evaluate this structure History: SOB. History of Crohn's disease. Height: 70 inWeight: 196 lbsBSA: 2.1 m^2BMI: 28.1 kg/m^2Left Atrium: The left atrial volume minus the pulmonary veins is 115 ml. There are four distinct pulmonary veins which drain normally into the left atrium.RSPV: 19.4 x 16.3 mmRIPV: 16.4 x 14.7 mmLSPV: 10 x 16.8 mmLIPV: 18.6 x 8.8 mmLUNGS: There is a 1.6 cm diameter cyst in the right lower lobe, probable pneumatocele. Numerous borderline enlarged mediastinal lymph nodes. Foci of coronary artery calcification in the LAD and LCx. OTHER: Splenule. Fatty infiltration of the liver parenchyma. Left ventricular hypertrophy.
No discrete abnormality to explain TTE findings. No mass in the left atrium or pulmonary veins. 1. Normal left atrial size and anatomy. 2. Normal pulmonary vein anatomy.
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63-year-old female status post left triple lumen catheter placement, rule out pneumothorax versus atelectasis LUNGS AND PLEURA: Interval total atelectasis of the left lung with volume loss and mild mediastinal shift to the left. Debris fills the left mainstem bronchus. Moderate left pleural effusion and left basilar chest tube. Right pleural effusion and compressive atelectasis with chest tube directed inferiorly.MEDIASTINUM AND HILA: Interval LVAD placement. ICD leads are unchanged. Central venous catheter tips extend to the cavoatrial junction. Swan-Ganz catheter and mediastinal drains. Mitral prosthesis. Mediastinal lymphadenopathy is again noted, likely reactive in etiology. Calcified lymph nodes, compatible with prior granulomatous disease.Cardiomegaly and mild pericardial thickening/effusion. Moderate coronary arterial calcification and atherosclerotic calcifications of the aortic arch.CHEST WALL: Status post median sternotomy. Diffuse anasarca.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Layering hyperdense bile.
1. Interval collapse of the left lung with debris filling the left mainstem bronchus likely representing secretions. Moderate bilateral pleural effusions. No evidence of pneumothorax.2. Bilateral pleural effusions.
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30 year-old female with altered mental status. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
No acute intracranial abnormality.
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69 year-old male with newly diagnosed AML, initiation of chemotherapy. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for mild mucosal thickening of the ethmoid air cells.
1. No acute intracranial abnormality. 2. Mild ethmoid sinus inflammatory disease. No acute sinusitis.
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35 year old female. Reason: Crohn's disease w/abd pain, questionable narrowing on OSH imaging. History: abd pain, N/V ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hypodense liver parenchyma, compatible with fatty infiltration. Status post cholecystectomy.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: Status post ileocecectomy. Mid-ileal segment of small bowel has a thickened wall with mucosal contrast enhancement seen best at coronal image 83. The segment measures approximately 10 cm in length. There is a shortened small bowel and evidence of chronic inflammatory changes with a somewhat patulous neoterminal ileum. Lesser degrees of wall enhancement are seen in ileal segment contiguous with the 10-cm lesion described above. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is loss of haustration and mildly increased mucosal contrast enhancement in the distal descending colon and sigmoid. This may be due to active or chronic inflammatory bowel disease, but the assessment is difficult due to lack of distention.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid in the pelvis, probably physiologic.
Thickened wall and mucosal contrast enhancement in mid-ileal loops is most compatible with active Crohn's disease. Findings are most prominent in a 10 cm segment of mid-ileum. Borderline inflammatory abnormalities are seen in the adjacent ilium and neoterminal ileum, as well as the distal descending colon and sigmoid. No fistula or abscess.
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Female, 25 years old. Reason: Status post renal txp, with CMV viremia, c diff and continued abdominal pain. Previous CT with poor PO contrast. Please re-evaluate. History: abdominal pain Exam is not sensitive at detecting lesions in the solid organs of vasculature due to lack of intravenous contrast. ABDOMEN:LUNG BASES: Small bilateral pleural effusions. Groundglass opacities suggestive of edema and several small micronodules bilaterally are unchanged.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic native kidneys consistent with history of medical renal disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The transverse colon, suspected to be abnormal on the prior CT scan of 11/23 is now filled with gas and there is no significant abnormality. Enteric contrast has reached the ascending colon. No specific abnormality was found. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Atrophic renal allograft right iliac fossa.Renal allograft left iliac fossa is unchanged. PELVIS:UTERUS, ADNEXAE: Stable right adnexal fluid collection likely ovarian cyst.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No definite free or loculated fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
Transverse colon has normal appearance. No bowel abnormality was found. Other findings are stable. No specific abnormality was found to explain abdominal pain. Bilateral pleural effusions.
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79 year-old female with metastatic lung adenocarcinoma. Reason: RPGN s/p renal transplant and metastatic lung adenocarcinoma presenting w abdominal pain, nausea, vomiting - eval for tumor progression, and other causes of abdominal pain. CHEST:LUNGS AND PLEURA: Marked left pleural thickening, volume loss, and cavitation with air-fluid level/hydropneumothorax in left hemithorax. Heterogeneous left mid lung mass is ill-defined, but appears stable. Nodule in right lower lobe measures 6 mm is stable. Otherwise, right lung is unremarkable.MEDIASTINUM AND HILA: Several enlarged lymph nodes in the upper mediastinum are stable.Severe atherosclerotic calcifications the aorta and coronary arteries. Heart is normal in size without pericardial effusion.Right central venous catheter terminates in upper right atrium.CHEST WALL: Left axillary lymphadenopathy and multiple left chest wall metastatic lesions; for reference left axillary node measures 3.1 x 4 cm (series 3, image 28).Multiple sclerotic foci in the osseous structures consistent with metastases. Significant sclerosis of all left ribs, which may be due to superimposed post radiation change. ABDOMEN:LIVER, BILIARY TRACT: Multiple hypoattenuating liver lesions compatible with metastases; no significant changeSPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal gland nodule measures 1.4 x 2.0 cm, nonspecific but may represent metastatic lesion.KIDNEYS, URETERS: Atrophic right kidney containing upper pole cyst. Status post left nephrectomy.RETROPERITONEUM, LYMPH NODES: Significant atherosclerotic disease affects the aorta and its branches. No evidence of retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple sclerotic foci in the osseous structures consistent with metastases.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: Large amount of stool in the rectum.BONES, SOFT TISSUES: Multiple sclerotic foci in the osseous structures consistent with metastases.OTHER: Right iliac fossa transplant kidney containing cyst noted.
1.Left lung mass consistent with known lung neoplasm, with associated left lung volume loss, hydropneumothorax, and pleural thickening.2.Metastatic disease noted involving osseous structures, axilla, chest wall, and liver is stable. 3.Other findings are stable since 11/26/2013.
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57 year old male. Reason: cholecystitis? History: RUQ abd pain ABDOMEN:LUNG BASES: Bibasilar atelectasis, right greater than left.LIVER, BILIARY TRACT: No definite cholelithiasis or cholecystitis although CT is less sensitive than ultrasound to evaluate the gallbladder. If indicated, ultrasound examination may be helpful for further evaluation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Both kidneys are enlarged with innumerable simple and complex cysts bilaterally. Findings are consistent with polycystic kidney disease. No definite solid masses. A prominent mass, probable cyst, is seen at the right renal hilum measuring 8 cm in diameter. The available images from an outside 2011 MRI examination show that this radiodense lesion has been present with minimal interval change. Most likely a hemorrhagic or proteinaceous cyst.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: No significant abnormality notedOTHER: No significant abnormality noted
Polycystic kidneys. No definite cholelithiasis or cholecystitis, although ultrasound examination may be helpful for further evaluation, if indicated.
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97 year-old female with abdominal pain. Reason: eval for mass, lesion seen on EGD, melena. ABDOMEN: Please note that this examination is limited in sensitivity for solid organ pathology due to lack of IV contrast.LUNG BASES: Bilateral lower lobe atelectasis, scarring, and traction bronchiectasis. No air space opacity suggestive of pneumonia. Calcified hilar lymph nodes.LIVER, BILIARY TRACT: No significant abnormality noted in the liver. Status post cholecystectomy since the prior exam. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Extrarenal pelvis in the left kidney is unchanged since the 1/20/2013 examination.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia. Gastric lesion is difficult to define, due to lack of enteric contrast in the stomach. Similarly, comparison with the prior exam on 1/28/2013 is difficult for the same reason. Suspicious for 3 cm diameter mid-gastric mass at axial image 34 series 4 and coronal image 70. Normal caliber loops of bowel without obstruction, associated fluid, or pneumoperitoneum. BONES, SOFT TISSUES: Sclerotic and lytic changes of the T11 vertebral body with compression deformity. Benign L4 bone island. Mild to moderate degenerative changes of the thoracolumbar spine.PELVIS:UTERUS, ADNEXA: Calcified uterine fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber loops of bowel without obstruction, associated fluid, or pneumoperitoneum. Normal appendix.BONES, SOFT TISSUES: Coarsened trabeculae and thickened cortex in the right hemipelvis, consistent with Paget's disease.
1. Status post cholecystectomy since the prior examination. 2. Paget's disease with involvement of the right hemipelvis and thoracic spine.3. Mid-gastric mass, ~3 cm diameter, corresponds with the abnormality found at EGD.
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63-year-old female with history of left parietal glioma. There is redemonstrationof a left parieto-occipital craniotomy with associated postsurgical changes. There is a small amount of pneumocephalus. Hypodense surgical cavity appears more defined in the left parietal lobe at the site of prior tumor. There are small hyperdensities in this region which likely represents trace hemorrhage. The edema in the left parietal lobe persists. There is no significant extra-axial fluid collections. There is minimal effacement of the left lateral ventricle without midline shift. Ventricular size is normal. The basal cisterns are normal in size and configuration. Bilateral basal ganglia calcifications are noted. Scattered periventricular and subcortical white matter hypodensities are stable and likely represent mild to moderate chronic small vessel ischemic disease. The paranasal sinuses are hypoplastic but clear. The mastoid air cells are clear.
Stable postsurgical changes of the left parieto-occipital craniotomy. No midline shift or significant mass effect.
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36 year old female. Reason: POD #10 from radical hysterectomy.Rule out urinoma/bladder injury. DELAYED imaging please. History: pelvic pain, pelvic fluid collection ABDOMEN:LUNG BASES: Bibasilar atelectasis.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: Status post hysterectomy.BLADDER: The urinary bladder is decompressed with a Foley catheter.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: A small amount of gas and gas bubbles are present in the abdominal wall extending especially given to the right flank. These are most likely due to the patient's recent surgery.OTHER: There is a central pelvic ill-defined fluid collection containing gas bubbles with an enhancing rim compatible with abscess. This measures approximately 4 x 10 cm at axial image 120 of series 6. The collection extends 7 cm craniocaudally, seen best at coronal image 59. This collection is contiguous with the vaginal cuff. A small amount of pelvic ascites is present.
Pelvic fluid collection, compatible with abscess. No urinoma or other evidence of bladder injury. Bibasilar atelectasis. Subcutaneous emphysema in the abdominal wall is probably due to recent surgery.
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19 year old male. Reason: trauma, gross hematuria History: flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No subcapsular hematoma or definite evidence of liver laceration. There is heterogeneous opacification of the lateralmost right hepatic lobe inferiorly near the right kidney which has an associated hematoma. The hepatic findings most likely represent a focal contusion seen best at axial image 31 of series 7.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Precontrast views show a radiodense collection at the right renal hilum on image 15 of series 3 compatible with a acute hematoma. There is fluid within the perinephric region on the right compatible with perinephric hematoma contained within Gerota's fascia. No definite renal cortical defect was found. No hydronephrosis or hydroureter. The renal collecting systems are intact bilaterally. No urinoma was found.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Urinary bladder is moderately distended. No definite evidence of hemorrhage or clots.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
Right hilar and inferior pole hematoma without a definite associated renal clinical or cortical defect. Focal contusion of the inferior right hepatic lobe without subcapsular hematoma. No ascites.
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19 year-old male status post MVC. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
No acute intracranial abnormality.
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44 year old male. Reason: eval for metastases History: seminoma in L groin CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Prominent pretracheal lymph node measures 0.9 x 1.4 cm at image 42 of series 4. No other significant abnormality noted.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:PROSTATE, SEMINAL VESICLES: Prostatic calcifications. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
Minimally prominent pretracheal lymph node. No definite lymphadenopathy. No measurable metastatic disease.
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44 year-old male with seizure. There is a 32 x 24-mm CSF collection in the right temporal pole. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear. There is mild mucosal thickening of the paranasal sinuses.
No acute intracranial abnormality. Right temporal arachnoid cyst.
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63 year old female. Reason: Assess for peristomal varices; evidence of portal hypertension; colostomy for Crohn's disease. Multiple surgeries for Crohn's disease culminating in short small bowel and colostomy. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild hepatomegaly. The liver has normal morphology. No definite fatty infiltration or changes of cirrhosis. Hepatic vasculature is patent.SPLEEN: No significant abnormality noted. No splenic varices. No splenomegaly.PANCREAS: 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. Markedly shortened small bowel. The distal ileum located in the left lower quadrant is chronically dilated in this patient who is status post proctocolectomy. No evidence of peristomal varices.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Fat containing ventral hernia in the pelvic midline at axial image 110 of series 3. No ascites.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Status post proctectomy. Left lower quadrant colostomy. These findings appear relatively stable since the small-bowel follow-through examination of 9/1/2010.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
No definite evidence of portal hypertension, cirrhosis or varices. The distal ileum is dilated chronically. Mild hepatomegaly. No ascites. No splenomegaly. No splenic, gastric or esophageal varices.
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42 year-old male with history of trauma. There is mild patchy hypodensity in the periventricular white matter. The ventricles, sulci, and cisterns are symmetric and mildly prominent. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. There is deformity of the left orbital floor with no evidence of fluid collection or fat stranding.
1. No acute intracranial abnormality. 2. Minimal small vessel ischemic disease of indeterminate age. Mild brain volume loss. 3. Left orbital floor chronic blowout fracture.
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38 year old female. Reason: eval for malignancy History: bony and brain rim enhancing lesions CHEST:LUNGS AND PLEURA: There is a 1.8 x 2.3 cm right upper lobe mass, most likely a primary malignancy. Small bilateral pleural effusions with associated compressive atelectasis. Left lower lobe atelectasis.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Diffuse predominantly lytic skeletal lesions, mostly involving the spine compatible with widespread metastases.ABDOMEN:LIVER, BILIARY TRACT: Innumerable diffuse hypodense masses in the liver compatible with widespread metastases. Status post cholecystectomy.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: Diffuse predominantly lytic skeletal metastases involving the entire spine and pelvis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Radiodense IUD is in expected position. Uterine myoma.BLADDER: The urinary bladder is markedly distended, but otherwise unremarkable.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse predominantly lytic metastatic disease involving the lumbosacral spine, pelvis and hips.OTHER: No significant abnormality noted.
Right upper lobe lung mass, probably primary malignancy. Diffuse predominantly lytic skeletal metastases. Innumerable hepatic metastases. Bilateral pleural effusions.
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71 year-old male status post fall and syncope. The ventricles, sulci, and cisterns are symmetric and prominent. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. There is chronic blowout fracture of the left lamina papyracea.
1. No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Moderate brain volume loss. 3. Chronic blowout fracture of the left lamina papyracea.
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55 year-old male with right hemiparesis. The right frontal approached EVD is in unchanged position. The hemorrhage extends through the left thalamus, extending through the left cerebral peduncle, midbrain and cerebellar peduncle has decreased in density. A second focus is unchanged at the insertion site of the EVD with in the right frontal lobe. Intraventricular hemorrhage layers bilaterally has been less. No new hemorrhage. There has been no interval change in dimension of the ventricular system and there is no mass effect including midline shift or herniation.There is unchanged patchy hypoattenuation within the corona radiata bilaterally as well as the right basal ganglia and right thalamus. Secretions layering within the ethmoid, sphenoid, and right maxillary sinus are unchanged. There is scattered opacification of mastoid air cells. Orbits are unremarkable.
Stable to mildly decreased intracranial hemorrhages as described above. No new hemorrhage. Stable ventricular size. Stable right thalamic, right basal ganglial and cerebral white matter hypodensities.