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Generate impression based on findings.
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Female 50 years old Reason: H/O MZ Lymphoma with involvement in breast, sc tissue, and node in need of restaging. Please compare to prior. History: Marginal zone lymphoma CHEST:LUNGS AND PLEURA: Few micronodules unchanged.MEDIASTINUM AND HILA: Scattered small mediastinal nodes particularly in the prevascular space AP window and lower left paratracheal region. An index lesion in in the prevascular space lateral to the right artery on series 3 image 34 measures 0.9 x 0.4 cm. Previously 1 x 0.5 cm.Left paracardiac mass irregular in shape limiting sensitivity of measurements, series 2 image 45, 4.9 x 1.9 cm. Previously 3.6 x 1.5 cm, however comparison the coronal plane shows in its thickness also increased from 1.3-cm on 1/7/13 coronal image 63 to 1.6-cm in the current study coronal image 52.CHEST WALL: Known right breast mass measures 3.6 x 2.4 cm series 3 image 41.Reference left axillary node measures 1.1 x 0.8 cm series 2 image 14. Previously 1.2 x 0.9 cm.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: Redemonstration of a focus of nephrolithiasis and the left kidney without associated hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Small shotty retroperitoneal nodes unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Uterus may be atrophic or surgically absent although tissue is seen in the adnexa suggestive of the ovaries, unchanged correlate clinically. Previously seen left adnexal cyst has decreased in size.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No new sites of disease. Measurements of index lesions as above. The left paracardiac mass is increased somewhat in size. Nonobstructive left nephrolithiasis unchanged.
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Generate impression based on findings.
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Reason: 53-year-old female with T-cell lymphoblastic lymphoma. Evaluate for improvement/progression History: T-cell lymphoblastic lymphoma LUNGS AND PLEURA: Mild subpleural scarring, unchanged.No sign of infection.MEDIASTINUM AND HILA: Small right thyroid nonspecific hypodensity unchanged.Decrease in previously enlarged superior mediastinal nodesAlmost complete resolution of a previously described mediastinal mass (series 3/28), now 8 x 19 mm, compared to 17 x 29 mm previously.PICC line tip in the SVC.CHEST WALL: Degenerative disease in the spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Previously questioned diaphragmatic nodularity is not confirmed.Sclerotic nonspecific lesion in the L1 vertebra, unchanged.
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Marked further decrease in mediastinal mass and mediastinal lymph nodes.
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Generate impression based on findings.
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67-year-old male with history of CLL now with syncope There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is circumferential thickening of the right maxillary sinus extending into the right anterior ethmoid air cells with thickening of the adjacent bone. This is overall unchanged in appearance from the prior exam and likely represent chronic sinusitis. There is mild mucosal thickening of the left maxillary sinus. The mastoid air cells are clear. The right lens is thin. The skull and extracranial soft tissues are unremarkable.
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1.No evidence of acute intracranial hemorrhage, mass or cerebral edema.2.Chronic sinusitis involving the right maxillary sinus and right anterior ethmoid air cells.3.CT is insensitive for the early detection of non-hemorrhagic CVA.
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Generate impression based on findings.
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Male 54 years old; Reason: re-staging scans s/p 9 cycles of chemo/maintenance avastin/palcebo therapy History: hx of metastatic bladder cancer CHEST:LUNGS AND PLEURA: Mild centrilobular and paraseptal emphysema. Bilateral dependent atelectasis. Scattered bilateral micronodules are unchanged. No pleural effusion. Note is made of a 5-mm right lower lobe subpleural nodule which is difficult to accurately measure secondary to dependent atelectasis in the surrounding area, however, this previously measured 5 mm (44; series 5).MEDIASTINUM AND HILA: Heart size is normal with small pericardial effusion/thickening, unchanged. No mediastinal or hilar lymphadenopathy. Note is made of vascular calcifications of the aorta and its branches.CHEST WALL: Note is made of a subcutaneous nodule along the posterior aspect of the right superior hemithorax measuring 23 mm, previously 19 mm (image two; series 3). An additional subcutaneous nodule along the posterior lateral aspect of the left hemithorax also appears increased in size when compared to prior study measuring 2.5 x 2.0 cm (65; series 3). This previously measured 1.6 x 1.3 cm on prior examinations dating back to 7/24/2012.ABDOMEN:LIVER, BILIARY TRACT: Probable fatty infiltration of the liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland is nodular, unchanged.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Reference para-aortic lymph node measures 11 x 7 mm, previously 13 x 5 mm (image 112/series 3).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Post operative changes in the left inguinal region from lymph node dissection.Left inguinal lymph node measures 1.1 cm, previously 1.2-cm (image 201, series 3), unchanged.Reference left external iliac lymph node measures 1.3 x 0 .9 cm, previously 1.3 x 1.2 cm (image 175/series 3).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Persistent right lower lobe subcentimeter nodule. Slight interval increase in size of subcutaneous nodules in the thorax, as described above.2.No significant interval change in the reference lymph node measurements provided above.
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Generate impression based on findings.
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Reason: Metastatic parotid poorly differentiated mucoepidermoid carcinoma; s/p Completion of Radiation Therapy: 7 months lung, 4.5 years parotid History: Completion of Radiation Therapy: 7 months lung, 4.5 years parotid CHEST:LUNGS AND PLEURA: A prior bilobed 7 x 11 mm left upper lobe nodule has coalesced into 118 x 16 mm nodule image 43 series 5, consistent with metastasis.Other nodules and tree in bud opacities are unchanged, consistent with inflammation.Lower lung zone predominant bronchiectasis is present.MEDIASTINUM AND HILA: Stable left thyroid cyst. No mediastinal or hilar lymphadenopathy is present.Mild to moderate proximal coronary artery calcifications are seen.CHEST WALL: Mild degenerative abnormalities affect the thoracic spine.Left supraspinatus lipoma unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis without cholecystitis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small right renal cysts.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.
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1. Enlarging left upper lobe nodule consistent with a metastasis, more likely than a lung primary cancer.2. Unchanged postinflammatory appearing nodules and bronchial wall thickening.
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Generate impression based on findings.
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54-year-old male with lung cancer s/p Tarceva therapy > 5 months CHEST:LUNGS AND PLEURA: Status post right middle and lower lobe resection with volume loss and persistent right hydropneumothorax. Persistent medial right upper lobe scarring and bronchiectasis.Unchanged left pulmonary micronodules.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. The heart size is normal. Moderate coronary arterial and aortic arch calcifications.CHEST WALL: Old unchanged right rib fracture deformities.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Status post splenectomy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral hypoattenuating lesions, likely representing cysts, are unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Surgical clips are again noted in the upper abdomen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Status post right middle and lower lobectomy with persistent hydropneumothorax and posttreatment changes in the right upper lobe. 2. No specific evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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Male 73 years old Reason: Pancreas cancer please assess for any vein/artery involvement for surgical Whipple canidate and provide index lesion measurements History: As above CHEST:LUNGS AND PLEURA: Atelectasis or scarring at the lung bases. Small left pleural effusion a suggestion of some loculation or nodularity. No definite soft tissue components. Metallic structure along the left posterior costophrenic angle appears to be a surgical clip.MEDIASTINUM AND HILA: Port-A-Cath tip in SVC above RA junction. Atherosclerotic calcifications coronary arteries and evidence of prior mediastinal surgery.Moderately dilated esophagus along its entire course. Correlate clinically for motility abnormality or obstruction.CHEST WALL: Evidence of surgery left lower lobe. Partial rib resection. Also post sternotomy. Port-A-Cath right chest wall.ABDOMEN:LIVER, BILIARY TRACT: Biliary stent in place with expected pneumobilia and mild biliary dilatation. No definite focal liver lesions. Gallbladder wall thickening versus pericholecystic fluid.SPLEEN: No significant abnormality notedPANCREAS: An abrupt transition of the dilated pancreatic duct in the region of the pancreatic head neck junction. The pancreatic duct is dilated to about 9 mm is seen on venous coronal image 49. Body and tail of the pancreas are atrophic. The soft tissue density comprising the pancreatic head presumably represents or includes tumor which is not discretely visible as a separate structure. There is some subtle hypoattenuation in the medial aspect of the head which could represent a portion of the tumor. There is no evidence of encasement of the celiac artery or its branches. The pancreatic head abuts the superior mesenteric artery with loss of fat plane over a sector of about 107 degrees on series 13 image 107. Elsewhere in the fat around the superior mesenteric artery is preserved.The confluence might abut the tumor but is not encased. There is no evidence of thrombus in the portal splenic or mesenteric venous system.Jejunal branches of the SMA are intact. Atherosclerotic disease is seen in the SMA.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Vascular calcification versus nephrolithiasis thickening upper poles and elsewhere. No hydronephrosis. No perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes aorta and branch vessels. No evidence of aneurysm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes T12, L1, L2.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Heavy atherosclerotic disease.
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Pancreatic mass is not discretely measurable. Borderline resectable.
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Generate impression based on findings.
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58 year old male. Reason: mitral valve prolaspe. History: SOB. Pt. having robotic mitral valve repair. VESSELS:AORTIC VALVE PLANE TO INNOMINATE ORIGIN: 10 cmSINUS OF VALSALVA: 33.4 X 35.4 mmSINOTUBULAR JUNCTION: 28 X 28 mmASCENDING THORACIC AORTA AT LEVEL OF MAIN PULMONARY ARTERY: 30 X 31.6 mmASCENDING THORACIC AORTA IMMEDIATELY PROXIMAL TO THE INNOMINATE ARTERY: 31 X 30.6 mmPROXIMAL DESCENDING THORACIC AORTA IMMEDIATELY DISTAL TO THE LEFT SUBCLAVIAN ARTERY: 24 X 24.8 mmDESCENDING THORACIC AORTA AT LEVEL OF HIATUS: 24 X 30 mmSUPRARENAL ABDOMINAL AORTA: 21.4 X 22 mmINFRARENAL ABDOMINAL AORTA: 21 X 21 mmDISTAL AORTA PROXIMAL TO BIFURCATION: 17.6 x 17 mmRIGHT COMMON ILIAC ARTERY: 12.8 X 11.7 mmRIGHT EXTERNAL ILIAC ARTERY: 10 X 10 mmRIGHT COMMON FEMORAL ARTERY: 10.6 X 10 mmLEFT COMMON ILIAC ARTERY: 11.7 X 12 mmLEFT EXTERNAL ILIAC ARTERY: 10.2 X 9.4 mmLEFT COMMON FEMORAL ARTERY: 10 X 10 mmCHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.The aorta has normal caliber and taper. All major branches are patent. 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: Nonobstructing right lower pole renal calculi. Left lower pole complex cyst with focal calcification. 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:PROSTATE: 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.The aorta, iliac and femoral arteries have normal caliber and taper. All major branches are patent.
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1.No measurable coronary artery calcification.2.Normal ventricular morphology and volume. 3.Nonobstructing nephrolithiasis.4.Aorta and major branches have normal caliber and taper. 5.Focal atherosclerotic calcification at the right subclavian artery origin.
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Generate impression based on findings.
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80 year-old female with metastatic mucoepidermoid carcinoma of the left parotid status post radical left parotidectomy and neck dissection with radiation in 2008. Within the visualized brain, there is no edema, acute hemorrhage, enhancing masses or extra-axial fluid collections.There are post treatment changes of a left parotidectomy and neck dissection. Obscuration of the facial planes throughout the left neck are similar to the prior exam. There are no new or suspicious masses to suggest disease recurrence. No lymphadenopathy is identified.Asymmetric effacement of the left puriform sinus is stable. 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, submandibular, and thyroid glands are unremarkable. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Left carotid calcifications are noted at the bifurcation. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. For evaluation of the thorax, please see dedicated chest CT performed on the same day.
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1.Stable posttreatment changes without evidence of tumor recurrence.2.For evaluation of the thorax, please see dedicated chest CT performed on the same day.
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Generate impression based on findings.
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69 year-old female, status post AAA repair (TAA with EVAR). Reason: Patient with a history of TAA and AAA after infrarenal AAA retroperitoneal repair (9/2010) and endograft repair of TAA (2/2011). CHEST:LUNGS AND PLEURA: Minimal compressive atelectasis in the left lung.MEDIASTINUM AND HILA: In the coronal plane, the maximal dimension of the ascending aorta is unchanged at 3.8 cm (coronal image 75). At the level of the aortic arch adjacent to the proximal descending thoracic aorta, there is an unchanged mild saccular enlargement which is stable at 4.9 cm diameter (series 9, image 21). There is decreased crescentic intraluminal thrombus at this level that does not extend to the stent graft.Stable endovascular repair of the descending thoracic aortic aneurysm with no evidence of endoleak. Stent-graft extends to the level of the celiac axis. The diameter of the aneurysm is unchanged at 5.6 cm near the diaphragmatic hiatus (series 9, image 57).Extensive coronary artery calcifications. Mitral valve anulus calcification. Multiple right thyroid lobe cysts and nodules. Mild cardiomegaly. Dilated left ventricle. CHEST WALL: Multiple hypodense thyroid nodules are again noted. Degenerative changes of the thoracic spine. ABDOMEN: LIVER, BILIARY TRACT: Cholelithiasis. SPLEEN: No significant abnormality notedADRENAL GLANDS: Right adrenal nodule is stable, likely an adenomaKIDNEYS, URETERS: Atrophic right kidney. Unchanged multifocal areas of left renal scarring and left renal artery stenosis. No evidence of mass or hydronephrosis.PANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Infrarenal abdominal aortic aneurysm is unchanged at 3.7 cm in diameter (coronal image 71). Adjacent thrombosed aortic bypass graft again noted, unchanged.The SMA remains prominent provides arterial perfusion to the bowel as both the celiac and IMA are occluded. Celiac axis is occluded at its origin and reconstituted via the pancreaticoduodenal arcade.Ectasia of the right common iliac artery is unchanged. Left common iliac artery 2.0 cm aneurysm is stable (series 9, image 131)BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Calcifications within the uterus are compatible with fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild diverticulosis without diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.The external iliac and common femoral arteries are patent bilaterally.
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1. Stable size of the extensive thoracic and abdominal aortic aneurysm.2. Stable endovascular repair of the descending thoracic aortic aneurysm without evidence of endoleak. 3. No other significant change.
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Generate impression based on findings.
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57-year-old male with a history of esophageal carcinoma. Status post chemoradiation therapy. Rule-out metastatic disease. CHEST:LUNGS AND PLEURA: There is biapical scarring/atelectasis. Note is made of a left upper lobe pulmonary micronodule. There is a 9-mm pleural based nodule along the medial aspect of right middle lobe. (8; series 5).MEDIASTINUM AND HILA: Note is made of vascular calcifications of the aorta and its branches. There are mild coronary artery calcifications. There is no evidence of pericardial effusion. Note is made of thickening of the distal esophagus, consistent with the stated history of esophageal carcinoma which appear slightly increased when compared to the prior study.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: Note is made of multiple subcentimeter hypodensities within the kidneys, which are too small to characterize, but may represent simple cysts.RETROPERITONEUM, LYMPH NODES: Note is made of multiple prominent paraesophageal and gastrohepatic lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Thickening of the distal esophagus consistent with the stated history of esophageal carcinoma. There are multiple pulmonary nodules, otherwise, there is no evidence to suggest metastatic disease.
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Generate impression based on findings.
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72-year-old female with lung cancer, follow-up bilateral lung nodules CHEST:LUNGS AND PLEURA: Status post right lower lobe wedge resection. Left upper lobe part solid pulmonary nodule is increased in size with increasing solid component and now measures 18 x 11 mm and previously measured 18 x 9 mm (image 29, series 6). Reference nodule in the left lower lobe measures 13 x 6 mm and previously measured 10 x 5 mm (image 30, series 6). Adjacent ground glass opacity is again noted.Unchanged apical scar like opacities. Scattered micronodules some of which are calcified consistent with prior granulomatous disease.MEDIASTINUM AND HILA:.No mediastinal or hilar lymphadenopathy. Atherosclerotic calcifications and noncalcified plaque of the thoracic aorta.CHEST WALL: No axillary lymphadenopathy. Degenerative changes of the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Unchanged right hepatic hemangioma. Calcified gallstones.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small hypoattenuating lesions, likely representing cysts, are unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES:Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.
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Increasing size of left lower lobe partially solid nodules most consistent with primary lung cancer.
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Generate impression based on findings.
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Female, 50 years old, stage IV ovarian cancer status post debulking and chemotherapy on maintenance Avastin. The mucosal tissues of the aerodigestive tract are within normal limits. No abnormal soft tissue mass, focal enhancement or pathologically enlarged lymph node is seen.The salivary glands and thyroid are free of suspicious lesions. No significant vascular abnormality is detected. The bones of the skull base and cervical spine are free of focal destructive lesions. Lung apices are clear.
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No evidence of metastatic disease in the neck.
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Generate impression based on findings.
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Reason: h/o HNC, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Scarring and several micronodules unchanged.There is no evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.Moderate to severe coronary artery disease is present.CHEST WALL: Unchanged benign-appearing sclerotic focus left humeral head.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholecystectomy clips.Unchanged multiple small hepatic cyst like hypodensities.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple renal cysts and angiomyolipomas are unchanged.Nonobstructing left renal calculus stable.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.
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1. No sign of metastases.2. Stable large renal angiomyolipomas and nonobstructing left renal calculus.
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Generate impression based on findings.
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Clinical question: Evaluate for intracranial process. Signs and symptoms: Alteration of mental status. Nonenhanced head CT:No detectable acute intracranial process. CT of her is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces.Previously noted few small periventricular foci of increased T2/flair signal (demyelinating disease) on prior MRI exam cannot be identified with certainty on this study.Unremarkable calvarium and soft tissues of the scalp.Unremarkable images through the orbits.Well pneumatized bilateral mastoid air cells and middle ear cavities and partially visualized paranasal sinuses.
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No acute intracranial process.
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Generate impression based on findings.
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Male, 68 years old, history of sphenoid sinus cancer, follow-up exam. Postsurgical alteration consistent with bilateral frontal craniectomy is redemonstrated. A soft tissue flap bridging the calvarial defect is unchanged in appearance. Mild thickening of the underlying dura is also unchanged. Encephalomalacia of the bilateral frontal lobes is similar to prior.Extensive sinonasal surgical alteration is also redemonstrated including resection of the ethmoid air cells, the posterior nasal septum, the middle and superior turbinates. Soft tissue thickening along the right posterior lateral aspect of the ethmoid bed is unchanged. As before, this soft tissue overlies an area of bony deficiency at the right posterior medial orbit. The soft tissue is also contiguous with soft tissue opacifying the sclerotic sphenoid sinuses. The maxillary sinuses remain small, the right is completely opacified, and the left is partially opacified.No pathologic adenopathy is identified in the neck by size criteria. A left level 2 reference node measures 6 x 5 mm (image 48 series 6), previously 7 x 5 mm. More posteriorly, a left level 2/3 node measures 5 x 2 mm (image 60 series 6), previously 9 x 8 mm.Salivary glands and thyroid are free of suspicious lesions. Vascular structures are unremarkable. No concerning osseous lesions are demonstrated.
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Stable extensive postsurgical alteration involving the calvarium, nasal cavity and sinuses. Soft tissue thickening along the ethmoid resection bed, as well as within the sphenoid sinuses, is unchanged. No pathologic adenopathy is detected in the neck.
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Generate impression based on findings.
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Female 49 years old Reason: Stage IV sigmoid colon adenocarcinoma please assess and provide index lesion measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: The catheter tip at SVC RA junction. Minimal atherosclerotic calcifications. No pathologic size lymph nodes.CHEST WALL: Port-A-Cath right chest wall. Subcutaneous emphysema consistent with recent insertion.ABDOMEN:LIVER, BILIARY TRACT: A few punctate scattered hyperattenuating foci of nonspecific. This could be followed.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right-sided hydronephrosis with decreased nephrogram on the right. This is secondary to compression of the right ureter by the right adnexal mass.RETROPERITONEUM, LYMPH NODES: Low retroperitoneal lymph nodes. For baseline purposes distal aortic caval node is measured on series 2 image 125, 1.9 x 1.6 cm.BOWEL, MESENTERY: Marked generalized ascites. Some nodularity in the omentum consistent with carcinomatosis. The baseline purposes solid component is seen in the right paracolic gutter measuring 1.4 cm in thickness is seen on coronal image 64/104 and in the axial plane measured on series 3 image 134/212 as 1.5 x 1.2 cm.The bowel is compressed but nonobstructive.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Large complex bilateral adnexal masses suggestive of carcinomatosis involving the ovaries given the clinical history of sigmoid colorectal cancer. For baseline purposes a smaller left adnexal mass is measured on series 3 image 157, 10.4 x 7.7 cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Is compressed by the large adnexal masses but not obstructed.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Ascites and carcinomatosis. Right and left large adnexal masses consistent with metastasis involving the ovaries favored over second primary. Retroperitoneal nodes.Marked right-sided hydronephrosis and hydroureter due to compression of the distal half of the right ureter by the adnexal mass.Nonspecific hyperattenuating foci in the liver.
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Generate impression based on findings.
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IV Contrast: 50 ml used, 10 ml wasted, Omnipaque 350.T2 N0 M0 site right alveolar ridge SCCA s/p resection The patient is status post right mandibular surgery. There are surgical clips present in adjacent soft tissues. There is an 18 x 11 mm ring enhancing lesion present adjacent to the alveolar ridge in the right mylohyoid muscle and a right hyoglossus muscle within the sublingual spaceThe patient is assess removal of the right submandibular gland. There is some infiltration of the fat planes of the remaining right submandibular space associate with some surgical clips and some retraction of the right pharyngeal mucosal spaceWithin the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses demonstrate opacification of the superior nasal cavity and ethmoid air cells and partial opacification of the maxillary sinuses. This was also present on the prior exam. The mastoid air cells are clear.The parotid and the left submandibular glands appear intact.The visualized lung apices appear clear but consistent with centrilobular emphysemaThe carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are multilevel degenerative changes present in the cervical spine with mild and distal ectasia of C2 on C3 where there is right-sided facet hypertrophic change. These findings are stable and compared to the prior exam
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1.There is a new ring enhancing lesion present adjacent to the right alveolar ridge to the right sublingual space. Please correlate with physical findings on clinical exam. The possibly that this represents a local recurrence cannot be excluded alternative explanation could be infection.2.Status-post a right to submandibular gland removal with associated post operative change3.No evidence for neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy4.opacification of superior nasal cavity and adjacent to ethmoid air cells . The possibility of a nasal polyposis cannot be excluded. Please correlate with clinical findings. The bony structures are not completely evaluated on this exam. If further investigation is warranted to determine if a there is an underlying lesion other than polyposis additional imaging of the paranasal sinuses may be of benefit.
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Generate impression based on findings.
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Female 79 years old Reason: pt with CLL on clnical trial, had Chlorambucil x 7 cycyles, for evaluation , please compare with previous History: lymphadenopathy Exam is not sensitive at detecting lesions in the vasculature or solid organs due to the lack of IV contrast. Given those limitations following observations are made:CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Massive adenopathy seen in the base of the neck through the entire superior mediastinum and small nodes scattered throughout the middle mediastinum. Large subcarinal reference lymph node measured at the level of the azygos vein estimated 2.9-cm transverse by 1.9-cm AP series 3 image 31. Previously 3 x 2 cm.Index right retrocrural lymph node, series 3 image 63 measures 2.7 x 1.9 cm. Previously 3.5 x 2.2 cm.Extrinsic compression of the thyroid gland by lymphadenopathy. Previously seen left thyroid nodule probably unchanged global is well seen.CHEST WALL: Extensive axillary adenopathy. Subjectively slightly decreased.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Mildly prominent spleen 12.6-cm cephalocaudad coronal image 47.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease. Extensive retroperitoneal lymphadenopathy redemonstrated. Lymph node is conglomerate portacaval node series 2 image 94, 3.6 x 2.4 cm. Previously 3.6 x 3.2 cm. Subjectively other nodes have slightly decreased throughout the retroperitoneum.BOWEL, MESENTERY: Extensive mesenteric adenopathy slightly decreased compared to the prior exam. No evidence of ascites. No bowel wall thickening or dilatation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Extensive adenopathy involving all chains. Reference right external iliac lymph node series 2 image 158P.1 by 1.9-cm. previously 3.5 x 2 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Decrease in size of most nodal chains. No new sites of disease.
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Generate impression based on findings.
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61 year old male. Reason: Evaluate for CAD. History: chest pain Height: 70 inWeight: 185 lbsBSA: 2 m^2BMI: 26.5 kg/m^2Cardiac Morphology:Left Ventricle:EDV: 113 ml The left ventricle is normal in size, shape, wall thickness, and volume. Right Ventricle:EDV: 169 ml The right ventricle is normal in size, shape, wall thickness, and volume. Left Atrium: The left atrial volume minus the pulmonary veins is 121 ml, within normal limits. There are four distinct pulmonary veins which drain normally into the left atrium.Right Atrium: The right atrial volume is within normal limits. The right atrium is structurally normal. Cardiac Veins: The coronary sinus is normal.Cardiac Valves: There are no aortic calcifications. 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: 38 mm Ascending: 30 mm Sinotubular Junction: 30 mm Descending: 26 mmPulmonary Artery: Main PA: 26 mmRight PA: 20 mmLeft PA: not included in field-of-viewVena 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. 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, just distal to its origin, with an associated 40% stenosis. No definite soft plaque is present.LCx: The left circumflex artery gives rise to the obtuse marginal branches. There is dense calcification in the LCx which precludes accurate assessment of stenosis severity.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. There is a focal distal calcification in the distal RCA. EXTRACARDIAC CHEST
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1. Normal ventricular volume and morphology.2. Coronary artery calcification in the LAD and RCA. 3. 40% stenosis at LAD origin. No other significant coronary artery stenoses.
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Generate impression based on findings.
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Chronic lymphoid leukemia, without mention of having achieved remission(204.10)Examination of participant in clinical trial There is a right supraclavicular lymph node measuring 20 mm x 15 mm which previously measured 17 x 22 mm axial dimensions. Image number 58There is a right posterior triangle lymph node present measuring 11 x 17 mm axial dimensions previously measuring 19 x 12 mm axial dimensions a left submandibular space lymph node previously measuring 13 x 10 mm and now measures 9 x 12 mm a left jugular chain lymph node at the level of the thyroid gland previously measured 10 x 9 mm in axial dimensions and now measures 9 x 9 mm axial dimensionsWithin the visceral space the thyroid gland appears stable. The left thyroid gland lobe is enlarged and contains a lesion previously measuring 39 x 25mm and currently measuring the same.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses are clear. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices there is a large right-sided pleural effusion which was significantly smaller on the prior exam.The carotid and vertebral vasculature visualized on this exam appears intact. Atherosclerotic calcifications are present at the carotid bifurcations.The cervical vertebral bodies in general are intact with no evidence for canal stenosis.
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1.Examination performed without contrast which may reduce sensitivity2.there is a redemonstration of lymphadenopathy within the soft tissues of the neck which has mildly decreased when compared to the prior exam from September3.there is a left thyroid gland lobe mass present which is relatively stable when compared to the prior exam, however, measurement is in part not as comparable due to lack of contrast and different patient position.4.there is a right-sided pleural effusion which has enlarged when compared to the prior exam
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Generate impression based on findings.
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Female, 59 years old, pituitary tumor, preoperative planning for removal. Clinical symptoms of headaches and elevated growth hormone. The pituitary mass seen on prior MRI is not well depicted on the present noncontrast CT. There is some probable expansion of the left aspect of the sella which may secondarily reflect the presence of the lesion.The paranasal sinuses are clear. The left maxillary infundibulum is narrowed or occluded by mild soft tissue thickening. The other major sinus ostia are patent. The nasal cavity is clear. The nasal septum deviates toward the left with a leftward projecting bony spur. The turbinates are unremarkable.The mastoid air cells and middle ear cavities are clear. The bones of the calvarium are intact.Incidental note is made of an expansile bony process centered on the root apex of the right maxillary central incisor which may reflect a periapical cyst.
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1. Pituitary mass was better assessed on the prior MRI with only secondary signs evident on the current study.2. The paranasal sinuses are clear.
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Generate impression based on findings.
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Male 79 years old Reason: T2 N0 M0 site right alveolar ridge SCCA s/p resection, contour bulge of pancreas on last exam History: T2 N0 M0 site right alveolar ridge SCCA s/p resection, contour bulge of pancreas on last exam CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema. Few scattered micronodules. No large nodules. No effusions.MEDIASTINUM AND HILA: Calcified nodes. Coronary calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Small spleen with a few calcified granulomata.PANCREAS: No significant abnormality noted. No evidence of pancreatic mass.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Two small hypoattenuating foci in the right kidney too small to characterize likely cysts. Fluid density structure dorsal to the right kidney prior to connect to the kidney and may represent an exophytic cyst. See series 13 image 128RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic disease. No discrete aneurysm. Small shotty retroperitoneal nodes not pathologic in size.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: There is prominent submucosal fat involving the rectum and sigmoid colon correlate for history of inflammatory bowel disease particularly ulcerative proctitis or colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of pancreatic mass. No evidence of metastasis. Other findings as above.
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Generate impression based on findings.
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51 year-old female with metastatic breast cancer Comparison with PET/CT is limited due to motion artifact.LUNGS AND PLEURA: Reference pulmonary nodules along the left major fissure are not significantly changed and measure 6 mm (image 49, series 5) and 5 mm (image 53 series 5) and previously measured 6 mm and 6 mm respectively. Additional subpleural nodules on the right are not significantly changed. Right basilar peribronchial ground glass opacities suggest infection or aspiration.Subpleural nodule in the right upper lobe measures 8 mm in thickness and previously measured 13 mm (image 37, series 5), decreased in size.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal.CHEST WALL: Status post left mastectomy and axillary lymph node dissection. Clips are noted in the region of the previous identified right chest wall mass. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypoattenuating splenic lesion is unchanged. Left adrenal nodularity appears slightly increased. A gastrohepatic lymph node measuring 1.0 cm (image 88, series 3) is mildly enlarged.
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Interval decrease in size of right upper lobe subpleural nodule. Additional metastatic lesions are not significantly changed in size.
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Generate impression based on findings.
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66-year-old male with prostate cancer rising PSA. Evaluate for metastases. Known liver hemangioma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Known left lobe hemangioma is stable. Hepatic vessels are patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Predominantly hypodense lesion within the right kidney, most likely representing cyst, unchanged from prior study.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia.BONES, SOFT TISSUES: Moderate degenerative changes affect the visualized spine and SI joints. No suspicious osseous lesions.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Postsurgical changes of a radical prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Multiple diverticula in the rectosigmoid and descending colon without evidence of diverticulitis.BONES, SOFT TISSUES: Few degenerative changes in the lumbosacral spine. OTHER: No significant abnormality noted
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Left lobe of liver known hemangioma. Stable right adrenal hypodense lesion most likely a cyst.No evidence of metastases.
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Generate impression based on findings.
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Male 55 years old; Reason: abdominal pain History: abdominal pain, dilated loops of bowel ABDOMEN:LUNGS BASES: Multifocal nodules right left lung bases. Bibasilar atelectasis or consolidation. Correlate clinically to rule out aspiration pneumonia.LIVER, BILIARY TRACT: A the several hypodense foci in the liver consistent with metastatic disease some may be new or better seen due to contrast bolus. A baseline purposes a lesion in inferior aspect of the right lobe as measured on series 2 image 39, .9 by .8 p.m. Other foci are seen in the posterior segment of the right lobe and anterior segment of the right lobe as well asSPLEEN: 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: Proximal jejunum is normal distal jejunum and entire ileum are markedly dilated with some loops in the upper abdomen measuring up to 5.1 cm in diameter is seen on coronal image 34. Fairly long segment of distal ileum show extensive marked wall thickening of low density consistent with submucosal edema. No intramural air or free air. Mesenteric arteries and veins appear to enhance normally without obvious thrombosis. There is prominent caliber in the right colon and a normal amount of stool seen in the transverse and left colon. I believe that obstruction is unlikely and the cause although uncertain is probably related to functional ileus secondary to whatever is causing with submucosal edema. Differential diagnostic considerations are primarily ischemia and infection much less likely.No evidence of ascites. No evidence of carcinomatosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lytic areas consistent with patient's known metastatic disease particularly moth-eaten appearance involving the right pubic bone. These findings are unchanged from the prior exam.Hypodense focus in the musculature lateral to the left hip series image 99 of uncertain significance, with 1.7 x 1.4 cm unchanged.OTHER: No significant abnormality noted.
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1.Marked small bowel dilatation with long segment of marked submucosal edema involving the marrow ileum of uncertain etiology. The patient may be at risk for perforation. No discrete transition zone is seen to suggest mechanical obstruction however.2.Possible progression of metastatic disease in the liver.3.Bibasilar atelectasis or consolidation. Rule out aspiration pneumonia.4.Lung nodules consistent with metastatic disease.
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Generate impression based on findings.
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Reason: 67-year-old female with metastatic lung cancer, ALK+, on ASP3026 now, s/p 8 cycles. Pls c.w previous study and evaluate tx response. History: lung ca CHEST:LUNGS AND PLEURA: Postsurgical changes in the right hemithorax. Reference left subpleural nodule measures 4 mm , previously 4 mm (series 5, image 41). No new or suspicious pulmonary nodules or masses are identified. No pleural effusions.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No lymphadenopathy. Mild coronary artery calcification. Note is made of vascular calcifications in the aorta.CHEST WALL: Sclerotic manubrial lesion with underlying bone destruction, unchanged.ABDOMEN:LIVER, BILIARY TRACT: Punctate left hepatic lobe hypodensity is too small to further characterize but likely benign, appearing similar to the prior study.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate nonobstructing right lower pole calculus.RETROPERITONEUM, LYMPH NODES: Reference left para-aortic lymph node measures 2.9 x 1 .9 cm, previously 2.9 x 2.2 cm (series 3/image 128).BOWEL, MESENTERY: Small fat containing umbilical hernia.BONES, SOFT TISSUES: Sclerotic lesions of the T1 vertebral body and right iliac wing, unchanged. 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: Sclerotic lesions of the T1 vertebral body and right iliac wing, unchanged. OTHER: No significant abnormality noted.
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1.No suspicious pulmonary nodules or masses.2.Persistent left para-aortic node.3.Sclerotic osseous metastatic lesions, unchanged.
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Generate impression based on findings.
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43-year-old female with shortness of breath on exertion, evaluate for sarcoidosis LUNGS AND PLEURA: Apical predominant paraseptal emphysema. Upper lobe predominant diffuse interstitial disease with faint granular opacities and nodularity along the fissures. Architectural distortion is noted in the left upper lobe. No honeycombing. MEDIASTINUM AND HILA: Mediastinal lymphadenopathy with a paratracheal lymph node measuring 1.8 cm (image 29, series 3). No pericardial effusion. Heart size is normal. Moderate atherosclerotic calcifications of the LAD.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Diffuse hepatic steatosis.
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1. Mediastinal lymphadenopathy and upper lobe predominant interstitial lung disease as detailed above, consistent with sarcoidosis.2. Diffuse hepatic steatosis.
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Generate impression based on findings.
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Reason: 60Yrs female here for follow-up of T4 N2b M0 squamous cell carcinoma of the right vocal cord IRB 10-069 completed 3/2013 History: as above CHEST:LUNGS AND PLEURA: Mild bronchiectasis and bronchiolitis particularly may lingula a round middle lobe consistent with microaspiration.Interval resolution of focal consolidation in the left lower lobe.No suspicious nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.Moderate coronary artery calcification.No pericardial effusion.CHEST WALL: Degenerative disease in the spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Mild biliary dilation, unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst with adjacent calcification, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Aortic atherosclerosis.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastrostomy tube in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Mild pulmonary abnormalities consistent with microaspiration. No specific evidence of metastases.
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Generate impression based on findings.
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62 year-old female with painless intermittent bowel obstruction, similar pattern in 2012. ABDOMEN:LUNG BASES: No significant abnormality noted. Note is made of a left lower lobe pleural based pulmonary micronodule.LIVER, BILIARY TRACT: Note is made of extrahepatic biliary ductal dilation measuring 10 mm in its greatest diameter. No gallstones or focal mass lesions are identified. Note is made of calcified granuloma in the liver.SPLEEN: No significant abnormality notedPANCREAS: Note is made of mild fat stranding around the head and uncinate process of the pancreas. Correlation with serologic markers is recommended to exclude acute pancreatitis on this could conceivably represent a paniculitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: IVC filter in place.BOWEL, MESENTERY: Note is made of a small hiatal hernia. There are no dilated loops of bowel to suggest obstruction. There is no evidence of free intraperitoneal air, pneumatosis intestinalis, or portal venous gas. There is a mild amount of stool noted throughout the colon.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy.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
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1. Mild mesenteric fat stranding in the region of the SMA and head and uncinate process of the pancreas. Correlation with serologic markers is recommended to exclude acute pancreatitis, although this could conceivably represent a paniculitis.2. Mild extrahepatic biliary ductal dilation, as described above. 3. No dilated loops of bowel to suggest obstruction.
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Generate impression based on findings.
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61 year old female history of squamous cell carcinoma of the right vocal cord for follow-up The vocal cords are asymmetric with the right vocal cord hypoattenuating and medialized, appearing similar to the prior exam. A small amount of enhancement in the left vocal cord may be secondary to treatment related hyperemia and appears simlar to the prior exam. No discretely measurable lesion is identified in the region of the previous glotic mass. Diffuse mucosal thickening is likely related to treatment-related changes. Heterogeneous sclerosis of the right arytenoid appears similar to the prior exam. The thyroid cartilage appears similar to the prior exam. The right cricoid cartilage appears infiltrated, however this is unchanged from the prior exam and is of uncertain significance. No lymphadenopathy is evident throughout the neck.The paranasal sinuses and mastoid air cells are clear. The oral cavity, oro/nasopharynx and hypopharynx airways are patent. The epiglottis, vallecula, and pyriform sinuses are unchanged. The parotid and submandibular glands are unremarkable. The thyroid is heterogeneous. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. The orbits are unremarkable. Within the visualized brain, there is no acute hemorrhage, edema, or extra-axial fluid collections or masses.
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1.Treatment related changes including supraglottic mucosal edema and hyperemia. The right vocal cord remains medialized, appearing similar to the prior exam. No definite mass lesions are identified at the level of the glottis.2.No pathologic lymphadenopathy.
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Generate impression based on findings.
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Female, 47 years old, headache with Valsalva. The cerebellar tonsils are ectopic extending 2 to 4 mm below the level of the foramen magnum. This does not technically qualify as a Chiari malformation. Similar findings were seen on the prior MRI. Brain parenchyma otherwise demonstrates normal morphology and attenuation. No mass effect is seen. No intracranial hemorrhage or abnormal extra-axial collections are detected. Ventricular system is patent and normal in size.The osseous structures of the calvarium and skull base are intact. The paranasal sinuses and mastoid air cells are clear.ANGIOGRAPHIC
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1.CTA of the head is within normal limits. Specifically, no evidence of aneurysm or other vascular abnormality is detected. 2.Evaluation of the brain parenchyma is significant only for cerebellar tonsillar ectopia. This does not meet imaging criteria for a Chiari malformation, and therefore, relationship to the patient's presenting symptoms is uncertain.
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Generate impression based on findings.
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Clinical question: Congestion, chronic sinusitis. Signs and symptoms: As above. Medtronic fusion sinus CT:Frontal sinuses.Mucosal thickening of the left frontal sinus and unremarkable otherwise.Ethmoid sinuses demonstrate minimal bilateral anterior ethmoid mucosal thickening and unremarkable otherwise.Sphenoid sinus demonstrate small foci of mucosal thickening at the level of bilateral sphenoethmoidal recess with resultant occlusion bilaterally.Maxillary sinuses demonstrate mild diffuse mucosal thickening (right greater than left). There is resultant occluded bilateral ostiomeatal units.Nasal cavity demonstrate very prominent concha bullosa of bilateral middle turbinates with resultant decreased caliber of nasal passage bilaterally at the level of the middle turbinates.Bilateral mastoid air cells and middle ear cavities are well pneumatized.Unremarkable images through the orbits.
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1.No acute sinusitis.2.Mild diffuse bilateral maxillary sinus mucosal thickening and occluded bilateral ostiomeatal units.3.Occluded bilateral sphenoethmoidal recess due to regional mucosal thickening. 4.Minimal bilateral anterior ethmoid sinus disease and moderate left frontal sinus disease as detailed.5.Significant bilateral middle turbinate concha bullosa with resultant decreased caliber of nasal passage at that level.6.Minimal to his bilateral mastoid air cells and middle ear cavities and unremarkable images through the orbits.
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Generate impression based on findings.
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Malignant neoplasm of stomach CHEST:LUNGS AND PLEURA: Few right lower lobe micronodules most unchanged from prior studyMEDIASTINUM AND HILA: Left thyroid hypodense nodule is unchanged from prior study.Mighty prominent right hilar lymph node is unchanged (image 44, 4).CHEST WALL: Tip of the Port-A-Cath at the cavoatrial junction.Degenerative arthritic changes of left sternoclavicular joint with endplate sclerosis, unchanged. ABDOMEN:LIVER, BILIARY TRACT: Left hepatic lobe hypodense mass measures 4.5 x 4.2 cm (image 86, four), previously measured 3.8 x 2.6 cm. This is increased in comparison with prior study. Hepatic vessels are patent. No new focal lesions noted.SPLEEN: Hypodense lesion in the spleen measures 8 x 6 mm, previously measured 7 x 8 mm (image 84, four).PANCREAS: Mixed attenuating, oval mass superior and anterior to the body of the pancreas is increased in size in comparison with prior study (image 96, four).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right midpole hypodense lesion has subtle peripheral nodular hyperdensity suspicious for enhancement. It is unchanged in size at 1 cm (series 4, image 97). Multiple other hypodense lesions in both kidneys are mostly unchanged from prior study.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval increase in size of a large heterogenous mass arising from gastric antrum measuring 6.7 x 5.5 cm (image 104.), Previously measured 6.3 x 4.1 cm, increased in comparison with prior study. The mass appears to abut and attenuate the suprarenal IVC, IMV and region of the head of the pancreas.A possible extension or lobulation of this mass is seen anterior and superior to the body of the pancreas as described above.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: Degenerative changes in lumbosacral spine.OTHER: No significant abnormality noted.
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1. Interval increase in left hepatic lobe mass.2. Interval increase in size of a large heterogenous mass arising from the gastric antrum and a possible extension or lobulation of this mass anterior and superior to the body of the pancreas.
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Generate impression based on findings.
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Reason: h/o HNC/CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Increase in a right lower lobe subpleural nodule (series 6/67) no 10 x 9 mm increased from 9 x 8 mm.Adjacent inferiorly located nodules have also increased in size. The pulmonary opacity in the right posterior costophrenic angle has become more confluent suspicious for tumor or infarct.5 mm subpleural nodule (series 6/51) in the right lower lobe, also increased progressively since 7/3/2013 suspicious for metastasis.Dense right perihilar opacity consistent with radiation reaction, unchanged.MEDIASTINUM AND HILA: No significant lymphadenopathy. A previously measured small right hilar node is not clearly visible due to absence of contrast material. No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis.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: No significant abnormality noted.OTHER: Grade 1 spondylolisthesis at L4 -- L5.
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Progression of right lower lobe metastases.
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Generate impression based on findings.
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67-year-old male with syncope, evaluate for PE PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: New diffuse tree in bud opacities and bronchiolar wall thickening consistent with bronchiolitis.Reference right lower lobe nodule measures 12 x 11 mm and previously measured 12 x 10 mm (image 92, series 10). Multiple additional pulmonary nodules are not significantly changed. Multiple additional scattered micronodules, some of which are calcified and consistent with prior granulomatous disease are unchanged.MEDIASTINUM AND HILA: Right hilar lymph node measures 1.3 x 1.8 cm and previously measured 1.6 x 1.7 cm (image 158 cm 7). Interval increase in mediastinal lymphadenopathy. Calcified mediastinal lymph nodes, compatible with prior granulomatous disease. CHEST WALL: Marked interval increase in axillary, supraclavicular and subpectoral lymphadenopathy. Reference left chest wall lymph node measures 3.3 x 1.6 cm and previous measured 2.3 x 1.6 cm..UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted..
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1. Technically adequate exam without evidence of pulmonary embolus. 2. Markedly increased axillary, mediastinal and chest wall lymphadenopathy. 3. New diffuse bronchiolitis pattern, likely infectious in etiology.4. Unchanged pulmonary nodules.
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Generate impression based on findings.
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Male, 73 years old, chronic lymphoid leukemia, evaluate disease status. No significant interval change is seen in numerous scattered cervical lymph nodes. No new or pathologic adenopathy is detected. Reference measurements are as follows:1. Left level 1b (image 30 series 6): 12 x 8 mm, previously 12 x 9 mm.2. Left level 2a (image 29 series 6): 10 x 8 mm, previously 11 x 9 mm.3. Right level 3 (image 38 series 6): 11 x 9 mm, previously 12 x 7 mm.4. Right level 5 (image 50 series 6): 12 x 9 mm, previously 12 x 10 mm. Left submental surgical clips are redemonstrated. The soft tissues of the neck are otherwise unremarkable without the benefit of contrast. The salivary glands and thyroid are free of focal lesions. The lung apices are unremarkable. The esophagus is patulous and contains dependent fluid similar to prior. No concerning osseous lesions are detected.
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Stable lymph node reference measurements as above. No new or frankly pathologic adenopathy is detected by size.
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Generate impression based on findings.
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Reason: lung cancer History: increased lung nodule CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema.Sharply defined superior segment left lower lobe nodule (series 5/44) now 12 x 16 mm, increased from 8 x 11 mm previously.Distal opacity compatible with bronchial impaction has not significantly changed.Marked bronchial thickening in the basilar segments of the lower lobes with scarlike opacities and tree in bud opacity consistent with recurrent aspiration.MEDIASTINUM AND HILA: Marked lymphadenopathy in the subcarinal and inferior left hilar regions, increased from previous.Subcarinal lymph nodes measure 23 mm in short axis compared to 17 mm previously.Severe and extensive coronary artery calcification.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: Small cysts and calcifications unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Enlarged periportal lymph nodes, unchanged.Small retrocaval nodes not clearly defined but probably unchanged.Descending aortic and bilateral iliac stent graft within a thrombosed lower aortic aneurysm, unchanged.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.
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Further enlargement of left lower lobe nodule, subcarinal and left hilar lymph nodes, suspicious for metastatic disease.
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Generate impression based on findings.
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Chemotherapy follow-up examinationRadiotherapy follow-up examinationMalignant neoplasm of tonsil. h/o HNC/CRT, compare to previous, measurements pls The patient is status post left neck surgery. Surgical clips are present in the left upper neck. Surgical clips are also present in the right neck. There is infiltration of fat planes adjacent to the surgical sites but no focal lesionsThere is an 8x7 mm axial dimension lymph node present adjacent to the trachea on the right side which a is at the level of the thoracic inlet and a previously measured the same. It does not meet size criteria for lymphadenopathy.The pharyngeal mucosal space appears stable when compared to prior exam without a focal lesion.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses demonstrates some minor mucosal thickening in the left maxillary sinus a lesser degree right maxillary sinus. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are endplate and uncal vertebral osteophytes present at C5-6 and C6-7 with bilateral neural foraminal encroachment of exiting nerve roots.
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1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy
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Generate impression based on findings.
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Chronic lymphoid leukemia without mention of having achieved remission. Examination of participant in clinical trial Limited study. Intravenous contrast was not administered. This limits the sensitivity to detect small lesions in solid organs and bowel.CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Mediastinal lymph nodes not enlarged by CT criteria. Coronary artery calcifications noted. Referenced right superior posterior mediastinal lymph node measures 1.4 x 0.7 cm (image 12, 3), unchanged from prior study, when it measured 1.3 x 0.7 cm. The referenced inferior subcarinal lymph node measures 1.6 x 0 .8 cm, previously measured 1.8 x 0.8 cm (image 48 at 3), unchanged from prior study.CHEST WALL: Referenced left axillary lymph node is unchanged from prior study, measured 1.4 x 1.8 cm (image 15, 3).ABDOMEN:LIVER, BILIARY TRACT: Calcifications in the portacaval region, probably are within a calcified lymph node. No focal lesions within the liver.SPLEEN: Splenule identified. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Referenced para-aortic lymph node measures 2.1 x 1 .8 cm, previously measured 2.5 x 1.9 cm (image 10603.), Reduced from prior studyreferenced mesenteric lymph node measures 1.2 x 0 .8 cm, previously measured 1.4 x 0.8 cm (image 24 and 3.), Grossly unchanged from prior study.BOWEL, MESENTERY: Mesenteric small lymph nodes, mostly unchanged from prior study.Diverticulosis without evidence of diverticulitis involving the descending and rectosigmoid colonBONES, SOFT TISSUES: Degenerative changes in lumbosacral spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Right operator index lymph node measures 3.2 x 0.8 cm, previously measured 3.1 x 0.8 cm in image number 180, stable. Index right inguinal lymph node measures 2.2 x 1 cm, previously measured 1.8 x 2.9 cm is also grossly unchanged on image number 189, series number 3.BOWEL, MESENTERY: Small central pelvic lymph node measures 8 mm (image 153), unchanged from prior study, when it measured 9 mm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Stable mediastinal lymph nodes.2. Minimal interval reduction in size of left para-aortic lymph node. The other pelvic and retroperitoneal lymph nodes are grossly unchanged.
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Generate impression based on findings.
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50 year-old female with history of ovarian cancer, CVA. CHEST:LUNGS AND PLEURA: Small new left pleural effusion.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right-sided central venous catheter in expected position.ABDOMEN:LIVER, BILIARY TRACT: The liver enhances homogeneously. Multiple subcentimeter hypodensities in the right lobe are too small characterize, but are stable and likely represent benign cysts. The liver is enlarged measuring approximately 22 cm in the craniocaudal dimension.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic right kidney, may be due to infarction given cortical irregularity, with compensatory hypertrophy of left kidney, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: An IVC filter is located at the level of the renal veins.Marked interval increase in now massive ascites, with associated greatly increased mass effect on the liver and bowel. The stomach is markedly compressed, and left upper quadrant bowel loops are displaced inferiorly and medially.Diffuse peritoneal thickening and nodularity consistent with peritoneal carcinomatosis. Comparison with prior study is limited due to the massive ascites.Redemonstrated soft tissue mass in the left upper quadrant anterior to the spleen and measuring 5.4 x 3.7 centimeters in greatest axial dimensions (image 88, series #5; see also coronal image 49), slightly increased in size.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Small amount of air in the bladder, presumably from recent instrumentation.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Thrombosis of the left femoral vein.
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1.Massive ascites with increased mass effect, most notably compressing the stomach.2.Left upper quadrant soft tissue mass demonstrates slight interval increase in size.3.Diffuse peritoneal carcinomatosis.4.Hepatomegaly.5.Atrophy of the right kidney with compensatory hypertrophy of the left kidney.6.Bilateral hypodense thyroid nodules.7.Left femoral vein thrombosis.
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Generate impression based on findings.
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Reason: left retromolar trigone squamous cell cancer s/p chemoRT with persistent pain History: left retromolar trigone squamous cell cancer s/p chemoRT with persistent pain LUNGS AND PLEURA: Diffuse bronchial thickening with areas of subsegmental atelectasis in the right middle lobe and lingula.Sharply circumscribed 5-mm nodule in the left upper lobe (series 4/22) which is indeterminate and further follow-up is recommended.No other suspicious nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.Extensive coronary artery calcification.Previous median sternotomy with intact sternal sutures.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. Multiple bilateral large renal cysts.Bilateral symmetrically enlarged adrenal glands with relatively low density, suggestive of adenomas.
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1.Indeterminant 5-mm right upper lobe nodule which may be an intrapulmonary lymph node or granuloma, but the differential diagnosis includes primary and metastatic disease and therefore further follow-up is recommended. 2. Symmetrically enlarged adrenal glands, most likely benign.
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Generate impression based on findings.
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Male, 25 years old, shortness of breath, epiglottic swelling and leftward shifted structures on laryngoscopy. Evaluate for deep neck infection. The mucosa of the supraglottic larynx and hypopharynx is markedly edematous. The airway through this region is effaced except for the presence of an ET tube.Edema/tracking fluid is evident through the fascial planes deep to the strap muscles of the neck and along the carotid space, right side more than left. No discrete loculated or rim enhancing fluid collection is seen at this time.Scattered prominent lymph nodes are evident bilaterally in the neck, likely reactive. The cervical arterial and venous structures remain patent. The salivary glands and thyroid are free of focal lesions. Lung apices are unremarkable. No concerning osseous lesions are detected.
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Extensive edema of the supraglottic larynx and hypopharynx with fluid and/or edema tracking through the deep fascial planes. No discrete or drainable fluid collection is seen at this time.
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Generate impression based on findings.
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49 year-old female with epigastric pain, left upper quadrant pain, CT to further evaluate ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal lesions in the liver. Hepatic vessels are patent.SPLEEN: Normal size of the spleen. No focal lesion.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Probably surgically absent.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
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No CT findings to explain patient's pain.
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Generate impression based on findings.
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Male, 68 years old, fever, tachycardia, rigor. Evaluate for sinusitis. The frontal sinuses are clear. Mild mucosal thickening is evident at the level of the frontoethmoidal recesses. The sphenoid sinuses and sphenoethmoidal recesses are clear. Scattered mucosal thickening is evident through the ethmoid air cells.The maxillary sinuses are free of significant mucosal disease and/or debris with the exception of minimal peripheral thickening on the right. The left maxillary outflow path is clear. The right maxillary outflow pathway is mildly narrowed secondary to expansion of the right middle meatus discussed below.The nasal cavity is clear. The nasal septum is intact demonstrating a gentle rightward deviation. The inferior turbinates are unremarkable. The right middle turbinate is lateralized within an expanded right middle meatus. The left middle turbinate is unremarkable.The mastoid air cells and middle ear cavities are clear.Incidental note is made of atherosclerotic calcifications affecting the intracranial circulation.
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No evidence of significant active sinus disease.
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Generate impression based on findings.
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Clinical question: Lumbar spinal stenosis/degeneration. Evaluate bone alignment possible preop planning. Signs and symptoms: Back pain and lower extremity pain. Nonenhanced lumbar spine CT:Examination demonstrate generalized uniform narrowing unexpected caliber of the spinal canal which is believed to be at least partially secondary to congenitally small canal/ short pedicles.The alignment of vertebral column remains anatomical.T11 -- T12 demonstrate mild degenerative disk disease without spinal stenosis or neural foraminal compromise.T12 -- L1 demonstrates advanced degenerative disk disease, loss of intervertebral disk height and vacuum phenomena. Mild asymmetric left sided facet hypertrophic changes. No central spinal stenosis, mild right neural foraminal compromise is suspected.L1 -- L2 is unremarkable with the exception of mild degenerative changes of posterior elements.L2 -- L3 demonstrates moderate disk disease, loss of intervertebral disk height and mild vacuum phenomenon. Mild facet and ligamentum flavum hypertrophic changes also present. There is broad-based bulge of the disk and this is soft and highly suspected moderate central spinal stenosis. CT is not sensitive for precise assessment of central spinal stenosis.L3 -- L4 demonstrate advanced degenerative disk disease, loss of intervertebral disk height and vacuum phenomenon. Mild facet and moderate ligamentum flavum hypertrophy changes are present. There is suspected moderate to severe central spinal stenosis at this level mild bilateral neural foraminal compromise (right greater than left.L4 -- L5 demonstrate mild degenerative disk disease and minimal hypertrophic changes of posterior elements. Mild broad base bulging disk and highly suspected mild to moderate central spinal stenosis.L5 -- S1 demonstrate minimal degenerative changes and suspected left neuroforaminal compromise.
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1.Generalized uniformly smaller than expected caliber of the spinal canal which is believed to be a congenital. 2.Degenerative changes of lumber spine at multiple levels with more severe level of changes at L3 -- 4 level with highly suspected moderate to significant central spinal stenosis. Mild to moderate spinal stenosis is also suspected at L2 -- 3 level and to a lesser degree at L4 -- L5.3.There is also evidence of neural foraminal compromise as detailed. Please review detailed report per level above.
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Generate impression based on findings.
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56-year-old male with abdominal distention. The absence of intravenous contrast limits evaluation of the solid organs. Given this limitation, the following observations were made:ABDOMEN:LUNGS BASES: Fibrotic changes and bullae in the lung bases are unchanged from the prior exam. Pacemaker wire is partially imaged. Bilateral basilar atelectasis.LIVER, BILIARY TRACT: Peripheral right lobe subcentimeter hypodensity is unchanged.SPLEEN: Small in size.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Homogeneously hyperdense right renal lesion is unchanged. Adjacent punctate hyperdensity is also unchanged. Atrophic left kidney.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: An IVC filter is noted in the expected location.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No CT evidence to explain abdominal distention.2.Prominent submucosal fat in the proximal stomach. Clinical correlation is recommended.3.Small spleen. Correlate clinically for hyposplenism.
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Generate impression based on findings.
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Please r/o mass effect or bleedSigns and Symptoms: chronic headache worsening for the last week and now with vomiting The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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No evidence for acute intracranial hemorrhage mass effect or edema.
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Generate impression based on findings.
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Male, 76 years old, history of metastatic thyroid cancer, compare to previous. Surgical change consistent with prior thyroidectomy is redemonstrated. There are small foci of nonspecific soft tissue within or around the thyroidectomy bed, not significantly changed. No suspicious lesions are seen at this location.A partially calcified lymph node posterior to the IJ vein within the right supraclavicular fossa is not significantly changed in size measuring 20 x 12 mm (image 58 series 6). Additional calcified lymph nodes are partially visualized in the pretracheal space of the upper mediastinum. These are better assessed on dedicated chest imaging. Elsewhere in the neck, no evidence of pathologic adenopathy is seen.The parotid glands are unremarkable. The submandibular glands are small. Quality of the contrast bolus is not optimal for evaluation of the vessels. Lungs are better assessed on dedicated chest imaging. Degenerative changes are demonstrated in the cervical spine similar to prior.
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1. No suspicious lesions in the thyroidectomy bed.2.Stable partially calcified right supraclavicular lymph node. Mediastinal nodes are better assessed on dedicated chest imaging.
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Generate impression based on findings.
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Malignant neoplasm of base of tongueRadiotherapy follow-up examinationOther postablative hypothyroidism Chronic kidney disease, unspecified CT neck:Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact. There is a small echodense focus in the left lobe of the thyroid gland which is stable when compared to prior examsThe airway appears patent.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact. There is loss of disk space height at C3-4 with mild posterior subluxation of C3 on C4 resulting in some narrowing of the spinal canal and spinal stenosis which is stable compared to prior examsCT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No acute intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy2.No evidence for brain metastases.
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Generate impression based on findings.
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32-year-old male with history of TB LUNGS AND PLEURA: Multiple right upper lobe nodules, some of which are calcified with associated bronchiectasis. Right upper lobe pleural thickening.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes, compatible with prior granulomatous disease. The heart size is normal. No pericardial effusion.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.
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No specific evidence of active disease. Right upper lobe nodules, some of which are calcified, with associated bronchiectasis compatible with previous granulomatous disease such as reactivation tuberculosis.
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Generate impression based on findings.
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70-year-old male with history of tongue cancer, evaluate response CHEST:LUNGS AND PLEURA: Unchanged left apical scarring/fibrosis. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Left hypoattenuating thyroid lesion is unchanged. Marked atherosclerotic calcification of the coronary arteries and scattered calcifications of the thoracic aorta.CHEST WALL: Degenerative changes of the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis. No focal hepatic lesions.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuating lesions, likely representing cysts and cortical scarring, unchanged.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.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. Small unchanged L1 vertebral body bone island.OTHER: No significant abnormality noted.
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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Male 76 years old Reason: h/o met thyroid ca, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Pulmonary nodules consistent metastases redemonstrated.Inspiration left lower lobe series 5 image 54 measures 2.3 x 1.8 cm. Previously 1.8 x 1.6 cm.MEDIASTINUM AND HILA: Thyroidectomy. Partially calcified nodes in the mediastinum and hila redemonstrated. Index right supraclavicular calcified noted since image 4 measures 1.4 x 1.2 cm. Previously 1.1 by 1.3-cm. No new nodes. Coronary artery calcifications.CHEST WALL: Redemonstration of degenerative changes. No lytic or blastic disease.ABDOMEN:LIVER, BILIARY TRACT: Possibly due to differences in phase of enhancement the lesion in the dome of the liver is not as well seen on current study. In narrow window settings the lesion is estimated on series 3 image 68 to measure 2.9 x 3.6 cm. Previously 3.2 x 2.5 cm. Other ill-defined hypointense foci in redemonstrated in the liver one in the medial segment of left lobe series 2 image 75 and one in the posterior aspect of the right lobe on image 84SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal mass series 2 image 89 measures 4.8 x 4.2 cm. Previously 3.6 x 3.4 cm.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Small nonpathologic sized retroperitoneal nodes. Atherosclerotic calcifications without evidence of aneurysm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.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
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Increase in size of index lesions.
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Generate impression based on findings.
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Female 25 years old Reason: history of spindle cell sarcoma History: none Exam is not sensitive detecting lesions in the solid organs or vasculature distal to lack of intravenous contrast. Given those limitations, the following observations are made: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: Status post left nephrectomy. No evidence of soft tissue in the renal fossa. The right kidney is normal in contour and texture.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small nonpathologic sized nodes in the mesentery. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No measurable disease.
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Generate impression based on findings.
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29 year-old female with leiomyosarcoma of the uterus. s/p 14 cycles of Gemzar/Taxotere. Please compare to last scan eval disease process. CHEST:LUNGS AND PLEURA: Previously described nodules are unchanged from previous study.MEDIASTINUM AND HILA: Pericardial effusion, unchanged.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: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat containing paraumbilical hernia.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Previous described fluid density collection. The left adnexa extending to the retroperitoneum, now measures 4.1 x 2.3 cm on image number 155 of series number 3, slightly smaller compared to previous study. Etiology of this lesion is unknown and may represent a lymphocele.Previously described right adnexal lesion is smaller, measuring 2.5 x 1.3 cm on image number 158, series number 3. The etiology is unknown.Left sided pelvic lymphocele is also unchanged, measuring 8 x 5.6 cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Pelvic index lesions are stable or minimally decreased in size within the internal. There etiology is unknown and may represent postsurgical changes/lymphoceles. Follow-up imaging, and/or pelvic MRI may be helpful for better characterization of these lesions.Minimal pericardial effusion is unchanged.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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75-year-old female with history of chronic type B dissection. CHEST:LUNGS AND PLEURA: Mild emphysema. Probable intrapulmonary lymph node along minor fissure unchanged (series 8, image 37). Several calcified granulomas again noted. No suspicious nodules or lesions.MEDIASTINUM AND HILA: Several prominent mediastinal lymph nodes are not significantly changed.Postsurgical changes consistent repair of the ascending aorta, appearing unchanged. No dissection identified in thoracic aorta. Mild to moderate coronary artery calcifications.CHEST WALL: Status post median sternotomy.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. No liver lesions identified.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Contour deformity of the posterior aspect of left kidney unchanged, most consistent with prior infarction.RETROPERITONEUM, LYMPH NODES: Again seen is abdominal aortic dissection extending from above the renal arteries into the left common iliac artery, unchanged. Dissection flap is again seen extending into the left renal artery, which has flow from both true and false lumens, unchanged.A small dissection flap is again seen in the proximal celiac artery, with associated aneurysmal dilation not significant changed and measuring 9 mm (series 9, image 115).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: Suprapubic catheter is in place.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Severe degenerative changes affect the lumbar spine, with unchanged severe compression deformity of L4 vertebral body.OTHER: No significant abnormality noted.
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1.Stable type B dissection of abdominal aorta, as described above. 2.Stable celiac artery aneurysm with focal dissection.
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Generate impression based on findings.
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Osteosarcoma and multiple relapses. LUNGS AND PLEURA: Multiple staple lines are present from resection of lung nodules. Multiple micronodules are again seen. The largest of these contains osteoid, is located in the left lower lobe and measures approximately 4 mm in diameter.The pleural based mass surrounding the left posterior eighth rib contains significantly more osteoid. It measures approximately 3 x 1.8 x 3.1-cm. Periosteal reaction is seen along the anterior surfaces of the seventh and eighth posterior ribs.MEDIASTINUM AND HILA: Ossification/calcification in the right atrium appears slightly larger than on the prior exam. The heart size is normal.CHEST WALL: The left Port-A-Cath device has its tip in the superior vena cava.UPPER ABDOMEN: Gadolinium opacifies the pelvicaliceal systems.
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Decrease in size of pleural based left mass with increase in osteoid formation. No change in largest left micronodule.
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Generate impression based on findings.
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22-year-old male patient. 29 weeks pregnant with tachycardia and new oxygen requirement. Echo showed positive McConnell's sign. PULMONARY ARTERIES: Suboptimal examination without complete opacification of the subsegmental branches of the pulmonary artery. No evidence of a central pulmonary embolus to the lobar level.LUNGS AND PLEURA: Patchy bilateral, predominantly posterior opacities suggestive of atelectasis, infection or aspiration.No pleural effusion. Significantly decreased lung volumes.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion.No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Suboptimal examination without evidence of a pulmonary embolus to the lobar level. If clinically warranted, can obtain a noncontrast magnetic resonance angiography of the pulmonary artery.Bilateral patchy opacities suggestive of atelectasis, infection or aspiration.
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Generate impression based on findings.
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79-year-old male with nausea, vomiting, abdominal pain. ABDOMEN:LUNG BASES: Partially visualized, pleural-based nodular opacity in the right lower lobe measures 6 mm (series 10284, image one). Mild basilar scarring.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: Atherosclerotic calcifications affect the aorta and its branches.BOWEL, MESENTERY: Multiple dilated loops of small bowel with diameter measuring up to 3.7 cm, consistent with moderate grade small bowel obstruction. The transition point appears to be located in a jejunal loop in the midabdomen adjacent to suture material in the bowel (axial series 10283, image 68). No evidence of bowel wall thickening, pneumatosis, or free air. A trace amount of free fluid is present in the pelvis.Distal small bowel is decompressed.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: As described above, dilated loops of small bowel consistent with small bowel obstruction. Trace amount of free fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Moderate grade small bowel obstruction with transition point located in the midabdomen adjacent to post surgical changes/suture material.2.Nonspecific partially visualized 6-mm nodule in the right lower lung lobe; consider follow-up chest CT for better evaluation.
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Generate impression based on findings.
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86 year old female with diffuse abdominal pain.. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is gallbladder wall thickening and surrounding fat stranding, as well as gallstones located near the bladder neck, consistent with acute cholecystitis. No fluid collection to suggest abscess.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications affect the aorta and its branches. No lymphadenopathy.BOWEL, MESENTERY: Large hiatal hernia. No bowel obstruction. Diverticulosis affects the distal colon, without evidence of diverticulitis.Small ventral hernia with mild protrusion of bowel into hernia but no obstruction.BONES, SOFT TISSUES: Degenerative and lumber spine.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: Nonspecific but likely benign lucencies in the right iliac bone, which may be degenerative in nature or due to focal Paget's disease.Partially visualized fat density lesion associated with left quadriceps musculature, most consistent with lipoma.OTHER: No significant abnormality noted
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Findings consistent with acute cholecystitis.
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Generate impression based on findings.
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15-year-old male status post trauma. CHEST:LUNGS AND PLEURA: A small right apical and subpulmonic pneumothorax is present. A moderate right pleural effusion is also seen. Right basilar dependent opacities are noted, likely reflecting a combination of hemorrhage and atelectasis. No acute traumatic abnormality is identified in the left lung.MEDIASTINUM AND HILA: Small foci of gas are noted in the mediastinal soft tissues adjacent the right lung apex. The heart is normal in size without evidence of pericardial effusion. No mediastinal or hilar lymphadenopathy is a seen.CHEST WALL: A metallic bullet is seen within the paraspinal musculature just dorsal to the tip of T7. Adjacent soft tissue gas is noted tracking inferiorly within the soft tissues. No fracture of the thoracic spine is identified.ABDOMEN:LIVER, BILIARY TRACT: A 2.7 x 2.1 cm region of hypoattenuation is identified at the inferior tip of the right hepatic lobe (image 110, series 3), compatible with a grade 2 liver injury. A small focus of free intraperitoneal air is noted adjacent to the liver capsule on image 98 of series 3.Gallbladder is normal. No intrahepatic or extrahepatic biliary ductal dilatation is seen. The portal vasculature appears patent. No active extravasation of contrast is identified.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is a right perirenal hematoma with associated region of hypoattenuation within the midpole of the right kidney. The region of hypoattenuation appears involve 30% of the renal parenchyma and appears to extend through the cortex, medulla and approaches the collecting system, compatible with a grade 3/4 laceration. No evidence of vascular injury or collecting system rupture, although the exam is not optimally timed for this assessment. Associated retroperitoneal free air is also noted.RETROPERITONEUM, LYMPH NODES: Foci of gas is noted within the right retroperitoneal soft tissues, compatible with free retroperitoneal air.BOWEL, MESENTERY: A small focus of free intraperitoneal air is noted adjacent to the liver capsule on image 98 of series 3.BONES, SOFT TISSUES: No significant abnormality noted. No fracture is seen. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: A mild amount of pelvic free fluid is present.BONES, SOFT TISSUES: Subcutaneous gas is present about the right hip and anterior abdominal wall, likely related to trajectory of bullet. No fracture is identified.OTHER: No significant abnormality noted
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1. Grade 3/4 laceration of the right kidney with associated perirenal hematoma and retroperitoneal air.2. Grade 2 liver injury with small focus of free intraperitoneal air adjacent the liver capsule as discussed above.3. Small right pneumothorax with a moderate pleural effusion and associated pulmonary opacities likely reflecting hemorrhage/contusion.4. Mild amount of pelvic free fluid.5. Metallic bullet fragment within the dorsal paraspinal soft tissues of T7/8.
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Generate impression based on findings.
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63-year-old female with active GI bleeding. ABDOMEN:LUNG BASES: Again seen extensive pulmonary fibrosis and traction bronchiectasis with honeycombing involving visualized lung bases.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: Atherosclerotic calcifications throughout aorta and its branches. There is focal narrowing of the proximal celiac artery (sagittal series 80649, image 58), which may be due to compression by the median arcuate ligament.IVC filter noted.BOWEL, MESENTERY: Contrast material from prior exam is seen throughout the colon, which limits evaluation for extravasation/active bleeding. Given this limitation, no focus of contrast extravasation is identified.NG tube noted in stomach.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Multiple calcified uterine fibroids.BLADDER: Foley catheter noted.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Contrast material from prior exam is seen throughout the colon, which limits evaluation for extravasation/active bleeding. Given this limitation, no focus of contrast extravasation is identified.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Oral contrast material is present throughout colon, limiting evaluation for bleeding. Given this limitation, no evidence of contrast extravasation to suggest active bleeding is identified.
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Generate impression based on findings.
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66-year-old female patient with history of metastatic uterine cancer presents with dyspnea. PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Interval increase in moderately large left pleural effusion with compressive atelectasis of the left lower lobe. Small right-sided pleural effusion.Right middle lobe nodule measures 8 x 6 mm (series 10 image 74), unchanged.Scattered calcified micronodules.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion.No mediastinal or hilar lymphadenopathy. Calcified hilar lymph node consistent with prior granulomatous disease.There are multiple enlarged lymph nodes in the bilateral cardiophrenic angles that have increased in size compared to prior examination and likely represent metastatic disease (coronal series 80660 image 62). Dominant right node measures 2.9 cm (series 5 image 193), previously 1.0 cm. Dominant left node measures 1.7 x 2.5 cm (series 7 image 197), previously 1.8 x 0.8 cm.CHEST WALL: Multilevel degenerative changes in the thoracic spine. Benign-appearing lesion in the T12 vertebral body is unchanged. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. There are incompletely evaluated masses in the left upper quadrant in the area of the prior nephrectomy, subjectively larger compared to abdominal CT 11/8/2013.Retroperitoneal lymphadenopathy.Sutures along the lesser curvature of the stomach from prior gastrectomy.Scattered granulomas in the splenic parenchyma.
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Technically adequate study without evidence of a pulmonary embolus.Interval increase in moderately large left pleural effusion.Enlarged cardiophrenic angle lymph nodes, consistent with metastatic disease.Interval increase in partially visualized left upper quadrant mass.
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Generate impression based on findings.
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32 year old female with breast cancer. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No pathologically enlarged mediastinal lymph nodes. Heart size normal without pericardial effusion. Soft tissue in anterior mediastinum consistent with residual thymus.CHEST WALL: Multiple prominent right axillary lymph nodes, largest measuring 13 x 8 mm (series 3, image 27). Heterogeneous lesion in the right breast noted (series 3, image 57).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 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.
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1.Right breast lesion consistent with patient's known breast carcinoma.2.Multiple prominent right axillary lymph nodes.
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Generate impression based on findings.
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24 old female with left flank pain and hematuria. Evaluate for kidney stones. ABDOMEN: The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given this limitation, the following observations were made:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted. The gallbladder is collapsed.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No renal or ureteral stones identified. No perinephric stranding or hydronephrosis.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: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of nephrolithiasis or ureteral stone. No other findings to explain patient's symptoms.
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Generate impression based on findings.
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Female 28 years old; Reason: s/p Celiac artery release/ KP transplant. Looking for intra-abdominal/ pelvic fluid collections to explain ongoing pain. History: Persistent abdominal pain ABDOMEN:The absence of intravenous contrast limits evaluation of the solid organs. Given this limitation, the following observations were made:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Atrophic native pancreas is redemonstrated. Lack of intravenous contrast limits evaluation of the right lower quadrant pancreatic transplant.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Native kidneys remain small and atrophic. Renal transplant in the left iliac fossa with interval decrease in perinephric fluid. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffusely mild dilation of small bowel loops represents a mild ileus pattern.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: 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.
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1.No loculated fluid collection identified, as clinically questioned.2.Mild ileus pattern.
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Generate impression based on findings.
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56-year-old female with sudden onset back pain and unsteady gait. Rule out dissection. CHEST:LUNGS AND PLEURA: Filling defect is seen in a small right pulmonary artery branch in the lower lobe, compatible with pulmonary embolus (images 65 to 71, series #3). A calcified left lower lobe granuloma is identified.MEDIASTINUM AND HILA: No evidence of aortic dissection. Mild atherosclerotic calcification of the thoracic aorta.CHEST WALL: No significant abnormality noted.ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Small splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral subcentimeter hypodensities too small to characterize though likely represent benign cysts.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches without focal dilatation. No dissection is identified.BOWEL, MESENTERY: No significant abnormality noted. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Right lower lobe pulmonary embolus.2.No aortic dissection.Findings were discussed with Dr. Ali via telephone at 10:15 a.m. on December 3, 2013.
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Generate impression based on findings.
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Motor vehicle traffic accident. Head: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Cervical Spine: The vertebral column alignment and vertebral body heights are intact. There is no evidence of cervical spine fracture. The prevertebral soft tissues are unremarkable.
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1. No evidence of intracranial hemorrhage or skull fracture.2. No evidence of cervical spine fracture or spondylolisthesis.
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Generate impression based on findings.
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Systemic lupus erythematosus with vomiting and headache. There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. The mild cerebral white matter abnormalities demonstrated on the prior MRI are not discernable on this exam due to differences in technique. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged mastoid air cells are clear. There is a small left maxillary sinus retention cyst. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage, mass, or cerebral edema. The mild cerebral white matter abnormalities demonstrated on the prior MRI are not discernable on this exam due to differences in technique. Consider MRI for further evaluation, if clinically warranted.
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Generate impression based on findings.
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Facial edema, possible fluctuance. There is an area of subcutaneous fat stranding in in the left cheek that measures up to 15 mm. There is mild retention cyst formation in the bilateral maxillary sinuses and mild partial opacification of the posterior ethmoid sinuses and left frontoethmoid recess. There are bubbly secretions within the right sphenoid sinus. The orbits and imaged portions of the intracranial structures are grossly unremarkable. There are mild periodontal lucencies surrounding teeth with dental fillings.
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1. Small area of subcutaneous fat stranding in in the left cheek. Differential considerations include cellulitis and contusion. No evidence of drainable fluid collection, although assessment for abscess is limited by lack of intravenous contrast. 2. Mild scattered paranasal sinus opacification, including bubbly secretions within the right sphenoid sinus that may represent acute sinusitis in the appropriate clinical setting.
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Generate impression based on findings.
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44-year-old male with history of right lower quadrant pain This study is limited due to lack of IV contrastABDOMEN:LUNG BASES: Dependent atelectasis at the lung bases.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is mild right caliectasis. Right kidney is slightly enlarged. There is perinephric and hilar. Fat stranding. No evidence of renal stones in the kidney or in the, ureters. These findings are suspicious for pyelonephritis. Correlation with urinalysis is recommended. Left kidney is unremarkable.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: The bladder is distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Pelvic phleboliths. Fat containing right inguinal hernia.
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Limited study due to lack of intravenous contrast. No evidence of urolithiasis. CT findings suggestive of right-sided acute pyelonephritis. Clinical correlation is recommended.
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Generate impression based on findings.
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POD# 1 s/p left craniotomy for tumor (astrocytoma)resection. There has been interval left frontal craniotomy for resection of an astrocytoma. There is a small amount of hyperattenuating blood products within and adjacent to the resection cavity, small amounts of subarachnoid and subdural pneumocephalus, and left scalp swelling. A small area of ill-defined hypoattenuation inferior to the resection cavity may represent residual tumor, although assessment is limited on this non-contrast CT. There is also a small area of hypoattenuation posterior to the resection cavity, which likely corresponds to changes related to the prior craniotomy. There is no midline shift or herniation. There is no hydrocephalus. The imaged paranasal sinuses and mastoid air cells are clear.
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interval left frontal craniotomy for resection of an astrocytoma with a small amount of blood products within and adjacent to the resection cavity. A small area of ill-defined hypoattenuation inferior to the resection cavity may represent residual tumor, although assessment is limited on this non-contrast CT.
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Generate impression based on findings.
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Reason: 50Yrs male here for follow-up of BOT/Tonsil SCC T1N2B s/p TFHX 8/5/09;R hilar recurrence 10/10 s/p hypofractionated radiation to chest 12/30/10 f/b adjuvant chemotherapy with carbo/docetaxel 3/11 History: as above CHEST:LUNGS AND PLEURA: Status post right lower lobectomy with stable right upper lobe radiation reaction changes. Mild centrilobular emphysema.No suspicious lesions or masses.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion. Ectatic ascending aorta is stable and measures 44 mm in the AP dimension (series 4 image 49).Scattered small mediastinal lymph nodes. Calcified hilar lymph nodes consistent with prior granulomatous disease.CHEST WALL: Mild multilevel degenerative changes of the thoracic spine. No axillary lymphadenopathy.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: Subcentimeter hypoattenuating lesion in the right kidney likely represent a cyst.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.Diverticulosis of the descending colon without evidence of diverticulitis.BONES, SOFT TISSUES: Mild multilevel degenerative changes of the lumbar spine.OTHER: No significant abnormality noted.
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No significant interval change or evidence of metastatic disease.
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Generate impression based on findings.
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31-year-old male with osteochondroma and plan for surgery. Again seen is the large osteochondroma arising from the right ilium, measuring approximately 12.0 x 6.6 x 12.3 cm. Fatty marrow is seen within the lesion. There is little, if any, cartilaginous cap. No other findings are noted to suggest malignancy.
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Right iliac osteochondroma, as described above.
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Generate impression based on findings.
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77 year-old female with flank pain. Rule out kidney stone. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: A small portion of the dome was excluded from the field-of-view. Interval removal of the gallbladder with cholecystectomy clips in the gallbladder fossa. A lobulated, homogeneously hypodense lesion in the right lobe of the liver at the dome measures 2.7 x 2.4 cm, demonstrating interval growth from previously measured 1.6 x 2.1 cm. Remains compatible with simple cyst. Multiple other subcentimeter scattered hypodensities are too small to characterize, though unchanged and likely of benign etiology.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No renal or ureteral stones are identified. No perinephric stranding or hydronephrosis bilaterally.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches without aneurysmal dilatation. Multiple retroperitoneal lymph nodes, unchanged. Reference portacaval node measures 13 x 8 mm (axial image 28).BOWEL, MESENTERY: Permanent submucosal fat in the gastric body. Vagotomy clips and postsurgical changes consistent with known prior Billroth II surgery are redemonstrated, correlating with upper GI findings from 5/20/2011. At least 10 pill-shaped high attenuation foci are seen intraluminally in the colon. May represent undissolved iron pills.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.
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1.No evidence of renal or ureteral stones.2.Postsurgical changes consistent with known Billroth II.3.Multiple pill-shaped foci in the colon may represent undissolved iron pills. Clinical correlation for anemia is recommended.
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Generate impression based on findings.
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History of L4-5 fusion. Six month postop for assessment. There is left pedicle screws fusion of L4-5 and foraminotomy with mild periprosthetic lucency surrounding the left L5 pedicle screw. There is significant intravertebral disc height loss at L3-4 and L4-5 with vacuum disc phenomenon and milder height loss at L2-3 and L5-S1. There are degenerative endplate changes at L3-L5, most prominent at the right lateral inferior L3 and superior L4 as well as left lateral inferior L4 and superior L5. There is preservation of overall lumbar lordosis and vertebral body height. Additional findings by level:L1-2: There is a mild disc bulge without significant spinal canal or neural foramen stenosis.L2-3: There is a posterior disc bulge without significant facet arthropathy. There is no significant spinal canal or neural foraminal stenosis.L3-4: There is a posterior disc-osteophyte complex and significant right facet arthropathy that results in moderate to severe right neural foraminal stenosis without significant canal or left neural foraminal stenosis.L4-5: There is a posterior disc bulge eccentric to the left and bilateral facet arthropathy, left worse than right, which results in mild left neural foraminal stenosis without significant right neural frontal stenosis. There is also mild canal stenosis at this level.L5-S1: There is a small posterior disc bulge and mild bilateral facet arthropathy without significant canal or neural foraminal stenosis.There is an incompletely characterized suprarenal aortic aneurysm that measures up to 3.3 cm in diameter.
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1. Mild lucency surrounding the L5 pedical screw, which may represent early loosening. 2. Multilevel degenerative spondylosis with only mild residual left L4-5 neural foramen stenosis, but severe right L3-4 neural foramen stenosis. In addition, a disc bulge at L4-5 results in mild spinal canal stenosis.3. Incompletely characterized suprarenal aortic aneurysm that measures up to 3.3 cm in diameter.
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Generate impression based on findings.
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T3N1 Cervical esophageal SCC, s/p 7 cycles TFHX with single daily RT completed on 12/4/09. Head: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is an unchanged right frontal developmental venous anomaly. Otherwise, there is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Neck: There is minimal residual thickening of the lower cervical esophageal wall and stranding of the surrounding fat related to radiation therapy. No discrete mass lesion or significant cervical lymphadenopathy by size criteria is identified. The thyroid and major salivary glands are unremarkable. The major cervical flow voids are intact. The osseous structures are unchanged. There is unchanged apical pulmonary scarring.
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1. Unchanged posttreatment findings without evidence of locoregional esophageal squamous cell carcinoma recurrence or significant cervical lymphadenopathy.2. No evidence of intracranial metastases.
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Generate impression based on findings.
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52-year-old male status post partial nephrectomy for renal cell carcinoma. Evaluate for recurrence. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable segment 6 lesion compatible with hemangioma.SPLEEN: No significant abnormality notedPANCREAS: Stable 5-mm hypodense focus in pancreatic body.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post partial right nephrectomy. Embolization coils again noted. Cystic lesion in right kidney appears unchanged, measuring 2.7 x 2.9 cm, previously measured 2.8 x 2.9 cm (series 7, image 47). No enhancing solid component is identified.Left kidney unremarkable.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
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Stable cystic lesion and post surgical changes in right kidney.
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Generate impression based on findings.
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Follow-up of BOT/Tonsil SCC T1N2B s/p TFHX 8/5/09; R hilar recurrence 10/10 s/p hypofractionated radiation to chest 12/30/10 f/b adjuvant chemotherapy with carbo/docetaxel 3/11. There are post-treatment findings related to neck dissection and radiation therapy. There is no evidence of mass lesions in the right oropharyngeal treatment bed. There is no significant cervical lymphadenopathy. There are bilateral air-filled laryngoceles. The airways are patent. The thyroid and parotid glands are unremarkable. There is multilevel degenerative spondylosis of the cervical spine. There are no aggressive appearing bony lesions. The major cervical vessels are grossly intact. The partially imaged intracranial structures are grossly unremarkable. There is a large nasal septal defect. The partially imaged paranasal sinuses and mastoid air cells are clear. There is pulmonary emphysema and right apical scarring. Refer to the separate chest CT report for additional details.
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No evidence locoregional tumor recurrence of significant cervical lymphadenopathy.
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Generate impression based on findings.
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T1N2C BOT SCC Everolimus induction on study with CFHX, as well as CRT and neck dissection, completed in November 2010. There are post-treatment findings related to radiation therapy delivered to the baso of tongue region and lymph node dissection. There is mild residual hypopharyngeal mucosal edema. However, no discrete mass lesion is identified. Likewise, there is no evidence of residual significant cervical lymphadenopathy by size criteria. The major salivary glands and thyroid are unchanged. Thre is no significant airway narrowing. There is mild atherosclerotic plaque at the bilateral carotid bifurcations. The osseous structures are unchanged, including a well-defined lucency in the left mandible that likely represents a residual cyst. There is a left maxillary sinus retention cyst. The partially imaged intracranial structures and orbits are grossly unremarkable. The partially imaged portions of the lungs are clear.
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No evidence of locoregional tumor recurrence of significant cervical lymphadenopathy.
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Generate impression based on findings.
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Clinical impression: Injury not specified. Nonenhanced head CT:Examination demonstrates no detectable acute posttraumatic intracranial or calvarial findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter to initiation.Unremarkable images through the orbits.Well pneumatized paranasal sinuses, mastoid air cells and bilateral mid and cavities.Examination of the straight multiple high-density irregularly-shaped foreign bodies partially or completely embedded into the soft tissues of the scalp in the right frontal, right supraorbital and soft tissues are right cheek regions. There is also evidence of minimal soft tissue emphysema and edema at the site. The largest fragments measure at 4 x 6, 4 x 4 and 4 x 3-mm in size. A very subtle bladder fragment and minimal soft tissue emphysema is also noted involving the right upper eyelid.Nonenhanced maxillofacial CT:Examination demonstrate no evidence of maxillofacial fracture.There is an irregularly shaped high-density foreign body embedded in the soft tissues of right cheek measuring 4 times 6-mm in transaxial dimensions. No appreciable surrounding subcutaneous fat edema. Images through the orbits and paranasal sinuses are unremarkable.There is also small focus of soft tissue emphysema and small high density foreign body fragments in the right upper eyelid and right supraorbital region as detailed in the report of head CT. There is no evidence of the orbital abnormality.
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1.Nonenhanced head CT demonstrates no detectable acute posttraumatic intracranial or calvarial findings. The intracranial contents remains normal. There are multiple varying sized high-density foreign bodies in the soft tissues of the scalp in the right frontal region, right supraorbital and right upper eyelid and in the soft tissues of the right cheek as detailed/measured above. Soft tissue edema and small laceration as well as a edema/hemorrhage in the right frontal scalp is also present.2.Nonenhanced maxillofacial CT demonstrate no evidence of fracture. Unremarkable images through the paranasal sinuses and retro-orbital spaces. Multiple irregular high density foreign bodies are present in the right soft tissues of cheek, right upper eyelid and right supraorbital and right frontal scalp soft tissues. Minimal soft tissue emphysema in the right frontal scalp as well as the right upper eyelid also are noted.
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Generate impression based on findings.
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Reason: abnl cxr History: sepsis LUNGS AND PLEURA: Large left upper lobe mass (image 42, series 5) measuring approximately 5.2 cm x 5.1 cm.Severe upper lobe predominant emphysema.Left lower lobe elevation/ atelectasis.Mild right basilar scarring/discoid atelectasis with minimal pleural thickening.MEDIASTINUM AND HILA: Left sided pacemaker.Prominence of and AP window lymph node (image 40 series 3) measuring 16 mm x 9 mm.Evidence of previous granulomatous disease..Cardiac size is normal without evidence of a pericardial effusion.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.
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Large left upper lobe mass highly suspicious for a primary neoplasm.
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Generate impression based on findings.
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Clinical impression: Injury not specified site. Nonenhanced head CT:Examination demonstrates no detectable acute posttraumatic intracranial or calvarial findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter to initiation.Unremarkable images through the orbits.Well pneumatized paranasal sinuses, mastoid air cells and bilateral mid and cavities.Examination of the straight multiple high-density irregularly-shaped foreign bodies partially or completely embedded into the soft tissues of the scalp in the right frontal, right supraorbital and soft tissues are right cheek regions. There is also evidence of minimal soft tissue emphysema and edema at the site. The largest fragments measure at 4 x 6, 4 x 4 and 4 x 3-mm in size. A very subtle bladder fragment and minimal soft tissue emphysema is also noted involving the right upper eyelid.Nonenhanced maxillofacial CT:Examination demonstrate no evidence of maxillofacial fracture.There is an irregularly shaped high-density foreign body embedded in the soft tissues of right cheek measuring 4 times 6-mm in transaxial dimensions. No appreciable surrounding subcutaneous fat edema. Images through the orbits and paranasal sinuses are unremarkable.There is also small focus of soft tissue emphysema and small high density foreign body fragments in the right upper eyelid and right supraorbital region as detailed in the report of head CT. There is no evidence of the orbital abnormality.
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1.Nonenhanced head CT demonstrates no detectable acute posttraumatic intracranial or calvarial findings. The intracranial contents remains normal. There are multiple varying sized high-density foreign bodies in the soft tissues of the scalp in the right frontal region, right supraorbital and right upper eyelid and in the soft tissues of the right cheek as detailed/measured above. Soft tissue edema and small laceration as well as a edema/hemorrhage in the right frontal scalp is also present.2.Nonenhanced maxillofacial CT demonstrate no evidence of fracture. Unremarkable images through the paranasal sinuses and retro-orbital spaces. Multiple irregular high density foreign bodies are present in the right soft tissues of cheek, right upper eyelid and right supraorbital and right frontal scalp soft tissues. Minimal soft tissue emphysema in the right frontal scalp as well as the right upper eyelid also are noted.
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Generate impression based on findings.
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T1N2b SCC oral tongue, receiving CRT with TFHX, status post bilateral neck dissections, tongue base resection and tonsillectomy, as well as wide local excision of an oral tongue cancer in March 2013. There has been interval evolution of post-treatment changes with diffuse hypoattenuating material within the left lymph node dissection bed. There is also mild asymmetric enhancement within the left tongue base, but no discrete mass. There is partial effacement of the left vallecula and piriform sinus, likely due to secretions and edema. The left internal jugular vein has been sacrificed. The other major cervical vessels appear to be intact. There is hyperemia of the left submandibular gland, likely related to radiation therapy. The thyroid gland is unremarkable. The partially imaged intracranial structures are grossly unremarkable, aside from a possible left cerebellar developmental venous anomaly.
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Interval post-treatment changes with likely seroma and/or increased necrosis in the left lymph node dissection bed, but no measurable locoregional tumor or discernable significant cervical lymphadenopathy.
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Generate impression based on findings.
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65 year-old female with metastatic pancreatic cancer. CHEST:LUNGS AND PLEURA: Stable appearing postsurgical changes in right lower lobe. Soft tissue attenuation adjacent to suture material appears stable.Left apical ground glass opacity is unchanged, measuring 1.3 x 1.3 cm, previously measured 1.3 x 1.4 cm (series 5, image 19).7-mm left lower lobe nodule unchanged (series 5, image 70). No new suspicious nodules.MEDIASTINUM AND HILA: Innumerable hypodense nodules in the thyroid not significantly changed. No mediastinal lymphadenopathy. Heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Left sided intrahepatic biliary ductal dilation is not significantly changed. However, the poorly marginated, hypoattenuating lesion at confluence of dilated ducts in the left lobe appears increased measuring 1.7 x 1.7 cm, previously measured 1.3 x 1.3 cm (series 3, image 84).SPLEEN: No significant abnormality noted.PANCREAS: Postsurgical changes consistent with prior Whipple surgery.ADRENAL GLANDS: Nodular thickening of left adrenal gland unchanged.KIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Multiple prominent upper retroperitoneal lymph nodes are mildly increased in size (series 3, image 87).BOWEL, MESENTERY: Status post Whipple surgery. Small hiatal hernia. Multiple prominent peripancreatic lymph nodes again 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: Previously measured right internal iliac soft tissue is most consistent with right ovary rather than lymph node as previously described (series 3, image 156).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Chronic deformity of left sacrum and right pubic bone, not significantly changed.OTHER: No significant abnormality noted.
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1.Persistent left hepatic lobe biliary ductal dilation, with interval increase of ill-defined hypoattenuating lesion at the confluence of dilated ducts concerning for malignancy such as cholangiocarcinoma. Consider further evaluation with dedicated liver MRI. 2.Mild increase in prominent upper retroperitoneal lymph nodes.3.Stable ground glass left upper lobe lung opacity; continued follow-up recommended.
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Generate impression based on findings.
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Reason: pe History: cancer with DOE PULMONARY ARTERIES: Technically adequate study without evidence of a pulmonary embolus.LUNGS AND PLEURA: Bilateral basilar subsegmental atelectasis/scarring, similar in appearance to the prior exam.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Right chest port with its tip in the right atrium.Cardiac size is normal without evidence of pericardial effusion.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple hepatic masses again consistent with metastatic disease.
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1.No evidence of a pulmonary embolus. 2.Bilateral basilar atelectasis unchanged.3.Numerous hepatic metastases .
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Generate impression based on findings.
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54-year-old male patient with history of AML and fungal pneumonia on vfend. Evaluate for response. LUNGS AND PLEURA: Widespread multifocal bilateral nodular opacities for the most part stable. Several small new nodules in the left upper lobe.Interval decrease in areas of consolidation in the superior segment of the right lower lobe and medial segment of the left upper lobe.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Moderate coronary artery calcifications. Scattered small mediastinal lymph nodes. No significant hilar lymphadenopathy.CHEST WALL: Mild multilevel degenerative changes in the thoracic spine. Soft tissue density in the subcutaneous tissue of the right back is stable compared to prior examination and likely represents a sebaceous cyst.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Multifocal bilateral nodular opacities are overall not significant changed and demonstrate a mixed response to therapy.Interval decrease in size of areas of consolidation in the right lower lobe and left upper lobe.
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Generate impression based on findings.
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Clinical question: Hemorrhagic conversion after stroke. Signs and symptoms: Right inferior MCA ischemic stroke. Nonenhanced head CT:There is better delineation of a previously known right MCA subacute stroke. There is no evidence of hemorrhagic conversion as clinically is questioned. There is regional mass effect and effacement of adjacent cortical sulci and several mass-effect on the trigone of right lateral ventricle and without evidence of midline shift.Eight indeterminate the small muscle ischemic strokes of mild to moderate degree is again noted. Heavy bilateral cavernous carotid, supraclinoid carotid and bilateral intracranial vertebral artery calcification is again noted. Punctate distal right MCA territory vascular calcification is also noted.
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Better delineation of right MCA territory subacute nonhemorrhagic stroke since prior exam and without evidence of hemorrhagic conversion as detailed above.
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Generate impression based on findings.
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Reason: history of metastatic renal cancer, recent film w/o contrast showing pulmonary nodules, please evaluate History: see above LUNGS AND PLEURA: Numerous pulmonary and pleural based masses are identified bilaterally, compatible with extensive metastatic disease. Representative left upper lobe nodule (image 34, series 5) measures 2 cm x 2.1 cm.Representative left lower lobe nodule (image 54, series 5, measures 2.4 cm x 2.8 cm. TheModerate size right pleural small left pleural effusions are present. MEDIASTINUM AND HILA: Large 3.4-cm right paratracheal lymph node (image 32, series 3).A large subcarinal lymph node (image 49, series 3) measuring 2.7 cm.Numerous other mediastinal and hilar lymphadenopathy.Large left cardiophrenic mass or.Large right costophrenic angle mass.Cardiac size is mildly enlarged without evidence of a pericardial effusion.CHEST WALL: Multiple bilateral chest wall massesUPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Large mass in the right lobe of the liver.Partially visualized right retroperitoneal mass (image 110, series 3).
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1.Innumerable pulmonary and pleural metastatic nodules.2.Extensive mediastinal and hilar lymphadenopathy.3.Multiple bilateral chest wall metastases. 4.Large right hepatic lobe metastasis with retroperitoneal nodules.5.Moderate right-sided and small left-sided malignant pleural effusions.
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Generate impression based on findings.
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60 year-old female with history of appendiceal cancer. Evaluate for changes and/or abnormalities. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. A small gallstone is noted dependently in the gallbladder.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: Status post appendectomy.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: Diverticulosis of the sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No CT evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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62 year old female with metastatic melanoma. CHEST:LUNGS AND PLEURA: Scattered punctate micronodules bilaterally unchanged. No new suspicious nodules. Stable right base scarring.MEDIASTINUM AND HILA: No mediastinal lymphadenopathy. Coronary artery stent noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. No suspicious liver lesions identified.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple hypoattenuating renal lesions are too small to characterize but appear unchanged and most likely represent benign cysts.Mild dilation of right ureter is not significantly changed, and likely due to compression by multiple uterine fibroids.RETROPERITONEUM, LYMPH NODES: Multiple mildly enlarged retroperitoneal lymph nodes are not significantly changed; reference retroaortic node measures 1.5 x 0.9 cm, previously measured 1.5 x 0.9 cm (series 3, image 125).Retroaortic left renal vein incidentally noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple lesions arising from the uterus appears similar, most consistent with fibroids. Cystic lesion likely arising from left adnexa appears unchanged, measuring up to approximately 8.1 x 6.6 cm, previously measured 8.4 x 6.5 cm (series 3, image 157).BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable appearing severe degenerative changes in the right hip. Degenerative changes also noted in the lumbar spine.OTHER: No significant abnormality noted.
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1.Stable mildly enlarged retroperitoneal lymph nodes.2.Multiple large fibroids arising from the uterus, with associated mild right highchair ureter likely due to mass effect from the uterus.3.Stable nonspecific cystic lesion in the pelvis, likely arising from left adnexa. Consider pelvic US for better characterization.
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Generate impression based on findings.
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75-year-old female with humerus fracture. Evaluate for comminution. Again seen is the comminuted fracture of the right proximal humerus, involving the head, neck and greater and lesser tuberosities. There is impaction of the fracture fragments. The greater tuberosity fragment is laterally displaced approximately 2 cm. Inferior subluxation of the humeral head with respect to the glenoid is again noted.Soft tissue swelling is seen along the posterior aspect of the arm and at the elbow.
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Comminuted fracture of the proximal humerus, as described above.
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Generate impression based on findings.
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73-year-old female with history of stage IIIB endometrial cancer status post hysterectomy, radiation therapy, chemotherapy. Assess for recurrent disease. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Central venous catheter in the expected location. Mild atherosclerotic calcification of the thoracic aorta.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: Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Unchanged T10 vertebral lesion, which likely represents hemangioma.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive diverticulosis of the descending and sigmoid colon.BONES, SOFT TISSUES: Unchanged left iliac sclerotic lesion.OTHER: No significant abnormality noted.
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No CT evidence of recurrence or metastatic disease.
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Generate impression based on findings.
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Reason: hx H\T\N ca, s/p CRT, evaluate dx and compare measurements to previous scans History: as above CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: .Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy.Scattered stable small hypodensitiesSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of the aorta.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.
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No interval change. No evidence of metastatic disease.
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Generate impression based on findings.
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Malignant melanoma CHEST:LUNGS AND PLEURA: Left lower lobe nodule measuring 4 mm is unchanged image number 75, series number 5. Patchy groundglass opacities are again noted.MEDIASTINUM AND HILA: Indexed subcarinal lymph node measures 1.8 by 1.1-cm image number 44, series number 3, smaller compared to previous study. Other mediastinal lymph nodes are also either small or unchanged.CHEST WALL: Index left apical chest wall nodule measures 1.4 by 1.1-cm image number 12, series number 3, smaller compared to previous study. Again noted associated rib destruction with this lesion. Index left axillary nodule measures 2.2 by 1.4 cm on image number 18, series number 3, not significantly changed compared to previous study. Other bilateral axillary lymph nodes are also grossly unchanged.Stable sclerotic lesions in T4 and T8 vertebral bodies.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Index hypodense lesion in the spleen measures 1.3 x 1 . 3 cm on image number 97, series number 3, slightly smaller compared to previous study. Other hypodense lesion is also slightly smaller compared to previous study.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: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Index right operator lymph node measures 2.3 by 1.4 cm on image number 175, series number 3, slightly increased compared to previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable to minimally decreased index lesions as described above other than the minimal increased right pelvic lymph node.Stable sclerotic lesions in the thoracic vertebral bodies.
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Generate impression based on findings.
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80 year old female with history of GIST status post resection. CHEST:LUNGS AND PLEURA: Stable left apical micronodule (series 9, image 16). No new or suspicious nodules or masses. Mild basilar atelectasis/scarring.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. Stable subcentimeter hypodensities most compatible with cysts. Several punctate foci of arterial enhancement are unchanged, most likely representing perfusion abnormalities. No suspicious lesions identified. Accessory left hepatic artery noted. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter left renal hypodensities unchanged, most compatible with cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes. No evidence of recurrent lesion.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.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: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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Reason: 57Yrs male here for follow-up of T1N2b SCC oral tongue who is receiving CRT with TFHX 7/12/13 History: as above. CHEST:LUNGS AND PLEURA:Stable calcified and noncalcified micronodules.No new suspicious pulmonary nodules or masses.No pleural effusion.MEDIASTINUM AND HILA: The heart remains normal in size. No interval pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: Surgical staples and postsurgical changes at the base of the left neck. Please see the corresponding CT neck soft tissue performed on the same day.No axillary lymphadenopathyABDOMEN: 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: 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: Nonspecific well-defined lucency right iliac wing unchanged.OTHER: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Renal cell carcinoma CHEST:LUNGS AND PLEURA: Focal area of tree in bud pulmonary nodules and left lower lobe nodule adjacent to the major fissure image number 54, series number 5, and not significantly changed over the time.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Postsurgical changes secondary to distal pancreatectomy. Enhancing mass in the pancreatic head measures 2.5 x 2.8 cm on image number 126 on series number 5, not significantly changed from pre-study.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small cysts involving the left kidney are unchanged. Status post right nephrectomy.RETROPERITONEUM, LYMPH NODES: Enhancing infiltrative soft tissue abutting the IVC in the right nephrectomy bed now measures 3 by 1.9 cm on image number 121, series number 5, not significantly changed from previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Fatty lesion in the left Caulfield subcutaneous fat is unchanged.OTHER: No significant abnormality noted
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No significant change in the pancreatic head, right nephrectomy bed metastases and lung nodules.
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Generate impression based on findings.
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50 year-old male with femoral bruit and absent pedal pulses on physical exam. Pre-kidney transplant evaluation, assess aorta and iliac vessels. ABDOMEN:The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:LUNGS BASES: Diffuse bilateral centrilobular ground glass opacities. LIVER, BILIARY TRACT: The gallbladder is surgically absent with cholecystectomy clips in the gallbladder fossa.SPLEEN: No significant abnormality noted.PANCREAS: Single punctate calcification in the pancreatic body.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Innumerable bilateral renal cysts, replacing the majority of the atrophic kidneys.RETROPERITONEUM, LYMPH NODES: Minimal atherosclerotic calcification of the distal abdominal aorta and right common iliac artery.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Minimal distal aortic and right common iliac artery atherosclerotic calcification.2.Innumerable bilateral renal cysts, likely acquired cystic kidney disease related to dialysis.3.Diffuse bilateral centrilobular groundglass opacities are nonspecific. Dedicated chest CT is recommended for complete characterization.
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Generate impression based on findings.
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Reason: recurrent tongue cancer History: r/o lung mets LUNGS AND PLEURA: Stable size of left lower lobe scarlike opacitymost likely post inflammatory.Pleural thickening within the fissures bilaterally.Groundglass opacities right lung base unchanged and may represent sequela of aspiration. A cluster of nodules within the lower lobe (series 5 image 61) likely related to aspiration/inflammation.No pleural effusions.No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: There is mucus within the right lateral trachea and extends to the ostium of the right main bronchus.Heart size is normal. No interval pericardial effusion. No mediastinal or hilar lymphadenopathy. Moderate coronary artery calcification.CHEST WALL: Report catheter terminates in the central superior vena cava.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Dependent hyperdensities within the visualized gallbladder compatible with cholelithiasis. Several hypodensities unchanged. Percutaneous gastrostomy tube remains in place. Stable retrocrural lymph nodes.
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Post inflammatory scar-like opacities and pleural thickening.Evidence of aspiration with mucus in the trachea and a cluster of micronodules in the right lower lobe.No suspicious pulmonary nodules.
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