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Generate impression based on findings.
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78-year-old male with metastatic renal cell cancer. CHEST:LUNGS AND PLEURA: Stable calcified and noncalcified micronodules. No new or suspicious nodules. New small bilateral pleural effusions, right more than left.MEDIASTINUM AND HILA: Nodular enlargement of right thyroid lobe unchanged.Mild increase in size of mediastinal lymph nodes; for reference, right paratracheal node measures 1.2 x 1.1 cm, previously measured 0.7 x 0.9 cm (series 4, image 19). Severe coronary artery calcifications. Heart is normal in size.CHEST WALL: Right axillary node appears unchanged, measuring 1.2 x 1.7 cm, previously measured 1.3 x 1.9 cm (series 4, image 36). Multiple prominent left axillary lymph nodes unchanged.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: Pancreatic mass with internal calcifications is mildly decreased, measuring 7.4 x 10.3 cm, previously measured 7.7 x 11.8 cm (series 4, image 107). Pancreatic tail is atrophic.ADRENAL GLANDS: Stable nodularity of the inferior right adrenal. Left adrenal not visualized, likely resected.KIDNEYS, URETERS: Status post left nephrectomy. No abnormal soft tissue in surgical bed to suggest recurrence.RETROPERITONEUM, LYMPH NODES: No pathologically enlarged retroperitoneal lymph nodes. Atherosclerotic calcifications throughout aorta and its branches, significantly affecting the splenic artery.BOWEL, MESENTERY: Ventral hernia containing loop of small bowel, without obstruction.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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1.Mild increase in size of mediastinal lymph nodes.2.Mild decrease in size of large pancreatic mass.3.New small pleural effusions.
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Generate impression based on findings.
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55 year old female status post Roux-en-Y surgery with G-tube in excluded stomach, cystectomy with ileal conduit, and end colostomy. New left lower quadrant pain. ABDOMEN:LUNG BASES: New small bilateral pleural effusions, right more than left. Stable left base nodule measuring 2.4 x 1.2 cm, previously measured 2.4 x 1.3 cm (series 4, image 21). New ground glass opacities in the lingula and right base, suspected to represent focal edema given the presence of the effusions. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensities in both kidneys, incompletely characterized but most likely benign cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes including Roux-en-Y gastric bypass and bilateral ostomies. Left lower quadrant ostomy is associated with peristomal herniation of bowel loops and mesenteric fat.Multiple loops are adherent to the anterior abdominal wall in the lower abdomen and upper pelvis, with tracts of inflammatory tissue extending from bowel loops to be open abdominal wound, consistent with enterocutaneous fistula (series 3, image 125). In the right lower quadrant, there is new inflammation with several hypodense foci measuring about 1 cm or less located adjacent to the surgical sutures, concerning for small abscess formation (series 3, image 126; coronal series 80288, image 59). No drainable fluid collection identified. Gastrostomy tube in place.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 1.7 cm cystic lesion arising from left adnexa, unchanged (series 3, image 136).BLADDER: Again seen is tract of inflammatory tissue extending from bladder to the lower aspect of the abdominal wound, concerning for developing fistulous tract (series 3, image 143).LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Orthopedic hardware again noted in left femur.OTHER: No significant abnormality noted
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1.Findings consistent with enterocutaneous fistula.2.New inflammatory change in the right lower quadrant with several small foci of hypodensity concerning for abscess formation. No drainable fluid collection is present at this time.3.Nonspecific 1.7-cm cystic lesion in in the left adnexa; this could be better evaluated with dedicated pelvic ultrasound.
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Generate impression based on findings.
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Atrial fibrillation ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: 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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Normal CT angiography of the abdomen and pelvis
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Generate impression based on findings.
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69-year-old female with history of malignant melanoma CHEST:LUNGS AND PLEURA: Numerous bilateral lung nodules. Right lower lobe index nodule measures 1.9 x 1.5 cm image number 68 of series number 9 significantly increased in size compared to previous study. Other bilateral lung nodules cells increased in size compared to previous study.MEDIASTINUM AND HILA: Index subcarinal lymph node measures 4.1 x 3.3 cm on image number 48, series number 7, increased in size compared to previous study. Right hilar adenopathy is also slightly increased in size compared to previous study.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple, new, subcentimeter hypodense lesions in the liver suspicious for metastatic disease. An index lesion in the left lobe measures 8-mm in diameter image number 85, series number 7.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: New right adrenal lesion suspicious for metastatic disease measuring 1.6-cm in diameter image number 92, series number 7.KIDNEYS, URETERS: Interval development of 1.6 1.4-cm right renal soft tissue density mass most likely representing metastatic disease.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: Right peroneal soft tissue density is increased in size and now measures 3.1-cm in diameter image number 196, series number 3.Subtle lucency in the right inferior acetabulum is unchanged.OTHER: No significant abnormality noted.
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Interval progression of disease with interval increase in the size of the lung nodules, mediastinal adenopathy. Interval development of liver and adrenal metastases.Interval increase in the size of the pelvic soft tissue mass.
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Generate impression based on findings.
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25 year old male. Atrial fibrillation. Reason: s/p previous EP ablation. History: SOB. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedThe aorta has normal caliber and taper. Normal great vessels. All major branches are patent.PELVIS: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 notedVESSELS:INNOMINATE ARTERY TO AORTIC VALVE PLANE: 8.5 cmSINUS OF VALSALVA: 30 X 31.7 mmSINOTUBULAR JUNCTION: 23.6 X 25 mmASCENDING THORACIC AORTA AT LEVEL OF MAIN PULMONARY ARTERY: 23.2 X 22 mmASCENDING THORACIC AORTA IMMEDIATELY PROXIMAL TO THE INNOMINATE ARTERY: 23.9 X 23 mmPROXIMAL DESCENDING THORACIC AORTA IMMEDIATELY DISTAL TO THE LEFT SUBCLAVIAN ARTERY: 19.5 X 18.8 mmDESCENDING THORACIC AORTA AT LEVEL OF HIATUS: 19.4 X 18.2 mm INFRARENAL ABDOMINAL AORTA: 11.6 X 12.5 mmRIGHT COMMON ILIAC ARTERY: 8 X 8.5 mmRIGHT EXTERNAL ILIAC ARTERY: 6.7 X 7 mmRIGHT COMMON FEMORAL ARTERY: 7.8 X 7.9 mmLEFT COMMON ILIAC ARTERY: 8.2 X 8.6 mmLEFT EXTERNAL ILIAC ARTERY: 6.8 X 6.9 mmLEFT COMMON FEMORAL ARTERY: 8.1 X 8.1 mmHeight: 70 inWeight: 160 lbsBSA: 1.9 m^2BMI: 23 kg/m^2Cardiac Morphology:Left Ventricle:The left ventricle is normal in size, shape, wall thickness, and volume. Right Ventricle:The right ventricle is normal in size, shape, wall thickness, and volume. Left Atrium: The left atrial volume minus the pulmonary veins is 51 ml. There are four distinct pulmonary veins which drain normally into the left atrium. The left pulmonary veins share a common trunk at their origin.RSPV: 8 x 13 mmRIPV: 15.8 x 16.2 mmLPV Common Trunk: 7.7 x 13.5 mmLSPV: 11.2 x 16.5 mmLIPV: 14.5 x 15.2 mmRight 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: 32 mm Ascending: 21.4 mm Sinotubular Junction: 23.1 mm Descending: 17.4 mmPulmonary Artery: Main PA: 21.6 mmRight PA: 20.5 mmLeft PA: 19.2 mmVena Cavae: The SVC is normal in size and without structural abnormality. The IVC is normal in size and without structural abnormality.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary Artery Anatomy:LM: The left main coronary artery arises normally from the left sinus of valsalva and trifurcates into the left anterior descending, ramus intermedius, and left circumflex coronary arteries. There is no significant plaque in the left main or ramus intermedius.LAD: The LAD gives rise to the diagonal and septal branches. LCx: The left circumflex artery gives rise to the obtuse marginal branches. RCA: The RCA arises normally from the right sinus of valsalva. It is the dominant coronary artery giving rise to the posterior descending artery and a posterolateral branch. CHEST: No infiltrates or effusions. No pulmonary nodules.
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1. Normal ventricular volume and morphology.2. No significant coronary artery disease. Ramus intermedius branch. 3. Normal left atrial size and anatomy.4. Common trunk at left pulmonary vein origin. Otherwise normal pulmonary vein anatomy. 5. Normal CT angiography of the abdomen and pelvis. No significant extracardiac findings.
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Generate impression based on findings.
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56-year-old male with history of bladder cancer. ABDOMEN:LUNG BASES: Several punctate micronodule are unchanged. No new or suspicious nodules. No consolidation or pleural effusions.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Moderate right hydronephrosis and hydroureter extending to anastomosis, not significantly changed; the right ureter does not fill on delayed images, limiting evaluation for intraluminal filling defects. Left ureter unremarkable. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes status post neobladder construction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy with neobladder creation. LYMPH NODES: Multiple pelvic surgical clips. No lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Lytic lesion in the left ischium unchanged, measuring 4.0 x 1.3 cm, previously measured 4.0 x 1.2 cm (series 8, image 129). OTHER: No significant abnormality noted
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1.Stable moderate dilation of right collecting system; the right ureter is not filled with contrast on delayed images, limiting evaluation for intraluminal filling defects. 2.Stable left ischial lesion.
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Generate impression based on findings.
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Clinical question: Evaluate for pars L5 -- S1 defect, also used for surgical planning. Patient has lumbar stenosis, right-sided radiculopathy. Signs and symptoms: The right buttock and back pain. Nonenhanced CT of lumbar spine:There is grade 1 anterolisthesis at L4 -- L5 secondary to degenerative changes and unremarkable alignment of vertebral column otherwise.T12 -- L1 is unremarkable with the exception of mild degenerative changes.L1 -- L2 demonstrate mild degenerative disk disease and degenerative changes of posterior elements and unremarkable otherwise.L2 -- L3 demonstrate mild to moderate disk disease with resultant slight loss of intervertebral disk height and mild facet and ligamentum flavum hypertrophy. Unremarkable otherwise.L3 -- L4 demonstrate mild disk disease and facet/ligamentum flavum hypertrophic changes. Unremarkable otherwise. L4 -- L5 demonstrate mild disk disease and advanced degenerative and hypertrophic changes of bilateral facet complexes and mild ligamentum flavum hypertrophic changes. There is minimal grade 1 retrolisthesis do be secondary to degenerative process. There is no suggestion of central spinal stenosis. Mild bilateral neural foraminal compromise is suspected.L5 -- S1 demonstrate advanced degenerative disk disease with significant loss of intervertebral disk height and extensive vacuum phenomenon. Mild to moderate degenerative changes of the articulating facets are also noted.There is no convincing evidence of pars defect as clinically questioned (please review thin 1 mm sagittal reformatted images). There is no central spinal stenosis. Moderate bilateral neural foraminal compromise is noted.Visualized S. I. joints demonstrate degenerative changes and bilateral vacuum phenomenon.No detectable paraspinal soft tissue abnormalities.
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1.Examination demonstrates no convincing evidence of pars defect as is questioned clinically.2.Advanced degenerative disk disease at L5 -- S1 and to a lesser degree hypertrophic changes of posterior elements results in bilateral neural foraminal compromise and no central spinal stenosis.3.Mild to moderate degenerative disk disease at L4 -- L5 and advanced hypertrophic changes of posterior elements without central spinal stenosis as detailed. Minimal bilateral neural foraminal compromise is suspected. There is mild grade 1 anterolisthesis present at this level.4.Minimal degenerative changes at other levels however without central spinal stenosis or neural foraminal compromise at any level.5.No detectable paraspinal soft tissue abnormalities.6.Degenerative changes of SI joints are with vacuum phenomena.
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Generate impression based on findings.
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55-year-old male with history of renal cell carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST 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: Multiple small hypodense lesions in the right kidney. These cannot be optimally characterized due to lack of and noncontrast phase. Follow-up imaging with a dedicated renal mass protocol CT or MR is recommended.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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Left para-aortic and retroperitoneal soft tissue masses worrisome for recurrent/metastatic disease.Multiple small hypodense lesions in the right kidney. Follow-up imaging is recommended to exclude a right renal neoplasm.
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Generate impression based on findings.
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67-year-old male with rectal cancer 7 cm from anal verge. Staging. CHEST:LUNGS AND PLEURA: Nonspecific groundglass opacities in the right upper lobe.MEDIASTINUM AND HILA: Mild atherosclerotic calcification of the thoracic aorta and its branches.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches. Scattered small retroperitoneal lymph nodes are non-pathologic appearing.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter is present in the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal wall thickening compatible with patient's known history of rectal cancer.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No CT evidence of metastatic disease.
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Generate impression based on findings.
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59-year-old male with history of colon cancer CHEST:LUNGS AND PLEURA: Emphysema, unchanged. Calcified 9 J.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Mild fatty infiltration of the liver. Mild splenomegaly.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval resection of the patient's known colonic carcinoma. Postsurgical changes in the abdomen.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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Interval resection of patient's known colonic adenocarcinoma.
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Generate impression based on findings.
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65-year-old male patient. Reason: pt with lung ca no therapy so far on Insulin History: now needs disease evaluation please evaluate all areas of adenopathy, comment on all areas. CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema.Irregularly shaped solid mass in the left upper lobe measures 4.0 x 3.1 cm (series 4 image 23), previously 3.8 x 2.6 cm.Right upper lobe nodule measures 6 mm (series 4 image 12), unchanged.Ectatic vasculature in the left lower lobe suggestive of two adjacent AVMs.No pleural effusions. Several micronodules, at least one present on prior examination.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion. Moderate coronary artery calcifications. Moderate atherosclerotic changes of the thoracic aorta.Scattered small mediastinal lymph nodes. Calcified mediastinal lymph node consistent with prior granulomatous disease. No hilar lymphadenopathy.CHEST WALL: Multilevel degenerative changes of the thoracic spine. There is a new lucent lesion in the T9 vertebral body.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Expected pneumobilia status post Whipple.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Enlarging right adrenal mass currently measures 4.4 x 3.8 cm (series 3 image 102), previously 3.4 x 3.3 cm. Left adrenal gland within normal limits.KIDNEYS, URETERS: Numerous bilateral renal cysts are noted and unchanged compared to prior.PANCREAS: Status post Whipple with interval resolution of peripancreatic loculated fluid collections.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic changes of the abdominal aorta and its branches. Focal dilatation of the infrarenal abdominal aorta (coronal series 8024 image 47), unchanged compared to 8/9/2013.No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Multilevel degenerative changes in the lumber spine. Small fat-containing ventral hernia.OTHER: No significant abnormality noted.
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Interval increase in left upper lobe mass with stable right upper lobe nodule.Left adrenal mass consistent with metastatic disease.New lucent lesion in the T9 vertebral body.
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Generate impression based on findings.
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92 year-old male with follicular lymphoma status post 3 cycles of chemotherapy. CHEST:LUNGS AND PLEURA: Basilar predominant subpleural scarring and atelectasis. No suspicious nodules or masses.MEDIASTINUM AND HILA: Interval decrease in supraclavicular and mediastinal lymphadenopathy; for reference, left supraclavicular node measures 1.3 x 3.0 cm (series 3, image 14). Moderate cardiomegaly. Enlarged main pulmonary artery measuring approximately 3.3 cm in maximal diameter suggestive of pulmonary arterial hypertension. Extensive atherosclerotic calcifications throughout aorta and coronary arteries.CHEST WALL: No significant abnormalityABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts. Mild to moderate bilateral hydronephrosis most likely due to retroperitoneal lymphadenopathy.RETROPERITONEUM, LYMPH NODES: Significant interval decrease in bulky, confluent retroperitoneal lymphadenopathy. For reference, confluent left periaortic lymphadenopathy at level of SMA measures 3.6 x 5.5 cm (series 3, image 96).Extensive atherosclerotic calcifications in aorta and its branches.BOWEL, MESENTERY: Significant interval decrease in mesenteric lymphadenopathy; for reference, mesenteric node in the mid abdomen measures 1.7 x 2.9 cm (series 3, image 113).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Interval decrease in right external iliac lymph node, currently measures 1.1 x 1.5 cm (series 3, image 171).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Significant interval decrease in lymphadenopathy, best appreciated in the retroperitoneum and mesentery.
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Generate impression based on findings.
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65-year-old female with history of gastrointestinal stromal tumor CHEST:LUNGS AND PLEURA: Index nodule in the right middle lobe measures 9 by 8mm image number 39, series number 9, not significantly changed from previous study. Other subcentimeter ill-defined tree in bud nodular opacities in the right middle lobe are also unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Small hypodense lesions in the liver are unchanged.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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No significant change from previous study.
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Generate impression based on findings.
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67-year-old male with recurrent tongue cancer, rule out recurrence Limited intracranial and orbital views are unremarkable. Prominent ectatic left vertebral artery. Flocculated secretions in the right sphenoid sinus. Mild mucosal thickening of the left maxillary sinus.Very ill-defined left submandibular space hypoattenuating lesion measures 12 x 6 mm (series 6 image 39), previously measured 17 x 8 mm.Ill-defined left tongue lesion is difficult to accurately measure and measures approximately 12 x 11 mm (series 6 image 31), previously measured 20 x 14 mm. The left sternocleidomastoid muscle is atrophic, unchanged.Similar to prior studies, there is diffuse infiltration of the soft tissues of the neck likely secondary to treatment related changes. Interval effacement of the right piriform sinus with associated avidly enhancing mucosa, right greater then left. Similar to the prior study, no lymphadenopathy by CT size criteria. Hypodense right thyroid nodule again identified. The parotid and submandibular glands are free of focal lesions. The major carotid and vertebral vasculature is patent. Bilateral carotid atherosclerotic vascular calcifications at the carotid bifurcations. There is noncalcified plaque in the left common carotid artery. The left jugular vein is absent and the left vertebral artery is significantly larger than the right.Multilevel degenerative changes of the visualized cervicothoracic spine including mild anterior subluxation of C4 on C5 and C5 on C6 with neuroforaminal narrowing at these levels. No suspicious osseous lesions are present.Partially visualized right chest port catheter. Biapical scarring and pulmonary micronodules, please see dedicated chest CT from today's date for further details.
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1. Interval decrease in size of left submandibular and left base of tongue lesions which were not FDG avid on recent PET examination.2. Interval effacement of the right piriform sinus with associated thickened, avidly enhancing mucosa, right greater then left. This finding is most likely post therapeutic in nature, however continued close follow-up is recommended.
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Generate impression based on findings.
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12-year-old female Reason: Please evaluate for etiology of abdominal and pelvic pain following UTI episode. Suspect gynecologic etiology possibly related to onset of menses. History: Hematuria, abdominal pain, pain with bladder draining (neurogenic bladder with failure to empty; bladder emptying through bladder stoma). ABDOMEN:LUNG BASES: The lung bases are clear without evidence of effusion or consolidation. No pericardial effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Solitary left kidney is again noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Suprapubic catheter is in place. Foci of air within the bladder are noted.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Wires are noted in the pelvis, post surgical in etiology. OTHER: No significant abnormality noted
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No acute findings to account for the patient's symptoms.
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Generate impression based on findings.
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Clinical question: Acute onset of memory loss. Signs and symptoms: Memory loss. Pre-and post enhanced head CT:Examination demonstrates no evidence of acute intracranial process CT however is insensitive for detection of acute nonhemorrhagic ischemic stroke.There are very minimal patchy foci of low attenuation in the subcortical white matter of the cerebral hemispheres which considering patient's age likely represent mild age indeterminate small vessel ischemic strokes.Cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is within normal patient stated age of 78.Minimal cavernous carotids vascular calcification is noted.Post enhanced images demonstrate no detectable abnormal enhancement the brain parenchymal or the leptomeninges.Calvarium and soft tissues of the scalp are unremarkable.Visualized orbits, paranasal sinuses and mastoid air cells are unremarkable.
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Minimal age indeterminate small vessel ischemic strokes and negative pre and post enhanced head CT otherwise for patient's stated age.
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Generate impression based on findings.
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Clinical question: Expansion of subdural hematoma. Signs and symptoms: Headache with known subdural on the left. Nonenhanced head CT:Interval decrease in the size of previously noted a small right posterior frontal acute subdural hematoma. Trace residual subdural is appreciated only on sagittal reformatted image 44 and coronal reformatted image 35.The ventricle and subcortical low attenuation of white matter grossly similar to prior study and likely representing age indeterminate small vessel ischemic strokes. Tiny previously noted left thalamic lacunar infarct is again noted and unchanged.Unremarkable and stable in cerebral cortex, cortical sulci, ventricular system and CSF spaces otherwise.Unremarkable calvarium, soft tissues of the scalp, orbits, bilateral mastoid air cells, middle ear cavities and all visualized paranasal sinuses.
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1.No detectable acute intracranial process CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes. 2.Interval decreased size of previously noted small right posterior frontal acute subdural with only trace residual subdural as detailed.3.Age indeterminate small vessel ischemic stroke remains grossly similar to prior study.
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Generate impression based on findings.
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58-year-old male with metastatic colorectal cancer. Restaging. CHEST:LUNGS AND PLEURA: 4-mm left lower lobe nodule remains unchanged (image 49, series #4).MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Reference subcarinal lymph node measures 1.2 by 1.0 cm, unchanged (image 45, series #3).OTHER: ABDOMEN:LIVER, BILIARY TRACT: Segment 7 right lobe hypodensity in the liver measures 2.4 x 1.8 cm (series #3, image 85) and appears unchanged from prior study,SPLEEN: No significant abnormality notedPANCREAS: Fatty replaced atrophic pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 8mm right renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: A reference retrocaval lymph node measures 1.1 x 0.9 cm (image 106, series #3), unchanged from prior study.BOWEL, MESENTERY: Pericecal right lower quadrant adenopathy is unchanged (image 143, series #3).BONES, SOFT TISSUES: No significant abnormality notedOTHER: Bilateral inguinal hernias containing only mesenteric fat, stable.PELVIS: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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1.No significant change from previous study.
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Generate impression based on findings.
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64 year-old male with severe headache. There is mild patchy hypoattenuation in the periventricular white matter. There is a focus of hypoattenuation in the left caudate head. The findings appear similar to that on the prior. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial hemorrhage. Chronic appearing mild small vessel ischemic disease and left caudate head lacunar infarct. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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Recurrent left ear infections with MRSA. Left temporal bone: There is mild thickening of the external auditory canal walls. There is thickening of the tympanic membrane, compatible with tympanoplasty. There is partial opacification of the middle ear cavity, including Prussak space. The stapes is difficult to discern due to surrounding opacification, although it appears to be likely intact, as does the rest of the ossicular chain. There is mild scattered opacification of the mastoid air cells with air fluid levels in the mastoid tip. The tympanic segment of the facial nerve appears dehiscent. The inner ear structures are unremarkable. There is no abnormal enhancement. Right temporal bone: There is mild thickening of the external auditory canal walls. There is thickening of the tympanic membrane, compatible with tympanoplasty. The middle ear cavity and mastoid air cells are clear. The ossicular chain is intact. The tympanic segment of the facial nerve appears dehiscent. The inner ear structures are unremarkable. There is no abnormal enhancement.
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Partial left middle ear opacification and mild mastoid air cell opacification with air-fluid levels, which may represent otomastoiditis. Mild blunting of the scutum on the left may indicate underlying cholesteatoma formation. MRI with high resolution DWI may be useful for further characterization, if clinically warranted.
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Generate impression based on findings.
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77-year-old male with history of renal cell cancer. please assess for disease progression. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Index pretracheal lymph node measures 1.6 x 0.9 cm (image 27, series #7), stable to slightly enlarged from prior study. Other mediastinal lymph nodes are borderline and appear stable from prior study. Moderate thoracic aortic and severe coronary artery atherosclerotic calcification is noted.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple hypoattenuating liver lesions are demonstrated, stable in size and appearance, likely representing benign cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodularity is unchanged.KIDNEYS, URETERS: Left lower pole renal mass measures 4.8 x 3.0 cm, grossly unchanged (image 120, series #7).RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal lymphadenopathy is redemonstrated, with index left retroperitoneal mass measuring 7.6 x 6.6 cm, unchanged (image 127, series #7).Moderate atherosclerotic calcification of the abdominal aorta and its branches with focal dilatation of the distal abdominal aorta measuring 4.3 cm in maximal AP diameter immediately proximal to the bifurcation. Previous measurements include 4.2 cm on 7/23/2013, 3.6 cm on 1/15/2013, and 3.2 cm on 7/31/2012.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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1.Limited study due to lack of IV contrast.2.Left renal mass, retroperitoneal adenopathy, and mediastinal adenopathy are unchanged.3.Distal abdominal aortic aneurysm demonstrates steady growth, now measuring 4.3 cm from 3.2 cm on 7/31/2012.Findings were relayed to Dr. O'Donnell via telephone at 4:30 p.m. on December 3, 2013.
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Generate impression based on findings.
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Reason: 63Yrs female here for follow-up of T3N1 Cervical esoph SCC s/p 7 cycles TFHX with single daily RT. Completed 12/4/09 History: as above CHEST:LUNGS AND PLEURA: Stable biapical radiation fibrosis. No suspicious pulmonary lesions.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Moderate coronary artery calcifications.No mediastinal or hilar lymphadenopathy.Unchanged nonspecific upper esophageal wall thickening.CHEST WALL: Multilevel degenerative changes in the thoracic spine. T11 vertebral body bone island unchanged.No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypoattenuating foci within the liver parenchyma are too small to characterize and are stable from prior.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: Mild atherosclerotic changes 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: Mild S-shaped scoliosis of the thoracic and lumbar spine. Moderate multilevel degenerative changes in the lumbar spine with degenerative disk disease.OTHER: No significant abnormality noted.
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Stable esophageal thickening without evidence of pulmonary or pleural metastases.
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Generate impression based on findings.
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70 year-old female with history of tongue cancer. CHEST:LUNGS AND PLEURA: Interval improvement in previously seen tree in bud opacities in right upper lobe, consistent with resolving aspiration or bronchiolitis. Basilar atelectasis and bronchiectasis.Subpleural right lower lobe nodule measuring 4 mm is slightly increased in size (series 5, image 50). Additional nodule in right upper lobe along minor fissure also appears slightly larger (series 5, image 43). No new suspicious nodules identified.MEDIASTINUM AND HILA: Mediastinal and hilar lymph nodes not significantly changed. Reference right hilar lymph node measuring 12 x 15 mm, previously measured 12 x 15 mm (series 3, image 38). Reference left hilar node measuring approximately 12 mm, previously measured 13 mm (series 3, image 46).Heart size normal. Moderate coronary artery calcifications.CHEST WALL: Soft tissue nodule adjacent to medial aspect of left pectoral muscle is not significantly changed, measuring 1.2 cm previously measured 1.2 cm (series 3, image 18).ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Hypoattenuating pancreatic head lesion not significantly changed, measuring 2.8 x 1.7 cm, previously measured 2.4 x 1.8 cm (series 3, image 95).Stable mild prominence of pancreatic duct and atrophy of pancreatic tail.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral hypoattenuating foci most compatible with cysts and unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastrostomy tube in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified fibroid in uterus.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.Slight interval increase in size of several nonspecific lung nodules. Continued follow-up is recommended.2.Stable mediastinal and hilar lymphadenopathy.3.Stable left chest wall metastatic nodule.4.Stable hypoattenuating lesion in pancreatic head.5.Improved bronchiolitis.
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Generate impression based on findings.
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Reason: 52Yrs female here for follow-up of Anaplastic TCA with papillary TCA background s/p resection f/b TFHX 1/09 History: as above CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Mild amount of debris within the trachea.Status post thyroidectomy.No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hepatic hypodensities, unchanged over 4 years. No suspicious masses.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: 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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Reason: Metastatic breast cancer receiving chemotherapy. Restaging. History: Bone pain in spine. CHEST:LUNGS AND PLEURA: No new suspicious pulmonary nodules or masses.No pleural effusion.MEDIASTINUM AND HILA: Stable mildly prominent hilar lymph node (image 36, series 3). No significant mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: Interval increase in size of the right axillary lymph node (image 17 series 3) now measuring 12 mm, previously, measuring 11 mm.Stable radiolucent lesion in the T3 vertebrae.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable scattered hypodensities. No new suspicious masses.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.Increasing mesenteric lymphadenopathy as well as increasing mesenteric stranding. Reference anterior mesenteric lymph nodes (image 116, series 3) now measures 2.5 cm x 1.2 cm, previously measuring 1.7 cm x 0.8 cm.BONES, SOFT TISSUES: Stable areas of sclerosis in the L1 vertebrae ,left iliac wing , and right ilium presumably represent sites of previous metastatic disease.OTHER: No significant abnormality noted.
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Increasing axillary and mesenteric nodal disease with mesenteric stranding. Stable skeletal metastases. No evidence of pulmonary metastatic disease.
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Generate impression based on findings.
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Pancreatic neuroendocrine tumor CHEST:LUNGS AND PLEURA: Right middle lobe nodule is unchanged measuring one by 0.9 cm on image number 56 on series number 7. No other nodules.MEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged.CHEST WALL: Small axillary lymph nodes are unchanged.ABDOMEN:LIVER, BILIARY TRACT: Interval enlargement of left lobe liver lesion. This lesion now measures 5.4 by 3.9 cm in image number 95, series number 7. Index right lobe lesion now measures 3.9 by 5.1-cm image number 108, series number 7, increased in size compared to previous study. Interval development of intrahepatic biliary dilatation. Distal common bile duct is compressed by patient's known pancreatic mass.SPLEEN: No significant abnormality notedPANCREAS: Patient's known pancreatic head mass now measures 9.2 x 9.5 cm on image number 125, series number 7, increased in size compared to previous study. Encasement of the major retroperitoneal and mesenteric vessels, again noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval increase in the size of the pancreatic head mass and liver metastases. Interval development of biliary dilatation.Right middle lobe nodule is unchanged.
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Generate impression based on findings.
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71-year-old female with history of fallopian tube cancer CHEST:LUNGS AND PLEURA: Index left lower lobe nodule measures 5-mm in diameter image number 70, series number 4. No significant change. Right lower lobe atelectasis and right-sided pleural effusion, unchanged. Diffuse right-sided pleural thickening, unchanged. An underlying right lower lobe endobronchial or parenchymal mass cannot be excluded.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis, hepatomegaly, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Focally diminished nephrogram of the left upper pole, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites around the liver, new from previous study.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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Stable lung findings as above. Interval development of small amount of ascites.
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Generate impression based on findings.
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Evaluate for recurrence, history of renal cell carcinoma 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: Simple cyst in the lower pole of the right kidney measuring 1 cm in diameter. No evidence of recurrence in the left nephrectomy bed.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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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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45-year-old female with metastatic hemangioendothelioma of the liver. CHEST:LUNGS AND PLEURA: Reticular opacities in the anterior aspect of left upper lobe appear unchanged. Multiple nodular opacities in the left lower lobe adjacent to the major fissure appears similar (series 5, image 80).Right lower lobe ground glass nodule unchanged, measuring 10 x 9 mm, previously measured 10 x 8 mm (series 5, image 47).No new suspicious nodules or lesions. No consolidation or pleural effusions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple liver lesions are not significantly changed accounting for difference in timing of contrast bolus. Reference segment 7 lesion measures 4.7 x 3.2 cm, previously measured 4.7 x 3.3 cm (series 3, image 97).Peripheral segment 8 lesion difficult to measure, however, does not appear significantly changed, measuring approximately 5.0 x 2.0 cm, previously measured 4.7 x 1.8 cm (series 3, image 92).Reference lesion in segment 6 also similar, measuring 4.0 x 2.0 cm, previously measured 3.8 x 1.9 cm (series 3, image 115).No new lesions identified.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: Prominent retroperitoneal lymph nodes not significantly changed.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.No significant change in left lower lobe nodular opacities. 2.Right lower lobe ground glass nodule stable since 2007.3.No significant change in hepatic lesions accounting for variation in technique.
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Generate impression based on findings.
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88 year old female with history of intermittent abdominal pain and right-sided hydronephrosis seen on ultrasound ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Simple cyst in the dome of the liver..SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral vascular calcifications. Right-sided extrarenal pelvis without evidence of hydronephrosis. Right ureter is normal in size. No evidence of stones in the right ureter. Punctate left renal stone and simple left renal cyst. No evidence of stones in the left ureter. Left ureter is also normal in caliber.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Bilateral renal vascular calcifications. Right-sided extrarenal pelvis. Punctate left renal stone and simple left renal cyst.
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Generate impression based on findings.
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Reason: f/u lung nodule History: none LUNGS AND PLEURA: Prior right upper lobe irregular nodule adjacent to surgical sutures has changed in orientation as there has been a progressive volume loss from fibrosis in this area. It may measure as large as 24 x 17 mm, previously 9 mm in long axis 12/10/2012, although this may all be evolving fibrosis and organizing pneumonia rather than tumor. 5 x 6 mm irregular spiculated nodule right lower lobe image 154 series 5 is now apparent, barely visible in hindsight on the prior study.Other scarlike opacities are stable as is central lobular predominant emphysema.MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy.Moderate to severe coronary artery calcifications are present.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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Enlarging right upper lobe nodule versus evolving fibrosis adjacent to an area sutures, and a new spiculated nodule in the right lower lobe. A PET is recommended for follow-up.
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Generate impression based on findings.
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47-year-old female status postop total proctocolectomy presenting with bilious vomiting ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Multiple nonspecific hypodense lesions in the spleen. An index lesion measures 1.3 cm on image number 44, series number 3.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Proximal small bowel loops are dilated measuring up to 6 cm. Distal small bowel loops in the pelvis are decompressed. Some of the small bowel loops demonstrate mild wall thickening and increased enhancement, nonspecific. Postsurgical changes in the pelvis. Small amount of fluid in the pelvis. A surgical drain with its tip in the pelvis.Left lower quadrant ostomy.BONES, SOFT TISSUES: Postsurgical changes in the midline abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Bilateral inguinal adenopathy. An index right inguinal node measures 2.3 x 1.1 cm image number 148, series number 3.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Proximally dilated and distally decompressed small bowel loops suggestive of mid small bowel obstruction. Etiology is unknown. Long segment small bowel loops in the upper pelvis demonstrate increased enhancement suggestive of inflammation, nonspecific.Postsurgical changes in the pelvis. No evidence of abscess.Nonspecific hypodense splenic lesions.
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Generate impression based on findings.
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Reason: Pt is a 61 y/o male with met melanoma, dyspnea, cough, evaluate for PE History: met melanoma LUNGS AND PLEURA: Paramediastinal fibrosis and bronchiectasis consistent with radiation pneumonitis. No suspicious pulmonary lesions.Tubing entering the left posterior chest wall and coiled in the left lung base. Small left pleural effusion with pleural thickening/disease.MEDIASTINUM AND HILA: Cardiac size within normal limits. Severe coronary artery calcifications. There is extensive mediastinal soft tissue tumor and scattered mediastinal surgical clips. There is a heterogeneous cardiophrenic angle mass that measures 7.3 x 4.0 cm (series 3 image 82), previously 5.0 x 3.0 cm.CHEST WALL: Median sternotomy hardware in place without abnormality. Multilevel degenerative changes in the thoracic spine.Right axillary lymphadenopathy and soft tissue density nodules in the right lateral chest wall (series 3 images 75 and 79).UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Right adrenal mass measures 4.7 x 3.4 cm (series 3 image 96), previously 4.2 x 2.8 cm. New, incompletely visualized left adrenal mass measures 4.2 x 2.8 cm.New retroperitoneal and intraperitoneal soft tissue nodules.Diffuse fatty infiltration of the liver.
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1.Paramediastinal fibrosis and bronchiectasis consistent with radiation pneumonitis.2.Progression of metastatic disease with enlarging cardiophrenic angle mass, bilateral adrenal gland masses and numerous soft tissue nodules.
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Generate impression based on findings.
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Reason: Patient with a history of nasal septal carcinoma treated with surgery and XRt in 2008. +emphysema and former smoker. Had CT chest with new right peripheral lung nodule. Please compare new scan with this one. History: Had CT chest with new right peripheral lung nodule. LUNGS AND PLEURA: Left paramediastinal radiation fibrosis unchanged.Previously reported right upper lobe subpleural nodule no longer identified.No specific evidence of pulmonary or pleural metastases identified.Mild centrilobular emphysema is present.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.A moderate amount of pericardial fluid is unchanged.Mild coronary artery calcifications are present.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. A previously described hepatic angioma is not seen today due to differences in the phase of contrast administration. Bilateral renal cysts are unchanged.
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Left lung radiation fibrosis and a pericardial effusion, unchanged. No nodules identified on today's study.
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Generate impression based on findings.
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6-year-old male with history of MVC, 3+ blood on urinalysis. Assess for kidney/bladder injury. ABDOMEN:LUNG BASES: Minimal dependent atelectasis is noted at the right lung base. No pericardial effusion is seen.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: 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 evidence of acute traumatic abnormality.
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Generate impression based on findings.
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Clinical question: Patient with subdural hematoma. Signs and symptoms:Subdural fluctuating exam. Nonenhanced head CT:There is no detectable intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is revisualization of small bilateral hemispheric low attenuation subdural collections which in comparison with prior exam demonstrate no evidence of any new acute hemorrhage and multiple measurements of subdural suggests slight interval decreased size since prior exam.There is interval noticeable decreased previously seen subarachnoid hemorrhage bilaterally.Mild primary periventricular and to a lesser degree subcortical foci of low-attenuation likely representing age indeterminate small vessel ischemic strokes appear grossly similar to prior exam.
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1.No detectable acute new findings since prior exam.2.Interval significant decreased subarachnoid hemorrhage since prior study.3.Interval slight decreased size of bilateral low attenuation subdurals since prior exam.4.Interval decreased foci of acute blood product in the subdural since prior exam.5.Grossly stable mild age indeterminate small vessel ischemic strokes or
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Generate impression based on findings.
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13-year-old female with somnolence, headache, DKA, rule out cerebral edema 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 acute intracranial abnormalities.
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Generate impression based on findings.
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Reason: lung nodule. history of right pleural based nodule.SUPER D NODULE History: cough LUNGS AND PLEURA: Scattered benign appearing micronodules are present.The largest is in the subpleural region of the left lower lobe superior segment, 6 mm, image 119 series 5; this has an adjacent cystic component.Areas of linear scarring are present. MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes are present but no lymphadenopathy.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Vascular calcifications are present as well as calcified hepatic granulomata.
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Benign appearing micronodules, the largest is 6 mm in the left lower lobe superior segment with an adjacent cystic component. If no intervention was performed at this time, follow-up in 3 to 6 months by CT is recommended.
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Generate impression based on findings.
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65 year old female with stage IV endometrial cancer. CHEST:LUNGS AND PLEURA: No significant change in loculated pleural effusion and underlying atelectasis/consolidation. Left pleural catheter in place. Nodular right base opacity is unchanged; it previously measured nodule measures 7 mm, previously measured 8 mm (series 4, image 67).No new suspicious nodules.MEDIASTINUM AND HILA: Left chest wall port catheter tip in right atrium. No pathologically enlarged mediastinal lymph nodes. Heart is normal in size without pericardial effusion.CHEST WALL: Right chest wall port.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter caudate hypodensity too small to characterize but unchanged. Peripherally enhancing hypodensity in left lobe tip unchanged, likely hemangioma (series 3, image 71).Stable appearing hourglass deformity of gallbladder, most likely due to adenomyomatosis.No significant change in moderate amount of ascites fluid, which is partially loculated around liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple prominent retroperitoneal lymph nodes not significantly changed.BOWEL, MESENTERY: Moderate amount of peritoneal fluid unchanged; associated left hemidiaphragm thickening highly suspicious for peritoneal carcinomatosis as etiology of fluid (coronal series 80296, image 38).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: Stable prominent bilateral iliac nodes.BOWEL, MESENTERY: Moderate ascites fluid.BONES, SOFT TISSUES: Filling defect in the left femoral vein consistent with thrombus (coronal series 80296, image 51).OTHER: No significant abnormality noted.
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1.No significant change in loculated left pleural effusion. 2.No significant change in peritoneal fluid and diaphragmatic thickening, most consistent with peritoneal carcinomatosis.3.Thrombus in the left femoral vein.Findings communicated via text page to Dr. Sulai at 4:17 p.m., 12/3/2013.
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Generate impression based on findings.
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Reason: Eval mediastinal mass seen on CXR PA and LAT History: Mediastinal mass LUNGS AND PLEURA: Small right pleural effusion.Diffuse mosaic perfusion pattern is present, which could be from small airway disease as the examination was performed in partial expiration.The main pulmonary artery is large, 34 mm, consistent with PA hypertension.Focal scarring is present bilaterally.MEDIASTINUM AND HILA: Right aortic arch and right descending aorta, accounting for the findings described on the chest radiograph report.Numerous marginally enlarged lymph nodes are present throughout the mediastinum, nonspecific.Moderate to severe cardiomegaly is present with severe coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Extensive vascular calcifications are present.
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1. Right aortic arch accounting for the mediastinal findings on the chest radiograph.2. Small right pleural effusion, possibly secondary to CHF given a significant degree of cardiomegaly.3. Mosaic perfusion pattern, possibly air trapping, but could be related to pulmonary arterial hypertension as the main pulmonary artery is enlarged.4. Nonspecific diffuse mediastinal nodal enlargement, which could be related to chronic inflammation although a low-grade lymphoma is in the differential diagnosis.
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Generate impression based on findings.
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61 year old patient status post resection of a right frontal meningiothelial meningioma. Left hand and mouth numbness/tingling episode. Expected postsurgical changes include the staple line within the scalp overlying a right frontotemporal craniotomy and underlying surgical packing material which incorporates punctate foci of low density. There has been interval resolution of subarachnoid air anteriorly.There are stable areas of patchy hypoattenuation within periventricular and subcortical white matter most likely in representing sequela of chronic small vessel ischemia. There is no focal intracranial mass, fluid collection, hemorrhage or midline shift. There is no hydrocephalus. The orbits are unremarkable.
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Expected postoperative changes without acute intracranial abnormality which would account for the patient's symptoms.
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Generate impression based on findings.
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31 year-old female with headache, evaluate shunt, rule out ICH Redemonstration of a right frontal approach VP shunt with the tip in the third ventricle, unchanged. Hypoattenuation of the parenchyma surrounding the course of the VP shunt similar to the prior compatible with focal encephalomalacia. Slight interval decrease in the size of the lateral ventricles.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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1. No acute intracranial abnormalities.2. Stable right frontal approach VP shunt catheter with slight interval decrease in size of the lateral ventricles.
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Generate impression based on findings.
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Reason: routine surveillance s/p chemoRT for stage IIIa NSCLC History: none CHEST:LUNGS AND PLEURA: Bilateral perihilar and paramediastinal radiation fibrosis similar in appearance to prior exams.No new suspicious pulmonary nodules or masses.Interval development of bilateral pleural effusions, right greater than left, with septal thickening at the bases, suggestive of edema.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.There is cardiac enlargement without evidence of pericardial effusion.Severe coronary artery and aortic calcification.CHEST WALL: Degenerative changes in the thoracic spine.ABDOMEN: Absence of IV and 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: Atherosclerotic changes of the aorta and iliac arteriesBOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes within the spine.OTHER: No significant abnormality noted.
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1.Post radiation changes in the perihilar and paramediastinal regions. No definite evidence of recurrence or metastatic disease.2.Interval development of moderate size right pleural effusion and small left pleural effusion with basilar interstitial opacities compatible with edema. Findings are compatible with CHF.
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Generate impression based on findings.
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19 year-old female with trauma to the larynx status post football injury, dysphonia Limited views of the brain and orbits are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear.Bilateral subluxation of the cricoarytenoid joint. Fracture of the cricoid cartilage with minimal airway narrowing. No soft tissue emphysema is present to suggest airway rupture. The thyroid cartilage and hyoid bone are intact. No hematomas are identified.No exophytic masses or focal effacement of the aerodigestive tract. No lymphadenopathy by CT size criteria. No soft tissue masses are present in the neck.The parotid and submandibular glands are unremarkable. Multiple hypoattenuating thyroid nodules.The visualized lung apices are clear. The cervical spine is unremarkable without malalignment or fracture.
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1. Subluxation of the cricoarytenoid joint and fracture of the cricoid cartilage with minimal airway narrowing. No subcutaneous emphysema to suggest airway rupture.2. Multiple hypoattenuating thyroid nodules.
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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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Dizziness, vertigo and giddiness. Evaluate for posterior CVA versus other ischemia versus mets. There is no intracranial mass, hemorrhage or edema. There is no hydrocephalus and the midline is intact. There are no aggressive appearing bony lesions and the visualized portions of the orbits, mastoids and paranasal sinuses are unremarkable.
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No visualized intracranial abnormality. If there is persistent suspicion for ischemia or metastatic disease, MRI examination could be considered.
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Generate impression based on findings.
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70 year-old male patient. Reason: lung nodules, spiculated nodule in the superior segment RLL, also LL nodule History: pre-op CT CHEST:LUNGS AND PLEURA: Moderate centrilobular and paraseptal emphysema.Spiculated nodule in the superior segment of the right lower lobe that extends posteriorly to the pleural surface measures 21 x 12 mm (series 5 image 45), unchanged.Spiculated subpleural mass in the left lower lobe contain internal cystic components and bronchiectasis measures 44 x 25 mm (series 5 image 56), unchanged.Stable right lower lobe nodule (series 5 image 61).No new suspicious nodules or lesions.Small fat filled left Bochdalek hernia.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Severe coronary artery calcifications. Mild atherosclerotic changes in the thoracic aorta.Scattered normal appearing mediastinal lymph nodes, stable.Mildly enlarged left hilar lymph node (series 3 image 51), left interlobar lymph node (series 3 image 56), and bilateral subcentimeter lymph nodes in the inferior pulmonary ligament (series 3 images 57 and 62), all stable.CHEST WALL: Moderate multilevel degenerative changes in the thoracic spine.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Abdominal aortic aneurysm treated with stent graft.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Moderate multiple degenerative changes in the lumbar spine.OTHER: No significant abnormality noted.
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No significant interval change in pulmonary nodules and no new suspicious lesions.
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Generate impression based on findings.
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Reason: h/o head and neck cancer History: eval right lower lung nodule seen on previous scan LUNGS AND PLEURA: Apical radiation fibrosis and severe apical centrilobular emphysema are unchanged.No suspicious pulmonary nodules are identified.Mild bronchial wall thickening is present bilaterally.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.The ascending aorta remains moderately ectatic, stable.Severe coronary artery calcifications are present.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic and renal cysts are stable. Gastrostomy tube present. Vascular calcifications are seen.
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No evidence of metastases. Emphysema is present as well as coronary calcifications.
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Generate impression based on findings.
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45-year-old male with bladder cancer. CHEST:LUNGS AND PLEURA: The previously reference 4-mm right upper lobe nodule is stable. Few micronodules in the right and left lung base. MEDIASTINUM AND HILA: Small left supraclavicular node noted measuring 1.4 x 1.9cm. Calcified nodes in the mediastinum noted from prior healed granulomatous disease.CHEST WALL: Filling defect in the left jugular vein noted, which is worrisome for thrombus. ABDOMEN: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: Retroperitoneal lymphadenopathy appears similar to the prior study with index left periaortic lymph node measuring 1.9 x 1.5 cm (series 3 image 133), previously 1.6 x 2.0 cm. Other non-reference periaortic lymphadenopathy also appears stable.BOWEL, MESENTERY: Right lower quadrant ileostomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy.LYMPH NODES: Index left common iliac lymph node measures 1.3 x 1.3cm (series 3 image 149), previously 1.1 x 0.9 cm not significant changed. Large inguinal lymph nodes are again noted with reference lesion measuring 2.3 x 2.4 cm (image 207 series 3) previously 2.5 x 2.1 cm.BOWEL, MESENTERY: Left pelvic lymphocele, which extends inferiorly into the pelvis and is grossly stable in size. An additional small right pelvic lymphocele is unchanged.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Interval development of a left jugular veinous thrombus2. Abdominal and pelvic lymphadenopathy as detailed above, not significantly changed from the prior study. Stable pelvic lymphoceles.Dr. Manchen was notified of the findings at 9:01 on 12/4/13
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Generate impression based on findings.
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DLBCL s/p ASCT on 1/17/12 now with new neck mass. There has been interval diffuse increase in size of the Waldeyer ring structures with mild narrowing of the oropharyngeal airway. There has been overall interval increase in size of numerous bilateral cervical lymph nodes, some of which appear to be necrotic. For example, there is a hypoattenuating left lateral retropharyngeal lymph node that measures 17 x 13 mm, previously 4 x 4 mm. Likewise, a right level 5 lymph node measures 11 x 15 mm, previously 4 x 6 mm. There is also increase in size of a right axillary lymph node. The thyroid and major salivary glands are unremarkable. The major cervical vessels are intact. The osseous structures are unremarkable. There is a new ill-defined nodule in the right upper lobe of the lung that measures up to 9 mm. There is interval decrease in size of the right chest wall subcutaneous stranding.
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1. Interval increase in size of the Waldeyer ring structures with mild narrowing of the oropharyngeal airway and overall interval increase in size of numerous bilateral cervical lymph nodes, some of which appear to be necrotic. These findings indicate progressive disease.2. New ill-defined nodule in the right upper lobe that measures up to 9 mm. Refer to the separate chest CT report for additional details.
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Generate impression based on findings.
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52-year-old male patient. Reason: h/o HNC, CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Trace bilateral dependent atelectasis. No suspicious pulmonary nodules or masses.Bilateral fat filled Bochdalek hernias.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Moderate coronary artery calcifications.Multinodular thyroid gland not significantly changed.Index left paratracheal lymph node measures 9 mm (series 3 image 42) slight decreased from 10 mm previously.Right hilar lymph node measures 14 mm (series 3 image 49), unchanged.CHEST WALL: Multilevel degenerative changes in the thoracic spine. T9 and T6 sclerotic foci are unchanged.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: Small left renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes 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: Multilevel degenerative changes in the lumbar spine.OTHER: No significant abnormality noted.
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No significant change in measured mediastinal and hilar lymph nodes.No suspicious pulmonary nodules or masses.
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Generate impression based on findings.
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Reason: evaluate thorax anatomy prior to AV replacement History: severe AS LUNGS AND PLEURA: Small left pleural effusion and loculated fluid within the major fissure on the right.Apical fibrotic changes on the right.Minimal septal thickening suggestive of mild interstitial edema.Mild basilar atelectasis.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Multiple scattered minimally prominent mediastinal lymph nodes without definite evidence of adenopathy.There is cardiac enlargement without evidence of pericardial effusion.Status post CABG with severe calcification of the native coronary arteries.Extensive calcification of the aortic valve.CHEST WALL: Median sternotomy.Extensive degenerative changes throughout the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. A surgical clip is identified posteriorly in the right perihepatic subdiaphragmatic region.
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1.Small pleural effusions, left greater than right, with loculated fluid noted within the right major fissure.2.Minimal amount of interstitial pulmonary edema.3.No suspicious pulmonary nodules or masses.4.Status post CABG with cardiomegaly, extensive vascular calcification, and aortic valvular calcification,
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Generate impression based on findings.
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62 year old man with family history of coronary artery disease referred for evaluation of coronary calcification.CPT: 75571 Calcium Score:LM: 0LAD: 0LCx: 0RCA: 0Total: 0.Coronary 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. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove.LCx: The left circumflex coronary artery courses normally in the left AV groove.RCA: The right coronary artery is large and arises normally from the right sinus of valsalva.Left Ventricle: Assessment limited due to absence of contrast. LV size appears to be normal.Right Ventricle: Assessment limited due to absence of contrast. RV size appears to be normal.Left Atrium: Assessment limited due to absence of contrast. The left atrium appears to be normal in size. There are four distinct pulmonary veins which drain normally into the left atrium. Right atrium, vena cavae, and coronary sinus: Assessment limited due to absence of contrast. The right atrium appears to be normal in size. SVC, IVC, and coronary sinus appear to drain normally into right atrium.Valves: There is no calcification on the aortic valve. There is no calcification on the mitral valve.Great vessels: The visualized portions of the thoracic aorta demonstrate no evidence of aneurysm; however, the ascending aorta is mildly dilated (43x43mm). The aortic arch is not seen. The main pulmonary artery is normal in size.Pericardium: The pericardium is normal in thickness.
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1. Total calcium score was 0.2. The ascending aorta is mildly dilated. This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report.
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Generate impression based on findings.
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56-year-old male with history of metastatic liver cancer with ? lung involvement. Presents with weight loss, hair loss, rash s/p chemotherapy, Lower back pain. CHEST:LUNGS AND PLEURA: Innumerable bilateral pulmonary nodules, consistent with metastatic disease. For reference, a left upper lobe nodule measures 0.9 x 0.9 cm (image 50, series #5).MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Diffuse hypodense liver lesions are diffuse almost entirely replace the hepatic parenchyma. Largest measurable lesion in the left lobe is 9.0 x 9.5 cm. The main portal vein and branches are patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral hypodense renal lesionsRETROPERITONEUM, LYMPH NODES: Upper retroperitoneal and gastrohepatic ligament adenopathy is consistent with metastatic disease.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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1.Hypodense liver lesions almost entirely replacing the hepatic parenchyma is consistent with known hepatic malignancy.2.Innumerable bilateral pulmonary nodules consistent with metastatic disease.
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Generate impression based on findings.
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Male 61 years old; Reason: Chest: pleural effusion, abd/pelvis: s/p liver RFA, assess tumor necrosis History: pleural effusion CHEST:LUNGS AND PLEURA: Bilateral pleural effusions, right greater the left. Compressive atelectasis bilaterally. Scatter micronodules without frank mass detected.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: The liver demonstrates cirrhotic morphology. Patient is status post RF ablation with numerous hypodensities throughout the liver compatible with RF ablation cavities.. The previously referenced segment 7 lesion measures 5.5 x 5.3 cm previously 3.1 x 3.0 cm, however it is difficult to assess whether this is necrosis from RF ablation, or tumor progression. Numerous other hypodensities appear larger than previous MR, also incompletely characterized.Attenuation of the portal vein at its bifurcation as well as small filling defect suggest portal venous thrombosis which extends partially into the right and left common portal veins.Patient is status post cholecystectomy. No intrahepatic or extrahepatic biliary ductal dilation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: The bilateral adrenal glands are nodular, a nonspecific finding.KIDNEYS, URETERS: Numerous nonobstructing nephrolith noted in the right renal pelvis. Small hypodensities in the kidneys bilaterally, too small to characterize, although likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Nonspecific bowel thickening in the right lower quadrant. No obstruction or pneumatosis evident.BONES, SOFT TISSUES: Compression deformity noted in the lumbar spine with degenerative changes.OTHER: Right-sided drain is in place. Trace ascites remains.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Nonspecific bowel thickening in the right lower quadrant. No obstruction or pneumatosis evident.BONES, SOFT TISSUES: Compression deformity noted in the lumbar spine with degenerative changes.OTHER: Trace ascites.
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1.Bilateral pleural effusions, right greater than left.2.Numerous hypodensities throughout the liver compatible with HCC with prior radio frequency ablation. Residual tumor size is difficult to assess and recommend triple phase liver protocol CT or MRI to fully assess residual tumor.3.Partial thrombosis of the portal vein as described above.4.Stable positioning of the right perihepatic drain with residual trace ascites.5.Non specific right lower quadrant bowel wall thickening, likely reactive.
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Generate impression based on findings.
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Clinical question: r/o brain lesionSigns and Symptoms: new AMS in transplant/immunosuppresed patient The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present.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 demonstrates a mild mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The left eyeball lens is thin. Atherosclerotic calcifications are present along the distal vertebral arteries. Atherosclerotic calcifications are present in the extracranial vasculature which is often seen in renal failure and diabetes. Atherosclerotic calcifications are present along the distal internal carotid arteries.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 3.CT is insensitive for the early detection of nonhemorrhagic CVA
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Generate impression based on findings.
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67-year-old male with abdominal distention, pain, and fever. Concern for abdominal process. Neutropenic fever. Evaluation of solid organs is limited secondary to lack of intravenous contrast. Evaluation of bowel is limited secondary to lack of enteric contrast.ABDOMEN:LUNG BASES: Note is made of small bilateral pleural effusions with underlying atelectasis/consolidation. No evidence of pneumothorax. Note is made of centrilobular emphysema.LIVER, BILIARY TRACT: Note is made of gallstones without evidence of acute cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Note is made of vascular calcifications of the aorta.BOWEL, MESENTERY: Note is made of diverticulosis, without evidence of diverticulitis. No dilated loops of bowel to suggest obstruction. There is no evidence of pneumatosis intestinalis, portal venous gas, or free intraperitoneal air.BONES, SOFT TISSUES: There is diffuse soft tissue anasarca.OTHER: Note is made of coronary artery calcifications. There is a small pericardial effusion.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Note is made of foci of gas density within the bladder which may be related to recent instrumentation, however, correlation for cystitis recommend.LYMPH 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. Bilateral pleural effusions with underlying atelectasis/consolidation.2. Gallstones without evidence of acute cholecystitis.3. Small pericardial effusion.
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Generate impression based on findings.
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Malignant neoplasm of brain, unspecified site. Eval for hemorrhage. headache Patient status post recent right-sided craniotomy for removal of a right frontal lobe mass. There is hypodensity mixed in with a foci of hyperdensity at the surgical bed. In addition a few air bubbles layer in a small right-sided extra-axial collection measuring 4 mm in thickness at the surgical site. There soft tissue swelling along the right-sided scalp tissues associated with small subgaleal collection.The visualized portions of the paranasal sinuses demonstrate mucus retention cysts and some mild mucosal thickening.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. There is a right-sided periorbital soft tissue swelling present associated with periorbital air.
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1.Status post a right frontal lobe surgery with attendant postsurgical findings. There are only small hemorrhagic foci within the surgical bed and there is a small extra-axial fluid collection at the craniotomy site and soft tissue swelling in the scalp tissues and around the right orbit.2.Portable CT has lower resolution than conventional CT.
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Generate impression based on findings.
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90 year-old female with abdominal pain, distention. Rule out diverticulitis. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Multiple right lobe subcentimeter hypodensities are too small to characterize though favor benign etiology.SPLEEN: Calcified splenic lesions likely prior granulomatous disease.PANCREAS: Small cystic lesion in the pancreatic body-tail may represent simple cysts versus branch type IPMN.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral renal cystic lesions, some incompletely characterized on single phase CT. 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: Calcified fibroids in the pelvis.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mesenteric stranding surrounding inflamed bowel in the left lower quadrant, demonstrating alternating with areas of low attenuation mesenteric fat and high attenuation bowel wall, consistent with intussusception. A leading mass is not identified, though a underlying neoplasm cannot be excluded. The affected bowel demonstrates wall thickening, mucosal hyperemia, and probable pneumatosis. Free pericolonic fluid extends superiorly in the left paracolic gutter and surrounds the spleen. The colon proximal to the intussusception is dilated and demonstrates air-fluid levels, compatible with colonic obstruction. Small bowel is not dilated.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Colonic obstruction secondary to intussusception of the sigmoid colon. Possible pneumatosis of the sigmoid colon. Small amount of ascites.
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Generate impression based on findings.
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Male 52 years old; Reason: reason for abdominal pain. History: pain at the site of renal tx. No contrast ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small calcifications in the native kidneys may represent small vascular calcifications.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber. Appendix is unremarkable.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: Right iliac fossa renal allograft with mild perinephric fat stranding, is nonspecific no fluid collections no evident hydronephrosis
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1.Right iliac fossa renal allograft without hydronephrosis with mild perinephric fat stranding. Consider Doppler sonography for evaluation of the allograft and vessels.
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Generate impression based on findings.
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Female 76 years old; Reason: Pt with RLQ pain and TTP on exam. Please eval for right sided diverticulosis vs appendicitis History: rlq pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No nephrolithiasis or hydronephrosis in either kidney. Small left renal cortical cyst.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small bowel is normal in caliber. Appendix is unremarkable. No bowel obstruction.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified uterine fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis affects the sigmoid colon without surrounding inflammation.BONES, SOFT TISSUES: Degenerative changes affect the lower lumbar spine with disk and endplate changes at L4-L5.OTHER: No significant abnormality noted.
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1.No findings of appendicitis.2.Diverticulosis without evident findings of diverticulitis.3.No hydronephrosis.
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Generate impression based on findings.
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Female 63 years old; Reason: 63 female with AML, neutropenia, found to have diverticulitis on previous CT. count now recovering and would like to re-image with PO contrast only, History: abd pain ABDOMEN:LUNG BASES: Interval improvement in basilar ground glass and nodular opacities, most likely representing resolving aspiration/infection.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Multiple calcified granulomas.PANCREAS: No significant abnormality notedADRENAL GLANDS: Stable bilateral adrenal nodules, measuring 4.9 cm on the right and 0.9 cm on the left. These remain indeterminate given attenuation of 30 HU.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is improvement in the previously noted diverticulitis in the sigmoid colon. Residual mild stranding and bowel wall thickening noted in the sigmoid. No evidence of free peritoneal air, abscess, or obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: The uterus is normal. 3 x 3.9 cm calcified right adnexal lesion, incompletely characterized.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Sigmoid diverticulitis, as described above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Interval improvement in the sigmoid diverticulitis without evidence of complications.2.Stable bilateral indeterminate adrenal nodules. MR or dedicated adrenal protocol CT advised.3.Improved basilar opacities compatible with resolving aspiration or infection. 4.Calcified right adnexal mass incompletely characterized. Ultrasound advised for full characterization.
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Generate impression based on findings.
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Evaluate talus calcaneal fusion Examination of the images reveals deformity of the calcaneus secondary to old trauma. There is flattening of Boehler's angle. There are clefts that extend into the the posterior facet of the subtalar joint. No evidence is seen of fusion of the subtalar joint.
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Posttraumatic deformity of the calcaneus with no evidence of fusion of the talus and calcaneus.
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Generate impression based on findings.
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27-year-old male with a large pancreatic pseudocyst and abdominal pain. Evaluate pseudocyst. ABDOMEN:LUNG BASES: Note is made of small bilateral pleural effusions, left greater than right, with underlying atelectasis/consolidation. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Note is made of a loculated fluid collection measuring 9.1 x 6.5 cm in the transverse dimension and 9.7 cm in the craniocaudal dimension, consistent with the stated history of pancreatic pseudocyst, appearing similar to the prior MRI examination performed on 12/2/13, when allowing for differences in technique. There is a focal area of decreased enhancement along the pancreatic neck which may represent a area of necrosis. There are no other complications of pancreatitis identified. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Note is made of vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: There are multiple focally dilated loops of small bowel in the left hemiabdomen, measuring up to 3.8 cm in diameter which may represent ileus. Oral contrast reaches the distal small bowel.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Note is made of a moderate amount of free fluid within the abdomen.PELVIS: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: Note is minimal large amount of free fluid within the pelvis.
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1. Large pancreatic pseudocyst as described above. There is a focal area of decreased enhancement along the pancreatic neck 2. Mild ileus3. Small bilateral pleural effusions with underlying atelectasis/consolidation.
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Generate impression based on findings.
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Female, 66 years old, essential tremor, intraoperative CT for planning. Imaging was acquired with a stereotactic frame in place. This, along with portable technique, results in reduced image quality.Images obtained prior to placement of stimulator leads demonstrate no evidence of intracranial hemorrhage, significant mass effect or other acute abnormalities.Images obtained subsequent to placement of stimulator leads demonstrate expected intracranial air. The leads course through burr hole placed along the bilateral coronal sutures and project posteriorly and inferomedially to terminate in the region of the thalami. No large parenchymal hematoma or extra-axial hemorrhagic collections are seen.
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Intraoperative CT before and after the placement of deep brain stimulator leads. No unexpected findings are seen.
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Generate impression based on findings.
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Female 74 years old; Reason: r/o abd pathology, colitis, urinary obstruction History: abd pain, watery diarrhea, AKI ABDOMEN:LUNGS BASES: Right basilar subsegmental atelectasis and consolidation. Trace pleural effusions. Cardiac pacer leads .LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Extensive vascular calcifications about the pancreas. No pancreatic ductal dilatation or focal inflammation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophy of the right kidney. Focal mass along the anterior aspect of the right kidney measures 1.9-cm.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: Right lower abdominal ileostomy with parastomal hernia and left lower abdominal colostomy. No bowel obstruction.BONES, SOFT TISSUES: Lower abdominal osteotomiesOTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: This the uterus is absent.BLADDER: Bladder is decompressed by a Foley catheter.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Severe degenerative changes of the right hip. Probable avascular necrosis of the left femoral head.Compression fractures of the L2 and L4.OTHER: No significant abnormality noted.
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1.Right lower abdominal ileostomy with parastomal hernia and left lower abdominal colostomy without bowel obstruction.2.Severe atrophy of the right kidney a focal upper pole mass which is not characterized without contrast. Follow up with a contrast enhanced MRI or CT (renal mass protocol) is suggested.3.Findings and recommendations discussed with Dr.Paesch via telephone at the time of dictation.
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Generate impression based on findings.
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57-year-old female patient with hypoxia and tachycardia. Rule out PE. Exam mildly limited by patient motion.PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Trace bilateral dependent atelectasis. Minimal right lower lobe subsegmental atelectasis versus scarring. No suspicious nodules or lesions.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.Mild atherosclerotic changes of the thoracic aorta.No mediastinal or hilar lymphadenopathy.Mildly ectatic esophagus with debris. Moderate thickening of the midesophagus with edema may be infectious or inflammatory nature, however a neoplasm cannot be excluded.CHEST WALL: Cortical discontinuity of the anterior medial aspect of the left first rib (series 10 image 49). Clavicular internal fixation device present on the left. Right chest with neural stimulator.Mild degenerative changes in the thoracic spine. Healed left rib fracture.No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia.
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Technically adequate examination without evidence of a pulmonary embolus.Ectatic esophagus with moderate thickening of the midesophagus of unclear etiology, consider endoscopy or esophagram for further evaluation.Cortical discontinuity of the anterior medial aspect of the left first rib , poorly seen secondary to motion. Recommend plain films of the manubrium and left first rib for further evaluation.
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Generate impression based on findings.
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73-year-old female with history of back pain This study is limited due to lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: 3.6 by 2.3-cm hypodense lesion in the right lobe liver image number 20, series number 3. This lesion cannot be optimally characterized due to lack of IV contrast. There are some additional subcentimeter hypodense lesions in the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral small, hypodense lesions in both kidneys, which cannot be optimally characterized due to lack of IV contrast.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: 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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Limited study due to lack of intravenous contrast. Indeterminate liver lesions and kidney lesions. No CT findings to explain patient's back pain.
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Generate impression based on findings.
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58-year-old female patient with history of lymphomatoid granulomatosis presents with pleuritic chest pain and shortness of breath. Evaluate for pulmonary embolism. PULMONARY ARTERIES: Technically adequate study without evidence of a pulmonary embolus. LUNGS AND PLEURA: Moderate interval decrease in left upper lobe consolidation and surrounding groundglass opacities. Mild decrease in left-sided pleural effusion with atelectasis and scarring from left lower lobe wedge resection.Right apical postsurgical distortion and lower lobe scarring is stable.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.Moderate interval decrease in confluent mediastinal and left suprahilar lymphadenopathy.Right-sided chest port with catheter tip at the cavoatrial junction.Left calcified thyroid nodule unchanged.CHEST WALL: Mild multilevel degenerative changes in the thoracic spine.Left humeral head collapse unchanged and likely secondary to avascular necrosis.Moderate interval decrease in right lower cervical lymphadenopathy.No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified granulomas in the liver parenchyma. Intrahepatic and extrahepatic biliary ductal dilatation is not significantly changed from prior. Diffuse fatty liver infiltration. Interval decrease in prominent porta hepatis and periaortic lymph nodes.
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Technically adequate study without evidence of a pulmonary embolus.Interval decrease in left upper lobe consolidation and mediastinal lymphadenopathy.
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Generate impression based on findings.
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Reason: PE? History: chest pain, h/o PE PULMONARY ARTERIES: Technically adequate study without evidence of a pulmonary embolus.LUNGS AND PLEURA: Mild interval decrease in right basilar wedge-shaped opacity (series 10 image 117), consistent with known history of pulmonary infarct. No new suspicious nodules or lesions.MEDIASTINUM AND HILA: Ventricular chambers are mildly enlarged for age.. Left ventricular wall appears mildly thickened. No pericardial effusion.Mild interval decrease in prominent mediastinal lymph nodes. No hilar lymphadenopathy.CHEST WALL: Mild multilevel degenerative changes in the thoracic spine. Unchanged bilateral gynecomastia. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Technically adequate study without evidence of a pulmonary embolus. Mild interval decrease in right basilar pulmonary infarct.Mild chronic enlargement of cardiac ventricular chambers with apparent wall thickening of the LV. As this exam is not cardiac gated, this is of uncertain clinical significance however cardiac workup is suggested if not recently done.
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Generate impression based on findings.
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Male 40 years old; Reason: Evaluate for intraabdominal process in patient s/p pancreatic, renal transplant History: abdominal pain, AMS ABDOMEN: The absence of intravenous contrast limits evaluation of the solid organs and vascular structures. Given these limitations, the following observations were made:LUNGS BASES: Bilateral bibasilar atelectasis. 4-mm nodule noted right lung base.LIVER, BILIARY TRACT: The liver is normal in morphology without focal lesion.The gallbladder is hydropic and markedly distended. No pericholecystic fluid, wall thickening, or radiopaque stones noted. There is no intrahepatic or extrahepatic ductal dilationSPLEEN: No significant abnormality noted.PANCREAS: Markedly atrophic, incompletely characterized given lack of IV contrast. Ductal dilation cannot be assessed, and should be further characterized with a contrast enhanced CT.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral native, and right iliac kidneys are atrophic and calcified. Left iliac transplant kidney appears normal. No hydronephrosis, renal calcifications, or perinephric fluid collection detected.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/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Catheter noted in the bladder with foci of air, likely iatrogenicLYMPH 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.Hydropic gallbladder without CT evidence of cholecystitis, however ultrasound is a more sensitive examination for acute cholecystitis and cholelithiasis.2.Incomplete evaluation of the pancreas given lack of IV contrast, and small tumor in the pancreas the ductal dilation cannot be excluded. Recommend dedicated pancreatic CT or MRI/M.R.C.P. for full characterization
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Generate impression based on findings.
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Male 50 years old; Reason: Cholangiocarcinoma metastatic to peritoneum please assess and provide index lesions for RECIST as required to capture for protocol therapy History: As above CHEST:LUNGS AND PLEURA: Micronodules scattered throughout the lungs, with 3-mm nodule noted left lung base. Bilateral atelectasis noted.MEDIASTINUM AND HILA: A 1.1-cm left supraclavicular node is noted. Extensive mediastinal adenopathy including a 1.6 x 1.8 cm para-aortic node.CHEST WALL: Right-sided Port-A-Cath is noted with its tip in the cavo atrial junction.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Low attenuating lesion in segment 5/6 with both capsular retraction and bulging measures 2.6 x 4.2cm (series 3 image 109). Perihepatic ascites with right pericolic inflammatory changes worrisome for peritoneal carcinomatosis. The gallbladder is contracted.SPLEEN: Enlarged without focal lesion.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Numerous stones are noted in the kidneys with mild left-sided hydronephrosis. No perinephric fluid collections, fat stranding, or lesion detected.RETROPERITONEUM, LYMPH NODES: 2.7 x 3.5 cm para-aortic node noted (series 3 image 123). BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lytic lesion incompletely characterized in the right acetabulum with a narrow zone of transition, incompletely characterized.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: Lytic lesion incompletely characterized in the right acetabulum with a narrow zone of transition, incompletely characterized.OTHER: Trace ascites in the pelvis
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1.Large hypoattenuating lesion in the inferior right lobe of the liver compatible with previously diagnosed cholangiocarcinoma. Perihepatic inflammation with nodularity and ascites worrisome for peritoneal carcinomatosis.2.Retroperitoneal and mediastinal lymphadenopathy.3.Bilateral non obstructing kidney stones4.Right acetabular lytic lesion incompletely characterized.
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Generate impression based on findings.
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38 year-old male with diffuse abdominal pain. Rule out obstruction. ABDOMEN:LUNG BASES: Note is made of bibasilar atelectasis/scarring. No pleural effusion or pneumothorax.LIVER, BILIARY TRACT: Note is made of multiple subcentimeter hypodensities in the liver, which are too small to characterize, but may represent simple cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensity in the superior pole of the left kidney is too small to characterize, but may represent a simple cyst.RETROPERITONEUM, LYMPH NODES: Note is made of multiple prominent retroperitoneal and mesenteric lymph nodes.BOWEL, MESENTERY: Note is made of nonspecific fat stranding within the mesentery adjacent to the SMA. No dilated loops of bowel to suggest obstruction.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: Note is made of nonspecific fat stranding within the mesentery adjacent to the SMA. No dilated loops of bowel to suggest obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Nonspecific mesenteric fat stranding and multiple prominent lymph nodes, as described above.
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Generate impression based on findings.
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Female 46 years old; Reason: 46 yo female with known gastric cancer; s/p distal gastrectomy on 10/3 at OSH; please evaluate for metastatic disease and or abnormalities History: gastric cancer CHEST:LUNGS AND PLEURA: Pleural based nodularity in the right lung base may represent atelectasis. No other nodules or mass detected.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Collapsed left breast prosthesis. The right implant is normal.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: Numerous too small to characterize lesions in the kidneys bilaterally. No hydronephrosis or perinephric fluid collections detected.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Patient is status post partial gastrectomy with surgical clips in the right upper quadrant. Asymmetric wall thickening in the stomach likely represents residual tumor (series 3 image 88). 0.7 x 1.3 cm perigastric lymph node 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.Asymmetric irregular wall thickening in the stomach, worrisome for residual tumor. Correlation with endoscopy advised.2.Perigastric lymphadenopathy.3.Pleural-based nodularity in the right lung base, which likely represents rounded atelectasis.
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Generate impression based on findings.
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35-year-old male with abdominal pain. Contrast extravasation description: Minor contrast extravasation into the left forearm.Supervising radiologist: Dr. VeronesiMinor or major extravasation: MinorContrast type: 120 cc of intravenous Omnipaque 350 were administered. Amount extravasated: 18 ccLocation of extravasation: Left forearmSigns and symptoms: Minor swelling without evidence of redness or pain.Treatment given: Cold compress PRNDischarge instructions given: YesLack of intra-abdominal fat limits examination.ABDOMEN:LUNG BASES: Left basilar scarring/atelectasis.LIVER, BILIARY TRACT: Gallstones, without evidence of acute cholecystitis. There are multiple subcentimeter hypodensities within the liver, which are too small to characterize, but likely represent simple cysts.SPLEEN: Atrophic or surgically absent.PANCREAS: 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 likely represent simple cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a right lower quadrant ostomy in place. There is wall thickening of the rectum measuring 10 mm and its largest diameter. No focal fluid collection to suggest abscess formation. There is no free intraperitoneal air, portal venous gas, or pneumatosis intestinalis.BONES, SOFT TISSUES: Note is made of multiple soft tissue defects along the posterior wall of the pelvis. There is associated extensive subcutaneous gas density and fat stranding in the soft tissues in the surrounding area. Additionally, the soft tissue defect along the left posterolateral pelvis appears to extend to the level of the left inferior pubic ramus and osteomyelitis cannot be excluded. No drainable fluid collection is identified.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a right lower quadrant ostomy in place. There is wall thickening of the rectum measuring 10 mm and its largest diameter. No focal fluid collection to suggest abscess formation. There is no free intraperitoneal air, portal venous gas, or pneumatosis intestinalis.Mild dilatation of the stomach and first and second portion of the duodenum is unchanged.BONES, SOFT TISSUES: Note is made of multiple soft tissue defects along the posterior wall of the pelvis. There is associated extensive subcutaneous gas density and fat stranding in the soft tissues in the surrounding area. Additionally, the soft tissue defect along the left posterolateral pelvis appears to extend to the level of the left inferior pubic ramus and osteomyelitis cannot be excluded. No drainable fluid collection is identified.There is atrophy of the left psoas muscle. In the pelvis there is extensive inflammatory change involving the left hip joint with extensive bony destruction and heterotopic bone formation along the hip joint similar to exam in 2007. The left femoral head is completely resorbed. Bony destruction is also noted of the iliac wing, the greater head of the left femur, left ischial tuberosity and left ischium. OTHER: No significant abnormality noted
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1. Findings consistent with cellulitis along the posterior pelvis in the region of multiple soft tissue defects, as described above. Additionally, there is extension of a soft tissue defect to the level of the left inferior pubic ramus and osteomyelitis cannot be excluded.2. Gallstones without evidence of acute cholecystitis.3. mildly dilated stomach and duodenum. Wall thickening of the rectum suggestive of inflammation.Minor contrast reaction as described above.
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Generate impression based on findings.
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Male, 78 years old, history of squamous cell carcinoma of the head and neck, evaluate for recurrence. Please note that image quality is degraded by dental streak artifact and motion artifact. Within these limitations, the following observation are made.Extensive treatment related change is redemonstrated in the neck including evidence of a left pectoral myocutaneous flap as well as extensive infiltration of the superficial and deep fascial planes, left side more than right.Heterogeneously enhancing tissue just below the left mastoid tip is redemonstrated appearing more ill-defined than on the prior examination. At the level of the C1 transverse process, this lesion measures 2.2 x 2.0 cm (image 18 series 80512), previously 1.8 x 1.5 cm. As on the prior examination, the superior margin of this lesion extends along the styloid process to some degree but this is very ill-defined which makes size comparison difficult. Inferiorly, the lesion continues to extend along the expected course of the thin residual sternocleidomastoid muscle.Elsewhere in the neck, no definite evidence of additional masses or pathologic adenopathy is seen. The mucosa of the oral cavity is difficult to assess secondary to streak artifact. The supraglottic larynx remains edematous and the piriform sinuses are asymmetric with effacement on the left similar to prior.The parotid glands are unremarkable. The submandibular gland is atrophic at least on the right and probably absent on the left. The thyroid is unremarkable.The left internal jugular vein is not visualized as on prior. The remaining cervical vessels are patent.Emphysema and apical scarring is demonstrated in the lungs bilaterally.No concerning osseous lesions are detected.
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Redemonstration of an enhancing lesion centered just beneath the left mastoid tip. On the prior exam, this abnormal tissue has become less defined and probably slightly larger. No new or discontiguous lesions are seen in the background of substantial treatment related change.
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Generate impression based on findings.
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Male 40 years old; Reason: re-evaluate abdominal fluid collection, evaluate for lung nodules History: inconclusive quantifuron gold, known abdominal fluid collection CHEST:LUNGS AND PLEURA: No pulmonary nodules identified.MEDIASTINUM AND HILA: No adenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive inflammatory changes are redemonstrated in the right lower quadrant involving the terminal ileum and cecum, including wall thickening and adjacent fat stranding. Inflammation is mildly improved with no measurable fluid collection and appendix appearing less involved, filling normally with enteric contrast. Associated findings of fibrofatty proliferation and adenopathy again favors Crohn's terminal ileitis over less likely cecal diverticulitis. An underlying neoplasm cannot be excluded.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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1.Extensive inflammatory changes of the terminal ileum and cecum are redemonstrated and mildly improved. No loculated fluid collection. Etiology favors Crohn's disease.2.No evidence of pulmonary TB.
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Generate impression based on findings.
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29 year-old female, preop for EVD placement. A stereotactic device is in place, which produces extensive streak artifacts and obscure visualization of the intracranial structures. A left parietal approach catheter has been stable in course and position, with mild edema along the catheter tract. A right parietal catheter tract is again seen. The lateral ventricles have mildly increased in size since prior CT 11/22/2013 but remain stable since prior MRI 11/27/2013. There is no mass effect, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable except for Burr holes. The paranasal sinuses and mastoid air cells are clear.
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The lateral ventricles have mildly increased in size since prior CT 11/22/2013 but remain stable since prior MRI 11/27/2013. No significant interval change on this preop planning exam otherwise.
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Generate impression based on findings.
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75-year-old male with history of CLL, CAD status post CABG, urosepsis, PE. Evaluate for abscess, pyelonephritis, kidney stones. ABDOMEN:LUNGS BASES: Posterior mediastinal lymphadenopathy is seen, consistent with known diagnosis of lymphoma. Small bilateral pleural effusions, left greater than right, with associated compressive atelectasis. Small pericardial effusion. Dense coronary artery calcifications. Partially imaged central venous catheter in the expected location.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Moderate splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral simple cysts and several other cystic lesions too small to characterize though likely of benign etiology.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Generalized mesenteric haziness with diffuse mesenteric conglomerate adenopathy is consistent with patient's known diagnosis of lymphoma.BONES, SOFT TISSUES: Bilateral inguinal hernias containing only mesenteric fat.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: At least 3 stones noted dependently in the bladder. A Foley catheter is present.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis in a tortuous sigmoid colon. No evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild ascites is seen in the pelvis.
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1.Three bladder stones present.2.No evidence of abscess, pyelonephritis, or nephroureterolithiasis.3.Conglomerate mesenteric adenopathy, posterior mediastinal adenopathy, and splenomegaly consistent with known lymphoma.
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Generate impression based on findings.
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Male 45 years old; Reason: rule out pancreatitis History: abd pain, vomiting, hx of pancreatitis ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Diffuse globular calcifications through an atrophic pancreas with 4 identified cystic lesions likely representing pseudocysts in the head, body, and tail are compatible with history of chronic pancreatitis. Largest pseudocyst in the body measures 3.2 by 2.3 cm (image 48, series #4). Dilated gastric venous collaterals (image 30, series #4) are suggestive of chronic splenic vein thrombosis. No evidence of hemorrhage or pseudoaneurysm formation. The bowel does not appear involved.Mild peripancreatic fat stranding and fluid around the head of the pancreas (image 52, series #4) are compatible with mild acute on chronic pancreatitis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: A nonobstructing right ureteral stone is identified just inferior to the right ureteropelvic junction measuring 7 mm (image 72, series #4). No surrounding stranding or fluid collection is identified. There are multiple tiny bilateral nonobstructing renal stones. The kidneys enhance symmetrically. Small simple cysts of the left kidney. RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Orally administered contrast passes freely throughout the bowel without evidence of obstruction or ileus.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.Findings compatible with mild acute on chronic pancreatitis with formation of several small pseudocysts.2.Findings suggestive of chronic splenic vein thrombosis.3.Nonobstructing 7-mm right ureteral stone.
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Generate impression based on findings.
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69 year-old female with flank pain on coumadin. Rule out retroperitoneal hemorrhage. ABDOMEN:LUNG BASES: There is right basilar scarring/atelectasis. Calcification in the left lower lobe suggestive of prior granulomatous disease.LIVER, BILIARY TRACT: Surgical clips in the right upper quadrant, consistent with the history of prior cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Note is made of a punctate, nonobstructing right renal calculus.RETROPERITONEUM, LYMPH NODES: There are vascular calcifications of the aorta and its branches. There is no evidence of retroperitoneal hemorrhage. IVC filter in place. Stent graft within the IVC and left common iliac. BOWEL, MESENTERY: There is extensive diverticulosis affecting the descending and sigmoid colon without evidence of diverticulitis. No dilated loops of bowel to suggest obstruction.BONES, SOFT TISSUES: There is a small fat-containing ventral hernia. There are multiple large collateral vessels noted in the soft tissues of along the anterior wall of the pelvis.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is extensive diverticulosis affecting the descending and sigmoid colon without evidence of diverticulitis. No dilated loops of bowel to suggest obstruction.BONES, SOFT TISSUES: There is a small fat-containing ventral hernia. There are multiple large collateral vessels noted in the soft tissues of along the anterior wall of the pelvis.OTHER: No significant abnormality noted
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No evidence of retroperitoneal hemorrhage, as clinically questioned.
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Generate impression based on findings.
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Male 84 years old; Reason: 83 year old man with follicular NHL s/p therapy. Compare to prior scans History: None. CHEST:LUNGS AND PLEURA: Calcified granulomata with perihilar calcified lymph nodes.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Coronary calcifications are present.Right paraesophageal mass measures 2.9 x 3.0 cm (image 75/series 3) previously, 2.7 x 1.4 cm.The mass is fluid in attenuation and insinuates from the gastrohepatic ligament via the diaphragmatic hiatus adjacent to the esophagus. Imaging features are more suggestive of a lymphatic malformation or other fluid containing lesion rather than lymphadenopathy.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Liver has a normal contour. Unchanged left hepatic cyst.SPLEEN: Spleen is normal in size. Small calcified granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Probable bilateral renal pelvis cysts.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta. Small portacaval lymph node measures 1.0 x 0.6 cm (image 99/series 3) previously, 1.4 x 0.6 cm.Left retroperitoneal mass adjacent to the left renal vein measures approximately approximately 3.1 x 1.3 cm (image 111/series 3) previously, 3.1 x 1.8 cm.BOWEL, MESENTERY: Small bowel is normal caliber. Colon is not distended. BONES, SOFT TISSUES: Fluid attenuating lesion adjacent to the lesser curve of the stomach .OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate is enlarged scattered central and peripheral calcifications.BLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No evident disease in the chest, abdomen or pelvis.2.Large cystic mass extending from the gastrohepatic ligament adjacent to the esophagus. His may represent a large lymphatic malformation. The lesion can be further evaluated with MRI of the upper abdomen/lower chest if clinically needed.
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Generate impression based on findings.
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80 year old female. History of extra nodal marginal zone lymphoma. Status post chemotherapy two years ago. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, some which are calcified, suggestive of prior granulomatous disease, unchanged.MEDIASTINUM AND HILA: Large hypodensity in the right thyroid unchanged. Note is made of a right sided laryngocele.Reference right paratracheal lymphadenopathy measures 10 mm in the short axis, previously 11 mm (seen image 21; series 3).Reference right paratracheal lymph node measures 7 mm in the short axis, previously 7 mm (35; series 3).Cardiac size is normal without pericardial effusion. Moderate coronary artery and aortic calcifications.CHEST WALL: Degenerative changes in the spine, as well as kyphosis. Wedge deformities at the level of T11 through L1 vertebral bodies, consistent with compression fractures, and similar to the prior study.ABDOMEN: 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: Reference left para-aortic lymph node measures 8 mm, previously 9 mm (3/99). Reference aortocaval lymph node measures 5 mm, previously 6 mm (3/97). BOWEL, MESENTERY: Status post appendectomy. BONES, SOFT TISSUES: Note is made of a small fat-containing ventral hernia.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted. A subcentimeter well-defined, round, fluid density lesion along the left side of the bladder is unchanged.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 significant interval change in right paratracheal and left periaortic lymph nodes, with reference measurements provided above.
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Generate impression based on findings.
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Female 60 years old; Reason: 60 year old female with DLBCL and questionable right lung mass. Compare to prior study. History: None CHEST:LUNGS AND PLEURA: Mild emphysematous changes. No dominant lung lesion. Small linear parenchymal opacity in the right middle lobe. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is enlarged. Coronary artery calcifications and stents. Main pulmonary artery measures approximately 3.5 cm in diameter.Left chest wall pacer and pacer leads terminate within the heart.Small right paratracheal lymph nodes are stable.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Hepatic contour is smooth. No suspicious hepatic lesions.SPLEEN: Spleen is normal in size.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small calcifications at the upper pole of the kidney. No hydronephrosis in either kidney. Probable renal column of Bertin in the interpolar region of the left kidney with soft tissue prominence.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Post operative changes with multiple clips adjacent to the iliac vessels. No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted.
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1.No new lymphadenopathy in the chest, abdomen or pelvis.2.Mild enlarged main pulmonary artery.3.Focal area of abnormal uptake PET/CT corresponds to a linear area of parenchymal opacity suggestive of atelectasis , focal consolidation or a sequela of prior infection.
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Generate impression based on findings.
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Male 70 years old; Reason: 69 year old man with h/o DLBCL in CR s/p chemotherapy. Compare to prior scan. History: none CHEST:LUNGS AND PLEURA: Mild upper lobe dominant paraseptal emphysema. Mild pleural parenchymal thickening in the right apex, unchanged. Calcified right upper lobe granulomata at its lateral calcified nodes. Subcentimeter pulmonary nodule along the right minor fissure presumably representing an intra-pulmonary lymph node (image 46 series 5), unchanged.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: Small biaxillary lymph nodes.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Hepatic and portal veins are patent. No biliary ductal dilatation. Small subcentimeter hypodense lesion adjacent to the right anterior portal venous branch (image 81/series 3), unchangedSPLEEN: Spleen size is mildly enlarged measuring approximately 15 cm in craniocaudal dimension with a few scattered calcified granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta. No retroperitoneal lymphadenopathy has developed.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Coarse calcifications in the prostate.BLADDER: No significant abnormality notedLYMPH NODES: No new pelvic lymphadenopathy. Left inguinal lymph node measures 1.7 x 1.1 cm (image 198/series 3) previously, 2.0 x 1.2 cm.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Compression fracture of the L4 vertebral body. Patchy sclerotic changes involving the right ilium, left iliac wing.OTHER: No significant abnormality noted
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1.Stable exam without new sites of disease.
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Generate impression based on findings.
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Female 57 years old; Reason: H/O with primary DLBCL of the bone, in need of restaging scans. Please compare to prior. History: Primary DLBCL of the bone, CHEST:LUNGS AND PLEURA: Calcified micronodules consistent with prior granulomatous disease. No suspicious nodules.MEDIASTINUM AND HILA: Calcified nodes within the mediastinum and hila consistent with prior granulomatous disease. No cardiomegaly or pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Calcified nodules within the spleen consistent with prior granulomatous disease.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple hypodensities throughout both kidneys bilaterally most likely represent benign renal cysts.RETROPERITONEUM, LYMPH NODES: Stable diffuse borderline enlarged retroperitoneal lymph nodes. The referenced portacaval lymph node measures 2.2 x 1.2 cm (series 3 image 105), previously the same. The second reference lymph node in the left para-aortic region measures 1.8 x 1.1 cm (series 3, image 106) also the same.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes of the lower lumbar spine and thoracic spine. Sclerotic changes within the left femoral head and neck from prior hardware fixation of fracture.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Multiple borderline enlarged lymph nodes throughout the pelvis. The referenced left iliac lymph node measures 0.8 x 1.3 cm (series 3, image 186) previously 0.9 x 1.3cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Stable diffuse borderline enlarged lymph nodes throughout the retroperitoneum and pelvis.
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Generate impression based on findings.
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63 year-old female with lumbar back pain with prolonged standing. There is normal lumbar lordosis. The lumbar spine alignment is anatomic. The vertebral bodies, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of spinal canal stenosis. The neural foramen are patent. The intervertebral disk spaces are preserved. The paraspinal soft tissues are unremarkable.Extensive abdominal aortic calcification. Degenerative changes are specified by the intervertebral level as follows: T12-L1: no neuroforaminal narrowing or spinal stenosis. L1-L2: minimal facet hypertrophy; no neuroforaminal narrowing or spinal stenosis. L2-L3: mild disc bulge; mild hypertrophy of facets and ligamenta flava; no neuroforaminal narrowing or spinal stenosis. L3-L4: diffuse disc bulge; minimal vacuum phenomena; mild hypertrophy of facets and ligamenta flava; no neuroforaminal narrowing; mild spinal stenosis. L4-L5: diffuse disc bulge; minimal vacuum phenomena; hypertrophy of facets and ligamenta flava; mild bilateral neuroforaminal narrowing; mild spinal stenosis. L5-S1: minimal disc bulge; mild hypertrophy of facets and ligamenta flava; no neuroforaminal narrowing or spinal stenosis. A cystic lesion is seen in the sacral canal on the right at S2-S3, which is likely a Tarlov cyst and remains unchanged since prior exam 2011. There is redemonstration of several foci of lucency in the left iliac wing, which remain unchanged since prior exam 2011.
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1. No evidence of lumbar spine fracture or subluxation, if spinal cord or ligamentous injury is suspected MRI is recommended.2. Mild degenerative disc disease of the lumbar spine as above. 3. Cystic lesion in the sacral canal on the right at S2-S3 is likely a Tarlov cyst and remains unchanged since prior exam 2011. 4. Several foci of lucency in the left iliac wing, which remain unchanged since prior exam 2011.
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Generate impression based on findings.
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Male 81 years old; Reason: metastatic Prostate cancer, evaluation of disease after 3 cycles of investigational therapy. Please complete PCWG2 History: metastatic Prostate cancer CHEST:LUNGS AND PLEURA: Reidentified right upper lobe pleural based nodularity associated with known rib metastases appears grossly stable. Bibasilar atelectasis is stable. New subtle fissural nodularity in the right lung is noted. MEDIASTINUM AND HILA: Mixed response of the previously seen mediastinal adenopathy. Interval regression of the referenced precarinal lymph node mass (image 39; series 3) measures 1.2 x 0.7 previously 1.9 x 1.3 cm. A retrosternal lymph node has increased in size, now measuring 1.8 x 2.0 cm (series 3 image 31), previously 1.4 x 1.4 cm. Coronary artery calcifications.CHEST WALL: No change in partially calcified left shoulder cystic lesion. Redemonstrated widespread sclerotic bony metastatic lesions. Enlarged right axillary lymph nodes unchanged. Left chest port.ABDOMEN:LIVER, BILIARY TRACT:Reidentified liver metastasis that appear smaller in size. Reference lesion in the dome of the right lobe measures 2.1 x 1.3 cm previously 2.3 by 1.8 cm (image 74; series 3). The previously seen second metastasis adjacent to the gallbladder fossa is smaller and not well visualized (image 85; series 3). Bilobar cysts are unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable bilateral renal cystsRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No change in widespread bony metastatic lesions.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No change in widespread sclerotic metastatic bony foci.OTHER: No significant abnormality noted
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1. Mixed response of the mediastinal adenopathy with larger retrosternal node and decrease in size of all other nodes. 2. Decreased liver metastases and other metastatic lesions (e.g., rib, and axillary adenopathy).
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Generate impression based on findings.
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Status post LVAD status post chest wound debridement evaluate for fluid collection. Heart replaced by assist device. CHEST:LUNGS AND PLEURA: Small bilateral pleural fluid collections, left greater than right with associated atelectasis. Mild pleural thickening on the left is nonspecific. Artifact from the patient's cardiac device limits assessment of the lung bases and upper abdomen.MEDIASTINUM AND HILA: Postoperative findings consistent with prior CABG and LVAD. Native coronary arteries are heavily calcified. Mild pericardial thickening anteriorly. Orphaned ICD leads.CHEST WALL: Sternal fixation hardware appears intact.The lateral margin of the disconnected/fractured ICD lead is situated along side the left pectoralis major and could potentially a PA cause of the patient's reported pain. There are no surrounding fluid collections. Punctate metallic or calcific fragment anteriorly in the left chest wall may be partially within the lateral aspect of the left pectoralis major (3/1). Metallic densities in the lateral left chest and deep breast region (3/33, 3/44) are unchanged in position and appearance and could represent metallic surgical clips; these do not appear to be intravascular however migration of the fractured wire fragments cannot be excluded.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Trace perihepatic fluid medially at the tip of the right lobe (3/138) versus volume averaging with adjacent bowelSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.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.No gross abnormalities noted.BONES, SOFT TISSUES: A very small extraperitoneal collection is noted at the inferior tip of the cardiac device (series 3 image 101, coronal series image 89), partially averaged with the diaphragm but appears unchanged in volume. The density is higher than simple fluid.No visible fluid collections surrounding subcutaneous portion of the drive line.OTHER: No significant abnormality noted.
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Small fluid collection along the inferior aspect of the cardiac assist device unchanged in volume, minimally increased in density. No evidence of fluid collection along the drive line and no visible peristernal fluid collections. The lateral tip of the left subclavian ICD wire is situated along the left pectoralis major, correlate for site of pain. In addition, there are couple of punctate metallic densities in the deep left chest wall which are unchanged in position and could represent either surgical clips or possibly minute migrated wire fragments. Although these appear to be extravascular, intravascular position cannot be entirely excluded without a contrast-enhanced examination.
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Generate impression based on findings.
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77-year-old male with abdominal aortic aneurysm and right renal mass with a history of hypertension. ABDOMEN:LUNG BASES: None is made of a small left Bochdalek hernia.LIVER, BILIARY TRACT: There is fatty infiltration of the liver. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nodular thickening of the left adrenal gland, unchanged.KIDNEYS, URETERS: The reference high density right renal mass measures 2.0 x 1 .7 cm, previously 1.7 by 1.6 cm on image number 66, series number 3. This lesion demonstrated enhancement on prior CT examinations. Small hypodense lesions are stable.RETROPERITONEUM, LYMPH NODES: Patient's known irregular infrarenal abdominal aortic aneurysm measures 4.4 x 4 .1 cm, previously 4.6 x 4.2 cm in image number 67, series number 3, not significantly changed in size compared to previous study. Focal right common iliac artery aneurysm is also unchanged measuring 2-cm on image number 87, series number 3. Vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: Borderline enlarged mesenteric lymph nodes are again noted, appearing increased when compared to prior study, with associated nonspecific haziness of the mesentery along the SMA. Retroperitoneal lymph nodes around the proximal abdominal aorta are again seen. The reference right Iliac lymph node measures 2.2 x 1 .5 cm, previously 2.0 x 0.9-cm on in image number 90, series number 3, slightly enlarged from previous study. Extensive diverticulosis affects the descending and sigmoid colon without evidence of diverticulitis. There is wall thickening of the distal sigmoid colon, appearing similar to the prior study, and correlation with recent endoscopy is recommended. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Note is made of coronary calcifications.PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: Status post cystoprostatectomy. Neobladder is intact.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Extensive diverticulosis affects the descending and sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Slight interval increase in size of a right renal mass suspicious for renal cell carcinoma.2. Slight interval increase in the reference retroperitoneal and mesenteric lymphadenopathy suspicious for recurrence in the setting of a known primary bladder carcinoma. 3. No significant interval change in infrarenal abdominal aortic aneurysm, as described above. 4. Persistent chronic appearing wall thickening of the distal sigmoid colon, correlation with recent endoscopy findings is recommended.
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Generate impression based on findings.
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Reason: metastatic breast CA to lung and liver and bone. On chemo. Followup, response to therapy. History: fatigue CHEST:LUNGS AND PLEURA: Interval moderate increase reference right upper lobe lesion (series 5/40) now 11 x 7 mm compared to 9 x 6 mm previously. Multiple additional nodules of similarly increased in size (arrows).Several new focal ground glass opacities are present which may be secondary to infection or aspiration, mainly in the lower lobes.MEDIASTINUM AND HILA: Small left thyroid cyst.Interval increase in several mediastinal lymph nodes.Reference AP window lymph node measures 11 mm in short axis compared to 9 mm previously.CHEST WALL: Skin thickening, focal fluid collection and surgical clips in the right breast, not significantly changed.Multiple lytic and sclerotic skeletal metastases, not significantly changed.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypodense lesions throughout the liver compatible with treated metastases, without significant change allowing for slight differences in contrast enhancement.Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small left renal 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.No gross abnormalities noted.BONES, SOFT TISSUES: Lytic and sclerotic metastases in the spine unchanged.OTHER: No significant abnormality noted.
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Interval moderate increase in size of pulmonary nodules and mediastinal lymphadenopathy, and new areas of ground glass opacity that may represent infection or aspiration.
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Generate impression based on findings.
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63-year-old female patient with tachycardia, tachypnea and shortness of breath. Evaluate for pulmonary embolism. PULMONARY ARTERIES: Technically adequate study. There is a nonobstructing pulmonary embolus in the left upper lobe apicoposterior segmental artery. Pulmonary artery size within normal limits.LUNGS AND PLEURA: There is elevation of the right hemidiaphragm with moderate pleural effusion and near complete compressive atelectasis of the right lower lobe.Left lower lobe subsegmental atelectasis.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. No right ventricular enlargement. Mild to moderate coronary artery calcifications. Scattered small mediastinal and hilar lymph nodes.Ectatic esophagus filled with debris.CHEST WALL: Multilevel degenerative changes of the thoracic spine. T5 vertebral body small sclerotic focus may represent a bone island.No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Moderate amount of abdominal ascites.Punctate calcifications within the liver parenchyma consistent with prior granulomatous disease.Midline abdominal wall staples.Incompletely visualized right adrenal mass is new compared to prior examination.
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Nonobstructing pulmonary embolus in the left upper lobe apicoposterior segmental artery. No evidence of infarct in this area or CT evidence of right heart strain.Moderate right pleural effusion with near complete atelectasis of the right lower lobe.Moderate abdominal ascites.Incompletely visualized new right adrenal mass is concerning for metastatic disease.Findings discussed with Dr. Brown at 10:30 AM on 12/3/2013 via telephone by Dr. McCann.
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Generate impression based on findings.
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30 year-old male with severe left sided headache and ringing in the left ear. NONCONTRAST CT HEADThe ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. Prominent adenoids. There is opacification of the left sided paranasal sinuses with fluids. There is also partial opacification of the left mastoid air cells, petrous bone and middle ear cavity. CTA HEAD There is opacification of the left sided paranasal sinuses with fluids. There is also partial opacification of the left mastoid air cells, petrous bone and middle ear cavity. The findings are suspicious for acute sinusitis, petrositis and mastoiditis. There is some fat stranding in the left carotid space and focus of air within the left carotid canal. In this background, the left internal carotid artery appears progressively narrowed starting from the distal cervical segment near the skull base, involving the lacerum, petrous and posterior genu of the cavernous segments. The most narrowed segment is seen in the carotid canal with 50-60% stenosis. There is otherwise normal contrast opacification through anterior circulation (bilateral petrous/cavernous/supraclinoid internal carotid arteries, anterior and middle cerebral arteries), posterior circulation (vertebral-basilar, posterior-inferior cerebellar, anterior-inferior cerebellar, superior cerebellar, and posterior cerebral arteries), and distal intracranial vasculature. There is normal contrast opacification through a complete circle-of-Willis with a patent anterior communicating artery and bilateral posterior communicating arteries. No evidence of aneurysm, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage.
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1. The findings described above likely represent acute sinusitis, petrositis and mastoiditis, with some fat stranding in the left carotid space and focus of air within the left carotid canal. In this background, the left internal carotid artery appears progressively narrowed starting from the distal cervical segment near the skull base, involving the lacerum, petrous and posterior genu of the cavernous segments, which could be resulted from infection. 2. No acute intracranial abnormality. 3. No evidence of aneurysm, occlusive thrombus, dissection, or vascular malformation.
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Generate impression based on findings.
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Male 51 years old; Reason: evaluate right renal mass History: hx of renal mass, liver mass and prostate cancer ABDOMEN:LUNG BASES: Basilar calcified granulomas. Mild dependent atelectasis.LIVER, BILIARY TRACT: Exophytic mass with central hypoattenuation and peripheral nodular enhancement extends inferiorly from the left hepatic lobe compatible with a hemangioma. Additional smaller lesions in the right hepatic lobe demonstrate similar imaging characteristics compatible with hemangiomas.SPLEEN: Nonspecific splenic hypodensities.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable 2.0 x 1.8 cm heterogeneously enhancing exophytic mass at the inferior pole of the right kidney demonstrates macroscopic foci of fat density compatible with angiomyolipoma. Hypodense lesion in the medial aspect of the right upper pole measures, which is too small to characterize. This lesion is unchanged since previous CT.A third hypoattenuating lesion in the midpole of the left kidney measures 1.4 x 2 cm (series 9 image 63) and measures 35 HU on precontrast, 60 HU on portal venous phase, and 70 HU on delayed phase imaging. This lesion previously measured 1 cm on the MRI of 8/29/12. RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat containing umbilical hernia.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: numerous body wall lipomas noted.
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1.Exophytic heterogeneously enhancing right inferior pole renal mass with foci of fat density typical for angiomyolipoma. 2.Too small to characterize lesion in the upper pole right kidney, however stable in size.3.2cm enhancing lesion in the midpole left kidney which has increased in size since previous MRI, worrisome for Renal cell carcinoma.4.Multiple hepatic hemangiomas.5.Body wall lipomasDr. Galocy notified of the findings at 11:57 on 12/4/13
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Generate impression based on findings.
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Mesothelioma status post decortication, presents with S.O.B. PULMONARY ARTERIES: Adequate contrast infusion. Vascular web in the left lower lobe pulmonary artery extending into the segmental and subsegmental branches. Minimal web also seen in the proximal left upper lobe artery. The appearance is suggestive of subacute to chronic thrombus. No acute-appearing filling defects are appreciated.LUNGS AND PLEURA: Pleural thickening and volume loss on the left consistent with provided history of mesothelioma and interval decortication with left diaphragmatic graft. Consolidation in the posterior basal right lower lobe is consistent with pneumonia. Pleural plaques suggestive of asbestos exposure. Mild contralateral pleural thickening. Anterior to the left diaphragmatic graft there is soft tissue which extends along the fascial planes of the abdominal wall anteriorly.MEDIASTINUM AND HILA: Pericardial thickening anterolaterally suspicious for tumor. Probable thrombus in the right atrial appendage. Mildly enlarged mediastinal and hilar lymph nodes. Left superior pulmonary vein is unopacified relative to the right and patency cannot be assessed. No pericardial fluid. Atherosclerotic calcification of the aorta and its branches.CHEST WALL: Postoperative findings with enhancing soft tissue nodules in the chest wall highly suspicious for chest wall involvement by tumor. Left axillary lymphadenopathy. Left internal mammary and left intercostal lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. Marked elevation of the left hemidiaphragm with intrathoracic position of the spleen. Hypoattenuating lesion along the caudal aspect of the spleen medially incompletely assessed, best appreciated on coronal image 30. Intraperitoneal nodule along the undersurface of the right hemidiaphragm (8/264). Retroperitoneal nodules in the right perinephric fat (8/31), consistent with tumor. Mild small retroperitoneal lymph nodes. Assessment of the upper abdomen is incomplete.
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1. Extensive subacute to chronic appearing pulmonary emboli on the left a hand probable thrombus in the right atrial appendage. No signs of right heart strain.2. Right lower lobe pneumonia.3. Postoperative findings of pleural decortication on the left with probable residual tumor in the anterior cardiophrenic angle extending along the fascial planes of the anterior abdomen. Evidence of involvement by chest wall and abdominal disease.Discrepancy between preliminary and final interpretation discussed with Thoracic Resident Aimee Kennedy (8467/2772) at the time of final interpretation.
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Generate impression based on findings.
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Reason: 49Yrs male with a h/o DLBCL s/p ASCT on 1/17/12 History: h/o DLBCL s/p ASCT on 1/17/12 CHEST:LUNGS AND PLEURA: New 10-mm part solid nodule in mid right upper lobe (series 5/32).Additional small nodules have developed adjacent to the major and minor pleural fissures on the right, and in the right middle lobe (arrow) additional very small contralateral nodules have developed.MEDIASTINUM AND HILA: Interval increase in mediastinal, hilar and internal mammary and paraspinous lymphadenopathy.Reference prevascular lymph node (series 3/30) now 15 x 35 mm, previously 16 x 26 mm.Marked interval increase in bilateral internal mammary lymph nodes (arrows).New marked lymphadenopathy in the right cardiophrenic angle area with nodes measuring up to 25 mm in short axis diameter.Catheter tip in the SVC.CHEST WALL: New and large subpectoral lymph node on the right (series 3/10).Previously described left supraclavicular lymph node measuring 8 x 6 mm, slightly increased from previous.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: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Probable interval increase in previously described peripancreatic lymph node, however not accurately measurable due to adjacent nonopacified bowel. Increased lymphadenopathy at the level of the left renal vein measuring 24 x 16 mm compared to 14 x 12 mm previously.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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Interval progression of disease in the lungs, mediastinum, chest wall and abdomen.
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Generate impression based on findings.
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Lung cancer status post chemo and RT. CHEST:LUNGS AND PLEURA: Reference right apical mass measures 3.2 x 3 cm (4/26), previously 3.4 x 3 cm. Left apical mass measures 1.7 x 3.6 cm, previously 1.8 x 4-cm (3/25) and is surrounded by consolidated lung with architectural distortion presumably secondary to prior irradiation. Emphysema. No pleural fluid. Punctate icon nodules on the right (4/45) unchanged..MEDIASTINUM AND HILA: Questionable small prevascular lymph node on the left (3/19) but now visible due to visible intervening fat plane. Thickened soft tissue in the left hilum (3/32-33), not significantly changed and could reflect treated tumor. No pericardial fluid.Small posterior mediastinal lymph nodes in the para-aortic fat measuring up to 7-mm unchanged but not normally visible. .CHEST WALL: Several very small low cervical region lymph nodes are seen on the right (3/3), of unclear clinical significance. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Peri-splenic soft tissue nodules unchanged and most consistent with splenules.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: A subcentimeter lucent lesions too small to characterize, possibly cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: A circumaortic left renal vein.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Focal dilatation of the descending duodenum incompletely assessed without oral contrast, correlate for symptoms.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: A possible nodule or small lymph node anterior to the right psoas muscle incompletely included within the scanning range (3/155).
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No significant change from prior examination with index level measurements provided in the body of the report.
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Generate impression based on findings.
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62-year-old male with a history an abdominal aortic aneurysm status post repair. ABDOMEN:LUNG BASES: Very coarse paraesophageal calcifications. Right basilar and hilar calcified lymph nodes compatible with prior granulomatous disease. Mild atherosclerotic coronary calcifications.LIVER, BILIARY TRACT: Hypervascular lesion seen in the right lobe of the liver. It measures 2.6 x 1 .9 cm, previously 2.3 x 2.0 cm and is incompletely characterized but may be benign (image 37; series 8).SPLEEN: Splenic granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Unchanged bilateral subcentimeter renal lesions, too small characterize. Left renal cyst. Exophytic small right kidney hyperdense lesion demonstrates no internal enhancement or interval growth, likely a complex benign cyst. RETROPERITONEUM, LYMPH NODES: Note is made of postoperative changes consistent with the stated history of abdominal aortic aneurysm repair. The aorta measures 4.9 cm at the level of the anastomosis, however, this is likely related to the orientation of the postsurgical ectatic abdominal aorta (81; series 8). More inferiorly, the abdominal aorta measures 3.5 cm in its greatest diameter (95; series 8). Note is made of vascular calcifications of the aorta and its branches. The renal, celiac and superior mesenteric arteries appear patent.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis. There is a small ventral hernia containing fat and a loop of small bowel without evidence of obstruction or strangulation.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: Small bilateral fat containing inguinal hernias.BONES, SOFT TISSUES: Severe degenerative disease of the visualized spine with multiple nonspecific sclerotic lesions in the pelvis and spine, unchanged. OTHER: No significant abnormality noted
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1. Postsurgical changes consistent with the stated history of surgical repair of an infrarenal abdominal aortic aneurysm, as described above. 2. Additional findings demonstrate no significant interval change.
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Generate impression based on findings.
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45 year-old male with metastatic urothelial cancer. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear except for mild maxillary and ethmoid sinus mucosal thickening. Limited view of the intracranial structure is unremarkable. There are multiple enlarged, enhancing lymph nodes in the lower posterior triangle and supraclavicular fossa on the left. Some of the nodes show necroses. One left supraclavicular node measures 16 x 14 mm (image 59 of series 6).There is a filling defect in the left internal jugular vein. The carotid arteries and jugular veins are otherwise patent. 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 osseous structures are unremarkable. Please refer to dedicated chest CT for pulmonary findings.
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1. Left sided cervical lymphadenopathy as above. 2. Left internal jugular venous thrombus.
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Generate impression based on findings.
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Lung cancer, had chemotherapy. CHEST:LUNGS AND PLEURA: Right upper lobe scar at site of prior neoplasm decreased in size measuring 2.8 x 1.7 cm (6/44), previously 2.9 x 1.7 cm.The right upper lobe nodule abutting the fissure has increased in size and is now solid. This measures 2.4-cm in long axis (sagittal image 24) compared to 1.8-cm previously (prior sagittal image 25).Right lower lobe ground glass nodule (6/55) not appreciably changed and may represent an indolent primary neoplasm such as an adenocarcinoma.Enlarged lymph node in the right lower lobe measures 8 x 9 mm, previously 10 x 8mm probably similar allowing for differences in scan variability.Right lower lobe nodule measures 6-mm, unchanged (6/75). A poorly seen irregular nodule in the right costophrenic angle medially (6/91) is now visible, suspicious for a metastasis.Minimal pleural thickening on the left but no pleural fluid.MEDIASTINUM AND HILA: Ectatic appearance of the thoracic aorta. Large circumferential pericardial fluid collection, about the same.Right hilar lymphadenopathy is difficult to identify or differentiate from vascular structures even in retrospect. Right hilar lymphadenopathy is approximately 3-cm in AP dimension (4/51) and has not significantly changed from 2.7-cm when remeasured. There is adjacent atelectasis anterior to the lymph node which is not included in the measurement. CHEST WALL: Scoliosis and degenerative change.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Confluent area of hypoattenuation in the right hepatic lobe inseparable from adjacent vasculature of unclear etiology and could represent intrahepatic biliary ductal dilatation; a mass lesion cannot be ruled out.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: Atherosclerotic calcification of the 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 change.OTHER: No significant abnormality noted.
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Right lung nodules consistent with multifocal neoplasm. The right upper lobe nodule inseparable from the major fissure has now increased significantly in volume, now solid. Newly visible irregular nodule in the right lower lobe, unable to exclude metastasis. Right hilar lymphadenopathy not significantly changed. Nonspecific hypoattenuation in the right hepatic lobe incompletely assessed and could represent intrahepatic biliary ductal dilatation however a mass lesion cannot be ruled out and correlation with ultrasound is suggested.
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