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Generate impression based on findings.
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Male 71 years old Reason: h/o HNC, new baseline scans pre-op, compare to outside, measurements pls CHEST:LUNGS AND PLEURA: Subcentimeter micronodules in the left lung base (image 79/series 5). The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. There is no pericardial effusion. Extensive coronary artery calcifications.Cardiophrenic lymph node measures 1.1 x 1.1 cm (image 68/series 4). CHEST WALL: Bilateral gynecomastia.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Liver has a cirrhotic morphology. Suboptimal evaluation for focal hepatic lesions given the single phase of contrast. The right hepatic lobe shows architectural distortion and areas of focal capsular bulging. The main portal vein is patent.There is perihepatic ascites.SPLEEN: Spleen is normal in size. Extensive peri-splenic and perigastric varices.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple appearing cyst near the lower pole of the left kidney. No hydronephrosis in either kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Borderline enlarged pericardiophrenic lymph node.; No suspicious pulmonary lesions. Small nonspecific left lower lobe micronodules.2.Cirrhotic liver, triphasic CT or preferably MRI is suggested for further characterization of the right hepatic lobe contour deforming lesions.
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Generate impression based on findings.
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Female 30 years old; Reason: rule out appendicitis History: abdominal pain worst in RLQ ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The kidneys enhance symmetrically. No nephrolithiasis identified, though contrast CT is limited in evaluation of small renal calculi. No hydronephrosis or perinephric stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Orally administered contrast passes freely throughout the bowel without evidence of obstruction or ileus. The appendix is not directly visualized though no periappendiceal fat stranding or fluid is seen.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 CT evidence to explain patient's right lower quadrant pain.
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Generate impression based on findings.
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Female 55 years old Reason: breast cancer, lung nodule - please assess and compare previous imaging History: Solitary 3-mm pulmonary nodule in the left lower lobe as seen on previous CT scan LUNGS AND PLEURA: Linear subpleural reticular opacities in the anterior subsegment of the left upper lobe likely due to radiation.Left lower lobe subcentimeter pulmonary nodule measures 3 mm (image 51/series 5), unchanged. The pleural space are clear. No new pulmonary nodules.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy has developed.CHEST WALL: Small left axillary lymph nodes. Post operative changes with bilateral breast prosthesis and left mastectomy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No change in the 3-mm left lower pulmonary nodule. No new evident sites of disease.
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Generate impression based on findings.
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73-year-old male patient. Reason: pleural mesothelioma, please evaluate for disease and compare with previous scans History: pleural mesothelioma CHEST:LUNGS AND PLEURA: Lobulated right sided enhancing pleural thickening consistent with patient's known mesothelioma associated with compression of the right lung predominately at the lung base.Representative measurements are as follows:1.At the level of aortic arch, 4 o'clock position measures 1.4 cm, unchanged; 9 o'clock position has been re-measured, currently measuring 1.6 cm, unchanged (series 3 image 27).2.At the level of the descending aorta, 2 o'clock position measures 1.6 cm, unchanged (series 3 image 41).3.At the right lung base, 6 o'clock position measures 9 mm, unchanged(series 3 image 71).Cluster of nodules along the minor fissure likely represent intrapulmonary lymph nodes and are stable compared to prior examination. Scattered left lung calcified micronodules. Interval removal of right lower lobe pleural catheter without significant interval change in right pleural effusion.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Severe coronary artery calcifications.Mild atherosclerotic changes of the thoracic aorta.Scattered small mediastinal lymph nodes are not significantly changed.CHEST WALL: Multilevel degenerative changes in the thoracic and lumbar spine.No axillary lymphadenopathy.No evidence of penetration of tumor through the chest wall.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Mildly nodular right adrenal gland is unchanged.KIDNEYS, URETERS: Multiple bilateral renal cysts and punctate nonobstructing renal calculi are again noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic changes in the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Multilevel degenerative changes in the lumbar spine.OTHER: No significant abnormality noted.
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Stable appearing right-sided mesothelioma; measurements provided.
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Generate impression based on findings.
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85 year-old female with syncope. There is patchy hypoattenuation in the cerebral white matter. 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. Intracranial arterial calcifications. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality. Small vessel ischemic disease of indeterminate age. 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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Male 63 years old Reason: Egus ca in f/u please compare to previous. CHEST:LUNGS AND PLEURA: Linear areas of atelectasis adjacent to the right minor fissure and in the lingular sub segments. No dominant lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.Postoperative changes from esophagectomy and gastric pull-through. At its proximal anastomosis, no evident leak or focal mass allowing for technique.CHEST WALL: Right chest wall port terminates at the cavoatrial junction.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple well marginated hypodense hepatic lesions representing small cysts or small biliary hamartomas. Some of these smaller hypodense lesions are too small to fully characterize on a single phase CT.Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Progressive increase in the soft tissue at the level of the gastrohepatic ligament. This is adjacent to the suture margin in the upper abdomen. The soft tissue partially encases the celiac artery. It measures at least 3.0 x 2.7 cm (image 101/series 3) previously (remeasured), 2.2 x 2.4 cm.BOWEL, MESENTERY: Postoperative changes of esophagectomy and gastric pull-through. Progressive increase in the soft tissue at the level of the gastrohepatic ligament.BONES, SOFT TISSUES: Well healed midline abdominal scar.OTHER: No significant abnormality noted.
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Progressive increase in the soft tissue at the level of the gastrohepatic ligament. Measurements provided above.
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Generate impression based on findings.
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58 year-old male with history of head and neck cancer. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure shows cerebellar volume loss. There are extensive postsurgical changes status post glossectomy with myocutaneous flap reconstruction. No evidence of recurrent mass is seen.No pathologic lymphadenopathy is appreciated based on the imaging criteria for lymphadenopathy. The airways are patent. Diffuse mucosal thickening in pharyngeal space appears unchanged and is likely related to post-therapy changes.Atherosclerotic disease of the carotid bifurcation with proximal ICA stenoses, right greater than left. Patent bilateral jugular veins are seen.There are degenerative changes of cervical spine.
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Stable posttreatment changes in the neck soft tissue with no evidence of recurrent mass or pathologic lymphadenopathy.
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Generate impression based on findings.
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79 year old female with a history of splenic artery aneurysm. CHEST:LUNGS AND PLEURA: There are scattered pulmonary micronodules.MEDIASTINUM AND HILA: Notice made of vascular calcifications of the aorta and its branches. No pericardial effusion is evident. There are mild coronary artery calcifications. CHEST WALL: Status post right axillary lymph node dissection.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: Notice made of a 15-mm saccular aneurysm of the proximal splenic artery with associated peripheral calcification. There is no evidence of active hemorrhage or contrast extravasation.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Note is made of a subcapsular fluid collection in about the left kidney and clinical correlation for a history of prior trauma or biopsy is recommended. Note is made of a punctate, nonobstructing renal calculus in the superior pole of the left kidney. There is no evidence of hydroureter or hydronephrosis. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis effects the descending and sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis effects the descending and sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. 15-mm splenic artery aneurysm, as described above.2. Subcapsular fluid collection about the left kidney. Clinical correlation for a history of trauma or recent biopsy is recommended.
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Generate impression based on findings.
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78 year-old female status post fall. There is redemonstration of hypodensity and volume loss of the right parietal lobe. Encephalomalacia is present in the left cerebellar hemisphere, with cerebellar volume loss. Periventricular and subcortical white matter hypodensities of a moderate degree are present.There is redemonstration of a bulbous appearance at the expected location of the basilar tip which is unchanged compared to prior exams. Atherosclerotic calcifications are present along the distal internal carotid and vertebral arteries. The ventricles and cisterns are symmetric and unremarkable. 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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1. No evidence for acute intracranial hemorrhage, mass effect or edema. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Stable appearance of right parietal and left cerebellar encephalomalacia and small vessel ischemic disease. 3. Stable appearance of basilar tip aneurysm.
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Generate impression based on findings.
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Female 76 years old; Reason: s/p ostomy takedown. PO contrast only. History: as above ABDOMEN:LUNGS BASES: Bilateral pleural effusions, right greater than left. Compressive atelectasis noted in both lung bases.Moderate to severe atherosclerotic disease of the aorta and coronary vessels.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Patient status post right lower quadrant ostomy takedown with contrast freely flowing from the stomach to the sigmoid colon. There is no evidence of contrast extravasation, or free air. Small bowel and colonic wall thickening and edema are noted in the right lower quadrant, nonspecific.Extensive mesenteric haziness is noted in the right lower quadrant, likely postoperative. No evidence of obstruction is seen. Surgical staples are noted in the right lower quadrant. Extensive gas in the anterior abdominal soft tissues is noted likely postoperative change from prior wound debridement. Foci of intraperitoneal gas is of dubious clinical concern.Surgical drain is noted entering the right lower quadrant extending up to subhepatic recess. Extensive diverticula are seen in the colon without evidence of diverticulitis.G-tube in place.BONES, SOFT TISSUES: Marked degenerative disease of the spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Foley Catheter noted in the bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Status post right lower quadrant ostomy takedown with freely flowing contrast from stomach to sigmoid colon without evidence of contrast extravasation, free air, or obstruction.2.Non specific bowel wall thickening in the right lower quadrant.3.Extensive fluid and gas collection in the anterior abdominal wall, likely postoperative from prior wound debridement. Foci of intraperitoneal gas is of dubious clinical concern.4.Bilateral pleural effusions, right greater than left.
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Generate impression based on findings.
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Male 58 years old Reason: h/o HNC, CRT, compare to previous, measurements pls History: none LUNGS AND PLEURA: The centrilobular pulmonary nodules have resolved. Residual pulmonary micro- nodules at the left lung base. No new dominant lung lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Percutaneous gastrostomy catheter terminates within the stomach.
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Stable exam without definite new sites of disease.
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Generate impression based on findings.
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Mesothelioma on observation. CHEST:LUNGS AND PLEURA: Small chronic subpulmonic pneumothorax on the right with adjacent atelectasis and pleural thickening. Pneumothorax measures 9 mm, previously 6-mm. Pleural calcification suggestive of prior asbestos exposure. Right hemithorax volume loss consistent with history of mesothelioma. Reference measurements on the right as follows:Level of the aortic arch (3/30) 2-mm at the 3 o'clock position, unchanged from measurement of 3-mm previously.Level of the main pulmonary artery 1 mm at the 4 clock position, unchanged (3/43).Level of the suprahepatic IVC (3/59) 4 mm, unchanged.Subtle non-index area of mediastinal pleural thickening anterior to the right atrial appendage (3/46) appears slightly more prominent as does a small nodule at the 12 o'clock position (3/39). New nonindex pleural lesion along the mediastinal pleural surface at the 3 o'clock position (3/25). These areas are now suspicious for early tumor recurrenceMEDIASTINUM AND HILA: No pericardial fluid. Mild cardiomegaly. Chest port tip in the distal right atrium. Small mediastinal lymph nodes not significantly changed with index right paratracheal lesion unchanged at 8-mm (3/32). Stable appearance of small cardiophrenic lymph nodes.CHEST WALL: Right internal mammary dissection clips. Focal thickening in the right paravertebral fat of the lower thorax extends to the vertebral body focally and it could be inflammatory however tumor cannot be excluded.Subtle thickening and nodularity along the right chest wall scar should be monitored, inconclusive. A tiny intercostal lymph node on the right between the ninth and tenth ribs is better seen on today's study.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: Left adrenal gland nodule unchanged, likely an adenoma.KIDNEYS, URETERS: Probable right renal cyst.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.Subtle fat stranding in the mesentery with a small lymph nodes measuring up to 9-mm unchanged in size and number.BONES, SOFT TISSUES: Degenerative change of the spine. Nonspecific mixed lucent and sclerotic appearance of the right ilium. The medial left ilium the appearance is suggestive of the same process. This is unchanged dating back to 9/28/12. It is atypical in appearance for osteoarthritic change as the joint space is not appear to be involved and inflammatory arthritis can be considered in the appropriate clinical context.OTHER: No significant abnormality noted.
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Right hemithorax index measurements unchanged however there are very subtle areas of pleural thickening which are suspicious for early recurrent tumor on the right. Chronic right pneumothorax not significantly changed, site of bronchopleural fistula is not identified. Correlate for inflammatory arthritis given atypical appearance of pelvic sclerosis.
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Generate impression based on findings.
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Male 51 years old; Reason: evaluate hepatic vasculature and echotexture, please provide lesion sizes, hx of TACE/RFA, f/u previous abnormal chest CT CIRRHOSIS PROTOCAL History: pre liver transplant evalution, HCV cvirrhosis, HCC, hx TACE \T\ RFA, hx hydrothorax LUNGS AND PLEURA: Wedge-shaped consolidation with air bronchograms in the right lung base is noted. Small right pleural effusion remains. No nodule or mass detected.MEDIASTINUM AND HILA: Status post CABG. Dense coronary calcification. Multiple small mediastinal nodes are present. Cardiomegaly.CHEST WALL: Mild degenerative change. Status post sternotomy.LIVER, BILIARY TRACT: Cirrhotic morphology of the liver is seen with the TIPS unchanged. A segment 8 lesion is again seen residual high density chemoembolization material throughout. There is no arterial enhancement seen in the portions of the lesion does not contain chemoembolization material. Stable size of the lesion currently measuring 3.0 x 3.1 cm (series 3, image 24) previously measuring 3.1 x 3.2cm. There are no additional areas of increased enhancement to suggest tumor lesions. Status-post cholecystectomy. Redemonstration of a dilated common duct and which is likely normal in the post cholecystectomy state.Portal veins, hepatic veins, and TIPS appear patent.SPLEEN: Splenomegaly without focal lesion.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Fat-containing lesion in the right kidney consistent with angiomyolipoma demonstrates minimal compared to prior exam. Punctate calcifications within the kidneys bilaterally are likely nonobstructing renal calculi. Renal cyst in the left kidney. A few small presumable simple cysts in the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large ventral hernia containing nonobstructed large and small bowel is again seen. Mild ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Cirrhotic liver with patent TIPS.2.Interval stable size of Segment 8 liver lesion retaining chemoembolization material is without evident vascular enhancement.3.No evidence of additional liver lesions.4.Redemonstration of portal hypertension with splenomegaly and portosystemic collaterals with mild ascites.5.Redemonstration of large ventral hernia, unchanged compared to prior exam.6.Resolution of the hydro-pneumothorax of the right lung.
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Generate impression based on findings.
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Male 73 years old Reason: h/o HNC, CRT, compare to previous, measurements pls History: none LUNGS AND PLEURA: Biapical pleural scarring, unchanged. Few scattered micronodules. No dominant lung lesion. Pleural spaces are otherwise clear.MEDIASTINUM AND HILA: Heart size is normal. Coronary calcifications in a triple vessel distribution.CHEST WALL: Degenerative changes affect the thoracic spine. With coarsening of the trabecula, unchanged. Probable left third rib fracture with healing. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Stable exam without evident metastatic disease.
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Generate impression based on findings.
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Female 50 years old Reason: sq cell skin Ca of RUE s/p RT and amputation History: 2 years post Rx. no new symptoms CHEST:LUNGS AND PLEURA: Calcified granulomata in the apical segment of the right lower lobe. Mild peri-fissural atelectasis. Scattered ground glass opacities in the right upper lobe are new. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Coronary calcifications in a triple vessel distribution. Calcified right hilar lymph nodes.Right subclavian stent.Heterogeneous attenuating thyroid parenchyma with a left thyroid nodule with internal calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Severe intrahepatic and extrahepatic ductal dilatation. The common bile duct is dilated up to the level of the ampulla.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: End stage atrophic native kidneys.PANCREAS: Severe atrophy of the pancreas with severe pancreatic ductal dilatation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evident metastatic disease.2.Nonspecific small ground-glass opacities in the right upper lobe. May represent infectious or inflammatory changes.3.Severe biliary ductal dilatation and severe pancreatic ductal dilatation with severe pancreatic parenchymal atrophy. Differential considerations include a obstructing lesion at the level of the ampulla or a choledochal cyst. Consider follow up MRI/ M.R.C.P. for further evaluation.
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Generate impression based on findings.
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Dyspnea. Check for pneumothorax. History of right pneumothorax LUNGS AND PLEURA: Persistent small apical right pneumothorax with a chest tube projected towards the apex. Extensive underlying diffuse paraseptal and centrilobular emphysematous changes in all 4 quadrants and greater in the upper lungs. No superimposed focal air space abnormality, specifically no nodules or masses. No significant effusions.MEDIASTINUM AND HILA: No lymphadenopathyThe cardiac and paracardial marsh significant for minimal pericardial thickening and/or small fluid collectionMild hiatal herniaCHEST WALL: Moderate chest wall emphysema. Mild scattered degenerative changesUPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Small to moderate residual right pneumothorax and chest tube with extensive underlying emphysematous changes
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Generate impression based on findings.
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Female 54 years old Reason: h/o recurrent HNC, s/p induction chemo, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Small calcified granuloma in the right base. No new pulmonary lesions. The pleural spaces are clear. Subcentimeter micronodule adjacent near the left major fissure best seen on image 56 / series 5 is unchanged.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Segment 6 peripherally nodular enhancing lesion (image 94/series 3) is unchanged and has imaging features suggestive of a hemangioma.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small renal cysts. Small calcification in the interpolar region and the left kidney may represent a small vascular calcification or nonobstructive calculus.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Perched has gastrostomy catheter terminates within the stomach lumen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evident metastatic disease.2.Probable segment 6 hemangioma
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Generate impression based on findings.
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Cough. Mesothelioma post pleurectomy/decortication and adjuvant chemotherapy. CHEST:LUNGS AND PLEURA: Mild nonspecific thickening of the fissures bilaterally and basilar subpleural reticulation, left greater than right. Small fluid collection near the right costophrenic angle but no discrete areas of residual pleural thickening. Minimal anterior pleural thickening at the 12 o'clock position near the left ventricular outflow tract level appears improved, likely the result of superimposed resorbed pleural fluid, 6-mm compared to 8mm previously (3/61).Minimal focal pleural soft tissue thickening in the deep left costophrenic angle anterolaterally (3/94), unclear if this was present previously due to surrounding inflammatory change on earlier study.MEDIASTINUM AND HILA: Coronary arteries are heavily calcified. No pericardial fluid. Mild right hilar lymphadenopathy 13-mm (3/43) decreased from 17-mm previously. Small left interlobar lymph node unchanged. Low right paratracheal lymph node 12 mm, previously 13-mm (3/31). Small right high paratracheal lymph node may be less prominent.CHEST WALL: Asymmetry in the density of the paraspinal musculature on the right is unchanged.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: Atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Right diaphragmatic graft.OTHER: No significant abnormality noted.
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Stable to improved findings with decrease in lymphadenopathy.
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Generate impression based on findings.
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neuroblastoma and new bone pain, elevated urine catecholamines CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are present bilaterally and not significantly changed. No pleural effusions.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Interval appearance of moderate superior mediastinal, prevascular, subcarinal, and retrocrural lymphadenopathy.CHEST WALL: There are multiple new soft tissue masses at left paraspinal region from T5 through T10 with extension of the lesions along the posteromedial left pleural surface. Elongated soft tissue mass in the left paraspinal region lateral to the thoracic aorta has significantly increased in size. For reference, it measures 2.5-cm in transverse dimension on image 56, series 3, previously 0.7-cm. Multilevel mixed sclerotic and lytic lesions of the thoracic spine are compatible with metastases and not significantly change since prior study. No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. No intra-or extrahepatic biliary ductal dilation. Normal gallbladder.SPLEEN: No focal splenic lesions.PANCREAS: No focal pancreatic lesions. No pancreatic ductal dilation.ADRENAL GLANDS: Normal right adrenal gland. Ill-defined soft tissue adjacent to the left adrenal gland is not significantly changed.KIDNEYS, URETERS: No focal renal lesions. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Retroperitoneal surgical clips. Mild soft tissue density in the right para-region extending to the GE junction is similar similar prior study.BOWEL, MESENTERY: No evidence of bowel obstruction.BONES, SOFT TISSUES: Multilevel mixed sclerotic and lytic lesions of the lumbar spine are not significantly changed.OTHER: No ascites.PELVIS:UTERUS, ADNEXA: Small ovarian cysts bilaterally, likely physiologic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction.BONES, SOFT TISSUES: Mixed sclerotic and lytic lesions of the bilateral ilium and sacrum are not significant changed.OTHER: No ascites.
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1. Stable scattered pulmonary micronodules.2. Interval appearance of moderate superior mediastinal, prevascular, subcarinal, and retrocrural lymphadenopathy. Interval appearance of multiple soft tissue masses arising from the left paraspinal thoracic region extending along the left posteromedial pleural surface.
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Generate impression based on findings.
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Mesothelioma, follow-up CHEST:LUNGS AND PLEURA: Interval removal of the left chest tube. Patient is status post pleurectomy and decortication with associated volume loss on the left and placement of a diaphragmatic mesh. Interval resolution of the moderate right pleural effusion. Again no distinct measurable residual tumor or interval change, however there is mild soft tissue thickening along the aortic margin and a residual punctate 4-mm soft tissue density posteriorly at the level of left atrium (image 63 series 3) representing a possible small lymph node.Mild centrilobular emphysematous changesMEDIASTINUM AND HILA: No lymphadenopathyMarked cardiac coronary calcifications. The cardiac and pericardium otherwise remains unremarkableCHEST WALL: Posterior lateral rib deformities on the left.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypodense hepatic lesions unchanged and compatible with cysts. The previous hyperdense lesion thought to represent a hemangioma is not currently appreciated.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atopic pelvic right kidney unchangedPANCREAS: 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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Left pleurectomy without interval change
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Generate impression based on findings.
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Female 50 years old; Reason: pancreatic cancer with rising LFT's. Please compare to last CT \T\ measure 1) left paratracheal lymph node, 2) left hepatic lobe lesion, 3) pancreatic head mass. Also evaluate right hepatic lobe mets History: post cycle and rising LFT's CHEST: LUNGS AND PLEURA: Scattered pulmonary micronodules. No dominant lesion. No pleural effusions. Bibasilar atelectasis.MEDIASTINUM AND HILA: Left paratracheal lymph node measures 2.1 x 0 .centimeters and the previously 1.9 x 1.1 cm (series 11, image 15). No additional lymphadenopathy. Filling defect in the distal SVC, unchanged.CHEST WALL: Interval placement of a left-sided Port-A-Cath extending into the azygous vein. ABDOMEN:LIVER, BILIARY TRACT: Reference left hepatic lobe heterogeneous lesion measures 7.2 x 7.3 cm (series 11, image 82), previously 5.9 x 3.9 cm . Increasing non referenced right hepatic lobe hypoattenuating lesions.Trace perihepatic ascites.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic head mass measures 3.2 x 2 .5 cm, previously 3.5 x 1.8 cm (series 11, image 102).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Thickening of the gastric fundus and duodenum, unchanged.BONES, SOFT TISSUES: Right anterior abdominal wall soft tissue nodules are new from the prior exam. 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. Increasing hepatic metastases.2. Stable right anterior abdominal wall soft tissue nodules are nonspecific, but may represent metastatic foci.3. Stable left paratracheal lymph node.4. Pancreatic mass, stable in size. 5. Persistent SVC thrombus with interval placement of a left port-a-cath in the azygous vein.
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Generate impression based on findings.
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Male 73 years old Reason: recurrent invasive base of tongue SCC.T3N2b;Underwent sx partial tongue resection Jan 2012 History: as above CHEST:LUNGS AND PLEURA: Calcified granulomata in the left lower lobe. Bilateral scattered areas of linear parenchymal scarring at the apices and subpleural regions anteriorly. No suspicious pulmonary lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy. Status post distal esophagectomy. Large hiatal hernia contained within the chest on the left.Irregularity of the right tracheal wall at the thoracic inlet with focal calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Spleen is normal in size.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcific arterial sclerotic disease affects the aorta.BOWEL, MESENTERY: Scattered colonic diverticula. Percutaneous gastrostomy catheter terminates within the stomach. Large hiatal hernia with an partially intrathoracic stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evident metastatic disease.
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Generate impression based on findings.
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Reason: 39yF with history of perirectal abscess s/p I\T\D of abscess and placement of Pezzar drain on 8/12/13 with drain still in place. Please evaulate for undrained fluid collections prior to drain removal. History: recurrent perirectal abscesses with pezzar drain PELVIS:UTERUS, ADNEXA: Mild heterogeneous enhancement of the lower uterine endometrium.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval removal of the right buttock drain. No definite residual fluid collection although the tract persists. The tract abuts the external sphincter on the right. OTHER: No significant abnormality noted.
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1.Resolution of the right buttock abscess with a well formed tract.2.A fistulous connection with the anus is possible given that the tract abuts the external sphincter. A pelvic MRI (peri-anal fistula protocol) is recommended when able.
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Generate impression based on findings.
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Cardiac arrest. Check for acute pulmonary process Motion degrades sensitivityLUNGS AND PLEURA: The endotracheal tube appears grossly unchanged. The nasogastric or Dobbhoff tube has been removed.Patchy streaky densities at both bases and somewhat dependent position with small effusions are again observed and mildly less pronounced. Probable aspiration with mild bronchial mucous plugging. A particular note is a small nodular 1 cm opacity along the periphery of the left lung and major fissure (image 25 series 6). This is not clearly atelectasis and previously identified in August 2013.MEDIASTINUM AND HILA: No lymphadenopathyThe cardiac and pericardium are grossly within limitsCHEST WALL: Multiple rib deformities and scattered healing rib fractures with lytic myelomatous diffuse lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Multiple myeloma with pulmonary changes suggesting aspiration and atelectasis. There is a small nonspecific nodular opacity in the mid left lung new since August and likely postinflammatory.
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Generate impression based on findings.
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Male 75 years old Reason: esoph ca, s/p chemo and RT and esophagectomy. Pls c/w previous study and evaluate dz status. History: esoph ca CHEST:LUNGS AND PLEURA: Left lower pulmonary micronodule (image 61/series 5) is unchanged.The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal without a pericardial effusion. No mediastinal lymphadenopathy. Status post esophagectomy and gastric pull-through. The esophagus stomach anastomosis at the left thoracic inlet is unremarkable.CHEST WALL: Right distal port terminates at the cavoatrial junction.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: Calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Status post esophagectomy and gastric pull-through. Multiple clips are noted in the expected location of the stomach. No focal mass evident.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable exam without evident metastatic disease.
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Generate impression based on findings.
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Myasthenia gravis with exacerbation, shortness of breath. Evaluate for mediastinal mass seen on outside hospital imaging. S.O.B. and weakness. LUNGS AND PLEURA: Tracheostomy tube tip above the carina. Calcified micronodules statistically most likely represent granulomas. Mild paraseptal and moderate centrilobular emphysema. Subsegmental atelectasis at the lung bases, right greater than left. No pleural fluid or pneumothorax. No pleural metastases are appreciated.MEDIASTINUM AND HILA: Heterogeneous right paracardiac soft tissue mass hyperattenuating to muscle density extends from the level of the main pulmonary artery to the level of the right inferior pulmonary vein ostium. At the level of the tip of the right atrial appendage the mass measures 4.4 x 2.2 cm (3/47). The full AP dimension of the mass is difficult to assess as it follows the curvature of the cardiac silhouette, almost 6-cm (sagittal image 39). Craniocaudal length is approximately 5.7-cm.Several sub-5 mm nodules are noted along the pericardium anteriorly (series 3, images 33, 34, 36, 44). There is a small left cardiophrenic lymph node which is isoattenuating to the mass (3/50). Other small lymph nodes in the mediastinum are not enlarged however some very small 2-3 mm lesions do appear to be isoattenuating to the mass making it difficult to exclude nodal metastases.CHEST WALL: No significant internal mammary or axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range is unremarkable.
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Right lateral paracardiac mass abutting the right atrium is radiographically consistent with thymic tumor such as thymoma. CT is insensitive for the detection of invasion. Differential considerations include thymic carcinoma given internal heterogeneity. Tiny pericardial nodules and a small left cardiophrenic lymph node; metastases cannot be excluded. Small but isoattenuating mediastinal lymph nodes should be monitored on subsequent exams for change.
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Generate impression based on findings.
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Male 43 years old; Reason: does he have calcification of his iliacs that would prevent a kidney transplant History: no palpable pulses in his feet and an ulcer on his toe. ABDOMEN:LUNGS BASES: Cardiac pacer leads. Metallic fragment in the right lower lung pleural space.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 hydronephrosis or nephrolithiasis in either kidney. No evident contour deforming mass.RETROPERITONEUM, LYMPH NODES: Mild calcific arteriosclerotic disease affects the aorta. Abdominal aorta is normal in caliber. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild calcific arteriosclerotic disease affects the common, internal and external iliac arteries.
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1.Mild calcific arteriosclerotic disease of the abdominal aorta and branch vessels. The lack of intravenous contrast limits evaluation for soft plaque which may cause obstruction of the vessels.
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Generate impression based on findings.
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Female 48 years old Reason: H/O Hodgkin Lymphoma s/p 6 cycles of ABVD chemotherapy in need of post treatment scans. Please compare to prior. History: Hodgkin Lymphoma CHEST:LUNGS AND PLEURA: Left upper lobe nodule measures 7 mm on image 35/series 4 previously, 9 mm.Other small pulmonary nodules remain. New areas of ground-glass opacities in the left upper lobe.Trace left pleural effusion.MEDIASTINUM AND HILA: Heart size is normal. Pericardial effusion has resolved. Anterior mediastinal nodal mass measures 5.1 x 3.9 cm (image 26/series 3) previously, 7.1 x 5.7 cm.AP window lymph node measures 11 mm on image 38 measures 3 previously, 16 mm.CHEST WALL: Right chest wall port terminates at the cavoatrial junction.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Well marginated fluid attenuating lesions most likely represent small cysts. Liver has a smooth contour.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 retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Decrease in the mediastinal lymphadenopathy.2.Stable size of the reference left upper lobe pulmonary nodule.3.Small new left upper lobe ground glass pulmonary opacities.
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Generate impression based on findings.
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Lung nodule follow-up LUNGS AND PLEURA: Multiple mixed semisolid ground glass nodular densities throughout both lungs are all unchanged. Reference measurements are as follows:1. Right upper lobe (image 26 series 5), unchanged measuring 1.8 x 1.0 cm2. Posterior left upper lobe (image 15 series 5), unchanged measuring 1.0 x 0.9 cm3. Left lower lobe posterior peripheral nodule (image 71 series 5), unchanged at 7 mm4. the 7 x 7 mm nodule in the right lower lobe unchanged (image 63 series 5)5. Cystic irregular thickening the superior segment of the right lower lobe (image 45 series 5) unchanged measuring 1.0 x 10.9 cm.Moderate extensive emphysematous changes. No new or suspicious pulmonary nodules or effusions.MEDIASTINUM AND HILA: No lymphadenopathyLeft thyroid nodule unchanged.Marked atherosclerotic and coronary calcifications. CABG surgical changesCHEST WALL: Status post sternotomy and moderate degenerative changes of the mid to lower thoracic spine are unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Stable multifocal and predominantly ground glass pulmonary nodules. Reference measurements are provided and annual evaluation is now recommended
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Generate impression based on findings.
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Female 80 years old; Reason: Evaluate adrenal adenoma History: Evaluate adrenal adenoma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: The previously seen left adrenal nodule measuring 2.2 x 1.9 cm is stable in size ( image number 42, series number 5). This lesion measures 12 Hounsfield units on precontrast, 114 Hounsfield units on postcontrast, and 34 Hounsfield units on delayed phase imaging for a total of 72% absolute washout most compatible with an adrenal adenoma.KIDNEYS, URETERS: Benign-appearing lower pole left renal cyst with punctate calcifications in its wall. These calcifications may represent small stones in the lower pole of the left kidney. Few other too small to characterize lesions in the kidneys bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Fat-containing helical hernia.OTHER: No significant abnormality noted
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1. Left adrenal lesion most compatible with an adrenal adenoma.
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Generate impression based on findings.
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66-year-old male patient. Reason: r/o infectious process, assess pneumonia History: RML pneumonia, immunosuppressed, shock Exam mildly limited by patient motion.LUNGS AND PLEURA: Diffuse mild septal thickening. Mild bronchial wall thickening with areas of endobronchial impaction and debris.Faint centrilobular nodular and groundglass opacities in the right lung suspicious for opportunistic infection. Airspace opacity in the caudal aspect of the right upper lobe abutting the minor fissure (5/137) consistent with postobstructive atelectasis and/or infection. Irregular consolidation in the right lung base similar to in appearance to abnormality in the right upper lobe.Small right pleural effusion with associated rounded atelectasis. Right middle lobe linear atelectasis.Mild interval decrease in size of small left pleural effusion with associated subsegmental atelectasis.MEDIASTINUM AND HILA: Left-sided central venous catheter with tip at the cavoatrial junction. Heart size within normal limits without pericardial effusion. Mitral annulus and aortic valve calcifications. Severe coronary artery calcifications. Mild atherosclerotic changes of the thoracic aorta.Mild interval decrease in right paratracheal and AP window region prominent lymph nodes.Moderately ectatic esophagus, though no wall thickening is appreciated.CHEST WALL: Moderate multilevel degenerative changes in the thoracic spine. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range.Nonspecific intra-abdominal fluid. Bilateral atrophic kidneys. Marked vascular calcifications.
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1.Limited examination due to respiratory motion artifact. Faint centrilobular nodular and groundglass opacities most compatible with opportunistic infection such as viral, Candida or atypical mycobacterial pneumonia. CMV is also considered, but the nodules are typically more uniform in size.2.Septal thickening appears nodular in some areas which would be highly atypical for an infectious process. Due to motion artifact this is very poorly assessed and fine detail is lost. A follow-up scan to document resolution is recommended after medical management as this may be seen in both lymphangitic tumor spread and sarcoidosis.3.New small right pleural effusion.4.Mild interval decrease in small left-sided pleural effusion with subsegmental atelectasis.5.Intra-abdominal fluid is nonspecific.
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Generate impression based on findings.
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Lung nodule, follow-up LUNGS AND PLEURA: Stable scattered micronodules and a part solid right lower lobe nodule again measuring 1.4 cm in diameter, unchanged (image 50 series 5). The central increased density remains highly suspicious for primary adenocarcinoma veryMultiple solid and some solid micronodules are scattered and all are otherwise unchanged. No effusions and mild centrilobular emphysema.MEDIASTINUM AND HILA: No distinct lymphadenopathy. The paratracheal and AP window area again appears unchanged with a 9-mm soft tissue density representing suspected conglomerate nodal tissue.Severe coronary artery calcifications without additional cardiac or pericardial abnormality. Ectatic descending aortaCHEST 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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Stable part solid right lower lobe nodular density with central increased density concerning for primary adenocarcinoma. Remaining pulmonary appearance is also otherwise unchanged
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Generate impression based on findings.
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Male 71 years old; Reason: Pt is a 71 y/o male with met prostate cancer, evaluate for progression History: met prostate cancer CHEST:LUNGS AND PLEURA: Few scattered pulmonary micronodules are unchanged. No pleural effusions.MEDIASTINUM AND HILA: Right paraesophageal lymph node measures1.1 x 1.3cm, previously 1.4 x 1.0 cm on image 8 series 3.CHEST WALL: Extensive sclerotic metastases. No axillary lymphadenopathy. The sclerotic lesions in the ribs have progressed.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent.SPLEEN: The spleen is normal in size, adjacent splenule is noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: Stable left adrenal myelolipoma. Right adrenal gland is unremarkable.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Arteriosclerotic disease of the aortaBOWEL, MESENTERY: Left lower abdominal ostomy. Small bowel is normal in caliber. Ventral abdominal hernia containing multiple loops of small bowel.Soft tissue polypoid mass within the second portion of the duodenum measuring 2.3-cm, unchanged.BONES, SOFT TISSUES: Extensive sclerotic metastases.Ventral abdominal hernia repair in the upper abdomen. There is a new fluid collection adjacent to the left rectus muscle with mass like soft tissue infiltration of the fat.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Large ventral hernia containing loops of small bowel without obstruction. Left lower abdominal colostomy.Residual rectal stump.BONES, SOFT TISSUES: Progression of the extensive sclerotic metastases.OTHER: No significant abnormality noted
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1.Extensive osseous metastatic disease. The sclerotic lesions in the ribs and spine have progressed.2.Left lower abdominal colostomy.3.Polypoid mass in the second portion of duodenum recommend endoscopy for tissue diagnosis.
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Generate impression based on findings.
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18 year-old male with staring spells and convulsion. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for mild sinus mucosal thickening.
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No acute intracranial abnormality.
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Generate impression based on findings.
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Hodgkin's disease, nodular sclerosis, unspecified site, extranodal and solid organ sites. Clinical question: H/O Hodgkin Lymphoma s/p 6 cycles of ABVD chemotherapy in need of post treatment scans. Please compare to prior.Signs and Symptoms: H/O Hodgkin Lymphoma There is an 11 x 9 mm axial dimension lymph node at the level of the thoracic inlet to the left and anterior to the leftThere is a left level 4 jugular chain lymph node measuring 13 x 10 mm axial dimensions which is stable compared with the prior exam.A 5-mm right level 4 jugular chain lymph node is stable compared to prior exam.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses are clear. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis.
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1.Measured lymph nodes are stable when compared with prior exam.
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Generate impression based on findings.
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Solitary pulmonary nodule fibrotic emphysema. LUNGS AND PLEURA: New bilateral moderate to small pleural effusions greater on the right. Mild to moderate central lobular and paraseptal emphysema grossly unchanged. Superimposed mild peripheral traction bronchiectasis is also noted with a fine pattern of unchanged honeycombing and fibrotic disease.A small semisolid nodular density adjacent to small cysts in the periphery of the left upper lobe (image 47 series 4) remains unchanged. The measurement remains 8 x 7 mm.MEDIASTINUM AND HILA: Nonspecific hypoattenuation in the thyroid gland bilaterally. Mild interval enlargement of the right hilar lymph node or conglomerate lymph nodes, measuring 2.2 cm (image 50 series 3) from a prior measurement of 1.5 cm. Similar mild enlargement is also identified superiorly in the upper mediastinum. A right paratracheal node (image 16 series 3) currently measures 7 mm from prior measurement of 4.Extensive coronary artery calcifications cardiac size is upper limits of normal.CHEST WALL: Stable appearing subpectoral lymph node (image 19 series 3).UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No gross interval change although a mild fullness to the left adrenal gland cannot entirely be excluded in this incomplete evaluation. Please note the gallbladder is not fully visualized and confirmation of gallstones cannot be made.
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Questionable increase in lymphadenopathy without significant change of the intrapulmonary semisolid nodule. New small and nonspecific bilateral effusions. This combination of findings again remains nonspecific a moderately suspicious for malignancy.
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Generate impression based on findings.
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Male 65 years old; Reason: assess for metastatic spread of bladder cancer History: bladder CIS ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Multiple subcentimeter hypodensities are too small to characterize, though likely of benign etiology. The gallbladder is surgically absent with cholecystectomy clips in the gallbladder fossa.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left inferior pole 1.0-cm simple renal cyst. RETROPERITONEUM, LYMPH NODES: Multiple small retroperitoneal lymph nodes. An aortocaval node measures 1.0 x 0.7 cm.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: Mild asymmetric thickening and enhancement of the bladder wall (coronal image 48, series #8048), likely represents known malignancy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastatic disease, as clinically questioned.1.Asymmetric thickening and enhancement of the bladder wall likely represents known primary malignancy.
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Generate impression based on findings.
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57 year-old female with headache. 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 abnormality.
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Generate impression based on findings.
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History of asbestos exposure, probable rheumatoid arthritis as well, evaluate lungs. LUNGS AND PLEURA: Low normal lung volumes. Basilar predominant traction bronchiolectasis and bronchiectasis with subpleural reticulation and groundglass opacity. No visible suspicious pulmonary nodules or masses. No pleural fluid or pneumothorax. Minimal anterior subpleural reticulation of the lung apices, but no anterior honeycombing which is typically seen in rheumatoid lung disease. No pleural plaques or calcification to suggest prior asbestos exposure. Punctate foci of calcification are noted in the periphery of the fibrotic lung regions, for example right lower lobe series 6 image 171, consistent with dendriform ossification.No subpleural line or band formation or conclusive tree-in-bud opacities to suggest asbestosis.MEDIASTINUM AND HILA: Minimally enlarged lower right paratracheal lymph node, 11-mm (4/37). Mildly prominent lymph nodes at the interlobar and segmental levels of the lower lobes bilaterally as well as mildly enlarged bilateral lower paraesophageal lymph nodes. Prominent left inferior pulmonary ligament lymph node, not normally visible.Moderate to severe coronary artery calcifications. Upper normal heart size. No pericardial effusion. Left subclavian ICD leads in the right atrial appendage and right ventricular apex.CHEST WALL: Left chest wall subcutaneous pacemaker generator. No skeletal stigmata of rheumatoid arthritis are appreciated.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range.
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Moderate pulmonary fibrosis in a pattern atypical for UIP. Pattern is most consistent with NSIP with a fibrosing component and may be seen in rheumatoid lung disease but is not specific regarding etiology in this case. Mildly enlarged mediastinal lymph nodes. No conclusive CT findings to suggest asbestos exposure or pulmonary asbestosis.
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Generate impression based on findings.
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assess for pulmonary metastasis History: Ewing's sarcoma LUNGS AND PLEURA: Stable two pulmonary micronodules in the left lower lobe. Equivocal pulmonary nodule in the left upper lobe stable from prior study. Surgical suture rows are seen in the anterior right upper lobe and posterior right lower lobe. No pleural effusions.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest wall Port-A-Cath tip in distal SVC. No axillary adenopathy. No suspicious osseous lesions.UPPER ABDOMEN: Visualized upper abdomen is within normal limits.
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Stable pulmonary micronodules in the left lower lobe.
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Generate impression based on findings.
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Male 74 years old; Reason: Pre-Kidney Transplant Evaluation, assess aorta and iliac vessels for transplant History: Pre-Kidney Transplant Evaluation, hx of DM and CAD ABDOMEN:LUNGS BASES: Calcifications in the expected location of the mitral valve.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: Atrophy of the native kidneys. Cystic changes of the kidneys. The cysts are suboptimally evaluated without contrast.RETROPERITONEUM, LYMPH NODES: Moderate to severe calcific arteriosclerotic disease affects the abdominal aorta and branch vessels. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate to severe calcific arteriosclerotic disease of the common, internal and external iliac arteries.
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1.Moderate to severe calcific arteriosclerotic disease of the abdominal aorta and its branches. 2.Cystic changes of the kidneys.
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Generate impression based on findings.
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Homonymous bilateral field defects in visual field. New onset L homonymous hemianopsia. Tingling in tongue and mouth. R.o tumor or aneurysm. Please evaluate. 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.There is a moderate degree of periventricular hypodensity present which is rather confluent extends into external capsulesThere is a posterior fossa subdural effusion presentThe 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 evidence for acute intracranial hemorrhage mass effect or edema.2.Periventricular and external capsule white matter lesions are non specific. They could represent a neurodegenerative process. If clinically indicated an MRI of the brain may be helpful to further delineate this.3.Posterior fossa subdural effusion is nonspecific. This may be related to brain atrophy.
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Generate impression based on findings.
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51 year-old female with altered mental status. There is patchy hypoattenuation in the cerebral white matter. There has been mild increase in size of the ventricular system since July this year. 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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1. No acute intracranial hemorrhage. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Mild interval increase in size of the ventricular system (since July 2013). Clinical correlation for hydrocephalus. 3. Mild small vessel ischemic disease of indeterminate age.
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Generate impression based on findings.
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Mesothelioma, please measure and tortuous target lesions CHEST:LUNGS AND PLEURA: Status post right pneumonectomy with diaphragmatic patch and mash, no change. The associated mediastinal shift is again observed with mild diffuse pleural thickening without discrete nodularity. Measurements remain approximately 5 mm in thickness.Left lung remains clear other than mild central lobular emphysematous changes and scattered micronodules. No left effusionMEDIASTINUM AND HILA: Reference precarinal lymph node remains 1.1 cm (image 39 series 4). Remaining mediastinal structures are otherwise unchanged.Mild coronary calcificationsCHEST WALL: Postsurgical changesABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Marked interval enlargement of a large mixed lobulated hyper and hypodense lesion in the lateral right lobe, currently measuring 7.5 x 5.6 cm (image 93 series 4) from a prior measurement of 2.0 cmSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Suspected renal cysts unchangedPANCREAS: 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: Interval enlargement of the right abdominal wall soft tissue mass with increased central hypodensity representing tumor necrosis and metastatic disease. This mass currently measures 5.1 x 2.9 cm (image 112 series 4).OTHER: No significant abnormality noted.
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Interval progression with increased size of the right abdominal wall lesion and hepatic lesions, measurements are above
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Generate impression based on findings.
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Malignant neoplasm of floor of mouth, part unspecifiedCirrhosis of liver without mention of alcoholPersonal history of venous thrombosis and embolism CT neck:Much of the floor of the mouth is obscured by metal artifact patient's dental work.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Incidental note is made of torus mandibularisWithin the visceral space the thyroid gland appears intact.The airway appears patent.There is a 13 x 21 mm axial image mass located in the right parotid gland which previously measured 19x11mm. There is an adjacent 6mm short axis dimension nodule.The left parotid and the submandibular glands appear intact. The right submandibular gland is smaller than left submandibular gland.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No acute intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular and subcortical white matter hypodensities of a moderate degree are present.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.There is a right parotid mass present which slightly larger on the current versus the prior exam.2.No evidence for brain metastases.3.Periventricular and subcortical white matter signal changes are nonspecific. At this age they are most likely vascular related though they could be related to a neurodegenerative process such as nonspecific leukoencephalopathy of aging.
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Generate impression based on findings.
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58 year old female. Reason: ILD protocol. Provisional dx of IPF in 2004 by bx, eval for fibrosis progression does not follow usual clinical course of IPF, ?NSIP fr microaspiration v other? Worsening Pulm fxn tests LUNGS AND PLEURA: Bilateral subpleural reticular opacities and micro-honeycombing with mild increase in disease in the lung apices. Subjective slight worsening of groundglass opacities anteriorly at the level of the arch (5/17). Mild interval increase in traction bronchiectasis in the anterior upper lobes.Numerous well circumscribed nonspecific small pulmonary nodules have minimally increased and size and density compared to prior by approximately 1 mm each compared to 2006, most likely benign. Surgical changes from lingular biopsy.Few focal areas of airtrapping on expiratory images.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.Scattered mildly enlarged mediastinal lymph nodes are not significantly changed in size. No significant hilar lymphadenopathy. Multiple right hilar calcified lymph nodes.CHEST WALL: Mild degenerative changes in the thoracic spine. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Diffuse fatty liver infiltration. Multiple hypoattenuating subcentimeter lesions in the liver parenchyma are too small characterize and likely represent cysts. Status post cholecystectomy.Scattered splenic granulomas.
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1.Slight worsening of disease in the anterior upper lobes there groundglass opacity may reflect active cellular inflammation. Degree of fibrosis elsewhere is stable to only minimally worse. UIP is possible, this distribution is atypical, correlate for possibility of collagen vascular disease.2.Only subtle interval increase in size of well circumscribed nonspecific pulmonary micronodules, most likely benign and possibly related to patient's underlying disease process.
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Generate impression based on findings.
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Male 85 years old; Reason: Metastatic prostate cancer post therapy History: prostate cancer CHEST:LUNGS AND PLEURA: Multiple scattered bilateral micronodules are grossly unchanged. Previously measured nodule in the right upper lobe measures 4 mm, unchanged (image 45, series #4).Bilateral basilar scarring versus atelectasis is unchanged, left greater than right.MEDIASTINUM AND HILA: Stricture previously described as a reference subcarinal lymph node more likely represents fluid in the superior pericardial recess. Small mediastinal lymph nodes are unchanged. Mild atherosclerotic calcification of the thoracic aorta.CHEST WALL: Extensive osseous metastatic disease is redemonstrated.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Unchanged bilateral adrenal nodules. KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive osseous metastatic disease is redemonstrated.OTHER: Elevated left hemidiaphragm.PELVIS:PROSTATE, SEMINAL VESICLES: Prosthetic radiation beads are present.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Extensive osseous metastatic disease is redemonstrated.OTHER: No significant abnormality noted
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1.Extensive osseous metastatic disease.2.Scattered bilateral pulmonary nodules are unchanged.3.Stable bilateral adrenal nodules.
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Generate impression based on findings.
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69 year-old male with altered mental status. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality. 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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relapsed rhabdomyosarcoma CHEST:LUNGS AND PLEURA: Moderate bilateral pleural effusions with overlying compressive atelectasis. No focal opacity is present.MEDIASTINUM AND HILA: Moderate pericardial effusion is present. No significant lymphadenopathy is noted. Right chest wall Port-A-Cath tip terminates in the right atrium.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Soft tissue mass adjacent to the tail of the pancreas measures 2.5 x 2.3 cm. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The kidneys demonstrate normal parenchymal enhancement.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Retroaortic left renal vein is present, a normal variant.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Incompletely distended and normal in appearance.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: A small amount of free fluid is present in the pelvis.
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1. New pericardial and pleural effusions.2. Stable soft tissue mass adjacent to the pancreatic tail.
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Generate impression based on findings.
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Lung cancer, prior resection. Please reevaluate LUNGS AND PLEURA: Extensive and grossly stable severe diffuse central lobular emphysema with numerous bulla greater in the upper lobes. No discrete interval change or new intra-pulmonary findings. Reidentified are multiple small mixed semisolid nodular densities all unchanged. The right upper lobe reference nodule remains barely perceptible and unmeasurable (image 46 series 6). The small reference single nodule in the peripheral right lower lobe (image 56 series 6) is also unchanged.The semisolid nodule in the right lower lobe (image 81 series 6) remains 14 mm. The overall density remains similar. No effusions.MEDIASTINUM AND HILA: No lymphadenopathy.Extensive coronary artery calcifications. The cardiac and pericardial appearance is otherwise unchanged.Hiatal hernia.CHEST WALL: Right mastectomyUPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No discrete upper abdominal abnormalities this limited view of the than diverticulosis observed in the splenic flexure partially
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Stable appearance of multiple semisolid nodular densities in extensive emphysema. See reference descriptions and measurements provided
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Generate impression based on findings.
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Male 88 years old; Reason: Assess bowel obstruction vs ileus. Please administer PO contrast only. History: continued distention ABDOMEN:LUNGS BASES: Calcified pleural lack of the lung bases. Corner disease involving the left coronary system.Bibasilar atelectasis and areas of consolidation.Trace bilateral effusions.LIVER, BILIARY TRACT: Stable cyst in segment 3 of the liver. Small amount amount of perihepatic ascites is new.SPLEEN: New peri splenic ascites.PANCREAS: The pancreas is atrophic.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild hydronephrosis of the left kidney.RETROPERITONEUM, LYMPH NODES: Severe calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: Small bowel obstruction with a transition point in the pelvis (image 114/series 4). The proximal small bowel loops are dilated measuring up to 4 cm and greater. Multiple air-fluid levels in the small bowel.Motion artifact limits evaluation for bowel wall pneumatosis. Within this limitation, no evident free intraperitoneal air or bowel wall pneumatosis.Right lower abdominal ileal conduit.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Status post cystoprostatectomyBLADDER: Status post prostatectomyLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Scattered colonic diverticulosis. Small bowel obstruction with a transition point in the ileum in the right lower abdomen.BONES, SOFT TISSUES: Post operative changes in the lower lumbar spine with pedicle fusion.OTHER: No significant abnormality noted.
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1.Small bowel obstruction with a transition point in the distal ileum in the right lower abdomen. Upper abdominal ascites is new.
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Generate impression based on findings.
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77-year-old female. Reason: previous heavy smoker, lung cancer screening History: previous heavy smoker, lung cancer screening LUNGS AND PLEURA: Severe centrilobular emphysema. Marked interval decrease in right upper lobe consolidation with residual scarring. Stable 4-mm irregularly marginated but flat subpleural nodule in the posterior right upper lobe, unchanged compared to examination in 2008, likely reflecting postinflammatory scarring.Right lower lobe calcified nodule consistent with healed prior granulomatous disease.Otherwise, no suspicious nodules or masses.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Moderate coronary artery calcifications. Mild atherosclerotic changes of the thoracic aorta.No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Mild degenerative changes in the thoracic spine. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified lymph nodes adjacent to the gastroesophageal junction unchanged.Status post cholecystectomy.Moderate atherosclerotic changes of the abdominal aorta and its branches.
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1.No suspicious pulmonary nodules or masses.2.Severe centrilobular emphysema.3.Suggest yearly screening CT given high risk category.
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Generate impression based on findings.
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Evaluate ILD. Worsening cough and S.O.B. History of hypersensitivity pneumonitis. LUNGS AND PLEURA: Interval resolution of the pleural fluid collections. Posterior and basilar predominant groundglass opacity and mild traction bronchiectasis, the bronchiectasis has slightly increased compared to the prior examination when measured.Patchy subpleural irregular nodules in the upper lobes were likely present previously allowing for differences in technique. Suture lines along the cranial aspect of the right major fissure and right lower lobe suggest prior wedge biopsy.No significant airtrapping on expiration sequence. No redistribution of the findings upon prone positioning to suggest emphysema. Basilar bronchiolectasis, but no conclusive honeycombing.MEDIASTINUM AND HILA: Normal heart size. Prominent hilar lymphatic tissue again noted consistent with mild lymphadenopathy, not appreciably changed allowing for lack of IV contrast. The esophagus is filled with air in its upper half but does not appear significantly dilated.CHEST WALL: Focal sclerosis in the T10 vertebral body on the right unchanged since 2007, likely benign.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range is unremarkable.
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Chronic fibrotic interstitial lung disease with subtle progression of bronchiectasis. When comparing back to earlier studies such as from 5/2010, apical subpleural nodules have worsened and may represent foci of cryptogenic organizing pneumonia; these are stable to perhaps minimally worse compared to the earlier study this year. Please note that the radiographic appearance is atypical for the patient's diagnosis of hypersensitivity pneumonitis.
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Generate impression based on findings.
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Female 21 years old; Reason: rule out pancreatitis History: N/V, abd pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted. Benign left cortical cyst seen unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted in stomach, small or large bowel. Appendix is well visualized and normal in appearance. BONES, SOFT TISSUES: Nonspecific bowel wall thickening in the descending and sigmoid colon, incompletely characterized given lack of distention.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted in stomach or small bowel. Nonspecific bowel wall thickening in the descending and sigmoid colon, incompletely characterized given lack of distention. Appendix is well visualized and normal in appearance. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Trace free fluid in the pelvic cul de sac.
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Non specific colonic wall thickening incompletely characterized given lack of distention.
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Generate impression based on findings.
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61 year-old female with dizziness. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. The osseous structures are unremarkable. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Empty sella.
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No intracranial abnormality.
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Generate impression based on findings.
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25-year-old female. Reason: AML s/p transplant one year ago with GVHD on steroids. New hypoxia. PE vs pneumonia History: hypoxia PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Interval right middle lobe subsegmental atelectasis, likely secondary to bronchial mucous plugging (series 9 image 77). Scattered nonspecific micronodules are too small to characterize and are likely benign given patient's age.No air space opacity to suggest pneumonia.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable subcentimeter right hepatic lobe cyst.
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Technically adequate study without evidence of a pulmonary embolus.Bronchial obstruction likely secondary to mucus plugging with associated subsegmental atelectasis of the right middle lobe.
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Generate impression based on findings.
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Off therapy. Paraganglioma (urinary bladder) assess for disease progression. LUNGS AND PLEURA: Motion artifact causes slice misregistration, limiting assessment for subcentimeter lesions. Within this limitation, no pulmonary nodules suspicious for active metastatic disease are appreciated. A subpleural lymph node is seen adjacent to the right major fissure, present previously. Numerous basal micronodules are unchanged in size, some is now calcified,. Given the benefit of retrospect, these have decreased in size compared to exams in 2010 and may represent treated metastases. No pleural fluid.MEDIASTINUM AND HILA: No significantly enlarged lymph nodes. And upper normal in size subaortic lymph node (3/34) was present previously and not conclusively changed allowing for differences in scan variability. No pericardial effusion..CHEST WALL: There are several hyperattenuating nodules in the left breast which are not conclusively changed since 2010 and it could reflect benign or treated lesions however are incompletely assessed by CT. Unchanged skeletal endplate depression at T11 and 12 posteriorly on the left. Congenital partial fusion of T7 and T8 vertebral bodies.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. Timing of contrast enhancement limited for detection of abdominal pathology. Prominent lumbar vein on the left, but no conclusive lymphadenopathy. Please refer to separately reported MRI of the abdomen and pelvis from today's date.
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Unchanged pulmonary micronodules and left breast nodules which may represent treated metastatic disease. Further evaluation of the breasts lesions may be made by breast MRI if clinically warranted.No new sites of disease are identified.
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Generate impression based on findings.
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Dizziness and giddinessChest pain, unspecified 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. The eyeball lenses are thin. There are scleral calcifications present adjacent to the insertion sites of the ciliary bodies most likely representing scleral plaque.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of nonhemorrhagic CVA
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Generate impression based on findings.
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Head and neck cancer. CHEST:LUNGS AND PLEURA: Stable appearing right upper lobe noncalcified nodules in micronodules scattered in both lungs. No suspicious nodules or masses. No effusions.MEDIASTINUM AND HILA: Calcified subcarinal and precarinal lymph nodes. No lymphadenopathy.The cardiac and mediastinal contours are within limitsCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: CholelithiasisSPLEEN: GranulomasADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered subcentimeter cortical lesions representing suspected cysts, unchangedPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: The stable para-aortic lymph node (image 101 series 3) remains 9 mm.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Diverticula and no additional findingsBONES, SOFT TISSUES: Multiple mild wedge deformities of the upper and midthoracic spine unchangedOTHER: No significant abnormality noted.
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Stable right upper lobe noncalcified nodules and no specific new abnormalities to suggest metastatic disease
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Generate impression based on findings.
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Female 64 years old; Reason: pt with mesothelioma s/p debulking of the abdomen including partial peritonectomy etc. History: doing better, now needs disease evaluation post surgical debulking compare to previous scans and comment ABDOMEN:LUNGS BASES: For full characterization of the lungs, please refer to the CT chest done same day.LIVER, BILIARY TRACT: Liver contour is normal without focal lesion. Multiple granulomas noted in the liver.Patient is status post cholecystectomy.SPLEEN: Status post splenectomy.PANCREAS: Mild ductal dilation the midportion of the pancreas is unchanged since previous exam. This is incompletely characterized, and for full characterization MRI M.R.C.P. advise.ADRENAL GLANDS: 2.8 x 3.4 cm indeterminant left adrenal lesion is noted. A smaller 1.5 x 1.6-cm indeterminant right adrenal lesion is also notedKIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Patient is status post omentectomy with subtle residual nodularity in the peritoneum.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: Patient is status post omentectomy with mild residual nodularity in the peritoneum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace ascites noted in the pelvic cul-de-sac.
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1.Status post omentectomy, splenectomy, and cholecystectomy, with residual nodularity in the peritoneum, and residual trace ascites.
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Generate impression based on findings.
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Lung cancer, follow-up CHEST:LUNGS AND PLEURA: Unchanged postsurgical left pneumonectomy with associated volume loss and shift. Chronic scarring and atelectasis in the right middle lobe anteriorly. No new suspicious pulmonary nodules or masses. No right effusion. Mild centrilobular emphysemaMEDIASTINUM AND HILA: No lymphadenopathyModerate coronary calcifications without interval change. The cardiac and pericardium are otherwise within limitsCHEST WALL: Moderate degenerative changes scattered throughout the thoracic spineABDOMEN: 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: Unchanged and suspected simple left renal cystPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Left pneumonectomy without evidence of recurrent disease
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Generate impression based on findings.
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Mesothelioma with surgical debulking. Please re-evaluate LUNGS AND PLEURA: A large left and moderate right pleural effusion with underlying compression atelectasis and suspected loculation greater on the right. Scattered calcified granulomasMEDIASTINUM AND HILA: Marked enlargement and heterogeneity greater within the left thyroid. Suspected nodularity and goiter.Borderline right paratracheal lymph node (image 20 series 4) unchanged. Calcified left hilar lymph nodes compatible of old granulomatous disease exposure.The cardiac and pericardium are grossly within limitsCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Incomplete visualization, however within this limited view, a large left adrenal mass measuring 3.4 x 3.0 cm (image 89 series 4) is again noted and grossly unchanged compared to 8/9/13. A linear metallic finding the left upper abdomen under the hemidiaphragm may represent suture or staple line. Hepatic granuloma
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1. Interval enlargement of bilateral pleural effusions. No distinct intrapulmonary findings to suggest recurrence2. Suspected goiter
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Generate impression based on findings.
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65 year-old female with recurrent adenoid cystic carcinoma. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. The orbits are unremarkable. The mastoid air cells are clear. The previously seen lesion along the margin of the preserved anterior left maxillary sinus wall, has been excised. There is 18 x 12 mm enhancing soft tissue at the surgical site. There appears progressive bony erosion of the adjacent frontal process.Extensive surgical change is redemonstrated including complete resection of the left maxillary sinus and maxillary alveolar ridge, the hard and soft palate, the middle and inferior turbinates on the left, middle turbinate on the right, part of the nasal septum, most of the bilateral ethmoid air cells, and the bilateral sphenoid sinuses. Also resected is the left pterygoid plate, the region of the left pterygopalatine fossa, and part of the masticator space and left nasopharyngeal soft tissues. Low-density soft tissue thickening within the right maxillary sinus is stable and likely reflects a mucus retention cyst.Scattered cervical lymph nodes are redemonstrated, none of which is pathologically enlarged or demonstrates aggressive features. Reference left submandibular node is stable in size measuring 11 x 9 mm (image 77 series 7).Subcentimeter cyst situated at midline in the base of tongue is unchanged and may reflect a thyroglossal duct remnant. The remainder of the aerodigestive tract is unremarkable.The left parotid gland is fatty replaced and atrophic relative to the right, a stable finding. Both are free of focal lesions. The submandibular glands are unremarkable. The thyroid is free of focal lesions.Pulmonary nodes. Please refer to the separately dictated chest CT for further details.
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1. Interval excision of a lesion at the anterior left maxillary sinus wall. There is enhancing soft tissue at the surgical site, which is nonspecific and may represent granulation or residual tumor or both. Continued followup is recommended. 2. No cervical lymphadenopathy. 3. No intracranial metastasis.
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Generate impression based on findings.
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Female 60 years old; Reason: Head and neck cancer, ? new liver lesion, PLEASE OBTAIN CT LIVER TRIPHASIC PROTOCOL. History: PLEASE OBTAIN CT LIVER TRIPHASIC PROTOCOL. no symptoms, new lesion. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: 1.5 x 1.3 cm hypodense segment 4 lesion is redemonstrated adjacent to the falciform ligament. Differential diagnosis includes perfusion abnormality versus focal fatty deposition. Metastatic disease is deemed less likely, however MRI may be used for further characterization. Multiple cysts are redemonstrated and stable. The gallbladder surgically absent with cholecystectomy clips in the gallbladder fossa.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: Balloon gastrostomy tube is in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Hypodense segment 4 liver lesion likely represents perfusion abnormality or focal fatty deposition, however metastatic disease cannot be excluded and MRI can be helpful for further characterization.
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Generate impression based on findings.
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ams receptive aphasia 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.Periventricular and subcortical white matter hypodensities of a moderate degree are present. Punctate hypodensities are redemonstrated in the thalami and basal gangliaThe 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. The eyeball lenses are thin.
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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.Punctate lesions in the basal ganglia and thalami are most likely related to infarcts4.CT is insensitive for early detection of nonhemorrhagic CVA
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Generate impression based on findings.
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Female 73 years old; Reason: gastric cancer restaging History: gastric cancer CHEST:LUNGS AND PLEURA: 6-mm nodule in the right upper lobe is stable.MEDIASTINUM AND HILA: Borderline enlarged mediastinal lymph nodes. Index pretracheal node measures 1.3 x 1.0cm previously 1.3 by 1 cm (image number 36, series number 3).CHEST WALL: Right port a cath is unchanged with its tip in the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Small hypodense lesion in segment 8 is unchanged and screws examination. Stable cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic right kidney. Simple right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The previously seen thickened gastric wall consistent with patient's on history of stomach cancer appears smaller on this examination. The stomach is incompletely distended limiting evaluation. The mass likely still extends into the perigastric fat. Pericardial nodularity in the immediate vicinity has resolved. No other CT evidence of peritoneal carcinomatosis.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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Interval decrease in the previously seen gastric wall mass. Decrease in the perigastric nodularity.
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Generate impression based on findings.
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Neoplasm of uncertain behavior of larynx There is a 28 x 45 mm coronal dimension and 26x38mm axial dimension mass centered in the right larynx which breaks through the thyroid cartilage. And involves the right thyroid gland.. It extends lateral to the cricoid right side its superior extent is at the level of the right thyrohyoid membrane the inferior extent is at the level of the cricoid and narrows the airway. It is unchanged when compared to the prior exam. The mass has a homogeneous density.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. There are numerous lymph nodes scattered throughout the soft tissues of the neck which do not meet the size criteria for lymphadenopathy.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses are clear. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are multilevel degenrateive changes in the cervical spine.
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1.There is a right-sided laryngeal mass present extending to the thyroid gland and eroding the right thyroid cartilage and narrowing the airway. It is stable since the October 11 exam
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Generate impression based on findings.
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Right lower lobe cavitary lesion and history lung cancer. Cough and hemoptysis LUNGS AND PLEURA: Interval resolution of the previously described lingular opacity and tracheal debris. Minimal similar basilar changes suggesting atelectasis superimposed upon moderate centrilobular and paraseptal emphysema. The reference lesions including the right lower lobe cavitary lesion remains 2.8 x 2.4 cm (image 26 series 5). Adjacent pleural thickening and cavitary component both appear unchanged. The noncalcified solid left apical nodule is also unchanged measuring 10 x 9 mm (image 18 series 5). Scattered calcified micronodules are also otherwise unchanged. Right upper lobectomyMEDIASTINUM AND HILA: No lymphadenopathy, specifically the high paratracheal lymph node previously measured is not currently appreciated.Mild to moderate coronary calcifications. Cardiac and pericardium are otherwise unremarkableLarge hiatal herniaCHEST WALL: Scattered degenerative changes throughout the thoracic spine. Healed left seventh rib fracture.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Stable appearing right upper lobe cavitary mass and other reference measurements. No new findings
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Generate impression based on findings.
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Female 53 years old; Reason: 53yo female with newly diagnosed grade 3 endometrial CA, assess for metastatic disease History: Endometrial CA ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: 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 evident metastatic disease detected.
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Generate impression based on findings.
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67 year-old male with head and neck cancer and status post CRT. The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are stable. There is redemonstration of the left orbital wall fracture. There is partial opacification of the left ethmoid air cells stable since prior exam. The paranasal sinuses and mastoid air cells are otherwise clear.There is diffuse laryngeal and pharyngeal mucosal thickening but no focal mass on the current exam. There appears some airway narrowing but no obstruction.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Atherosclerotic calcifications are present at the carotid bifurcations. The cervical vasculatures are patent. Within the visceral space the thyroid gland appears intact. The parotid and the submandibular glands appear intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are degenerative changes of the cervical spine, grossly unchanged. There is loss of vertebral body height of T4 and T5, unchanged. Pulmonary nodules. Please refer to dedicated chest CT for details.
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Posttreatment changes with no evidence for tumor recurrence or neck lymphadenopathy.
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Generate impression based on findings.
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Patient with history of pneumonia, chest CT pre-allogeneic main stem cell transplant. History of nodular lymphoma. LUNGS AND PLEURA: Nodular scarring at the lung apices. Focal cylindrical bronchiectasis in the right apex unchanged. Small scar like opacities in the right lower lobe (5/62, 5/89) unchanged. Focal scar at the right lung base abutting the diaphragm (5/92) at at site of a prior nodule seen on 9/9/13.Mild septal thickening and nodularity in the anterior left lower lobe new from previous. Focal endobronchial obstruction due to internal debris or aspirate in the mid-anterior segmental bronchus.4-mm groundglass density nodule left upper lobe not conclusively changed (5/29) and could be a small area of atypical adenomatous hyperplasia. Other scattered micronodules are peripheral and probably represent areas of distal endobronchial impaction, unchanged.MEDIASTINUM AND HILA: Right jugular chest port tip at the SVC. No significant lymphadenopathy. Calcified left hilar region lymph nodes. Mild coronary artery calcifications. Normal heart size. No pericardial fluid. CHEST WALL: Endplate degenerative changes of the spine. No axillary lymphadenopathy. Right chest port.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. Splenomegaly. Partially seen exophytic cystic lesion arising from the apex to the right kidney. Splenic vein appears tortuous, correlate for portal hypertension. Retroperitoneal fat stranding and nodularity similar to previous.
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Subtle abnormality in the left lower lobe suggestive of bronchiolitis, possibly due to aspiration though postobstructive inflammatory process or infection cannot be entirely excluded without follow-up. As this abnormality is beyond the resolution of visibility for conventional radiographs, reduced dose unenhanced thoracic CT may be of use in a few days to assess for clearance. No significant intrathoracic lymph adenopathy.
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Generate impression based on findings.
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31-year-old female with history of breast cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Large right breast mass. The mass measures 7.7 by 5.3 cm on image number 49, series number 3. The mass invades the right pectoralis muscle and abuts the cortex of the anterior ribs.Right axillary adenopathy measuring 1.5 x 1.2 cm on image number 32, series number 3.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Compression deformity of T10 vertebral body.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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Right breast mass and right axillary adenopathy.Compression deformity of T10 vertebral body, nonspecific, and can be congenital.
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Generate impression based on findings.
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Reason: 69 year old female with a history of bladder cancer post chemotherapy. eval for response History: bladder cancer with metastasis CHEST:LUNGS AND PLEURA: Centrilobular and paraseptal emphysema with an upper lobe predominance, unchanged. No new or suspicious pulmonary nodules or masses. Note is made of a calcified nodule in the left upper lobe suggestive of prior granulomatous disease.MEDIASTINUM AND HILA: Reference left supraclavicular lymph node, measures 1.5 x 0 .6 cm, previously 1.5 x 0.7 cm (series 3, image 8). No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion. Small hiatal hernia.CHEST WALL: No significant abnormality noted. Prominent axillary lymph nodes, unchanged. Right chest port tip terminates in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating lesion in segment 5 measures 2.3 x 1.6 cm, previously 2.2 x 1.5 cm (series 3; images 80) and is incompletely characterized. Additional hypoattenuating lesions are too small to further characterize, but unchanged in appearance and likely benign.SPLEEN: Calcified splenic granulomata.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Interval placement of a right nephroureteral stent. Severe persistent right hydronephrosis, which appears decreased when compared to the prior study. Mild left-sided hydronephrosis. Bilateral subcentimeter renal hypodensities are too small to characterize but may represent simple cysts.RETROPERITONEUM, LYMPH NODES: Reference paraaortic lymph node measures 1.9 x 0.8 cm, previously 2.0 x 0.9 cm (series 3; image 112). Reference portocaval lymph node is no longer discretely measurable. Third reference retroperitoneal lymph node mass is no longer measurable.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: Again seen is irregular wall thickening of the posterolateral left bladder wall, which is difficult to measure/compare to prior study, given the difference in bladder distention. Laminated bladder stone, unchanged.LYMPH NODES: Reference left pelvic lymph node measures 1.4 x 0 .8 cm, previously 1.2 x 1.0 cm (series 3; image 175).BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Persistent eccentric bladder wall thickening which is difficulty to accurately measure/compare to the prior examination secondary to varying distention of the bladder.2.No significant interval change in reference lymph nodes in the supraclavicular, retroperitoneal, and pelvic regions.3.Interval decrease in right sided hydronephrosis. Status post right nephroureteral stent placement.4.Interval development of mild left hydronephrosis.
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Generate impression based on findings.
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Male 63 years old; Reason: 62Yrs male who completed CRT August 2012. New right upper neck mass that has increased in size and now tender. last CT showed lesion of the left kidney suggestive of either renal infarctor met. Now with increasing left back pain radiating to groin History: left bac k pain radiating to groin and history of left renal lesion, r/o met CHEST:LUNGS AND PLEURA: Numerous new nodules are noted throughout the lungs bilaterally with reference new nodule in the left lung base measuring 7mm. Other subcentimeter nodules measure up to 6mm in the right middle lobe and left lung base.Calcified granuloma in the right upper lobe.MEDIASTINUM AND HILA: Borderline mediastinal lymphadenopathy is stable.Calcified lymph nodes compatible with previous infection.Moderately severe coronary artery calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: LIVER, BILIARY TRACT: New hypoattenuating lesions are seen throughout the liver, with a reference lesion in hepatic dome measuring 1 cm in short access. Few others in the left lobe and segment 8 are noted and also new. Stable calcified granulomas.SPLEEN: Calcified granulomas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Large hypoattenuating lesion in the midpole left kidney measures 4.9 x 3 .2 cm, previously 3.6 x 2.9 cm (series 6 image 131). This lesion is larger, and demonstrates continued perinephric inflammatory change concerning for neoplasm. Interval development of a subcentimeter hypodensity in the midpole right kidney (series 6 image 142) too small to reliably characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal adenopathy noted with a reference left para-aortic conglomerate mass measuring 4.9cm x 2.7cm. BOWEL, MESENTERY:No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the spine.OTHER: No significant abnormality noted.PELVISUTERUS, 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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1. Large left renal lesion which has grown in the interim, worrisome for renal cell carcinoma versus metastatic disease. 2. Numerous hypodense lesions in the liver, which are new since previous exam 9/12/13 worrisome for metastatic disease.3. Numerous new nodules in the lungs, presumed metastatic in nature.4. Interval development of conglomerate retroperitoneal adenopathy, likely metastatic in nature
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Generate impression based on findings.
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History of pancreatitis ABDOMEN:LUNG BASES: Large right-sided pleural effusion and bilateral dependent atelectasis.LIVER, BILIARY TRACT: Numerous hypodense lesions in the liver. Some of the more to small to accurately characterize, but larger ones, most likely represent cysts.SPLEEN: No significant abnormality notedPANCREAS: Enhancing pancreatic tissue is noted in the pancreatic neck and tail. Pancreatic head and most of the body are replaced by large pseudocysts. The pseudocyst in the body of the pancreas measures 9.5 x 7.6 cm. The pseudocyst in the head and uncinate process of the pancreas measures 10 cm in diameter and extends inferiorly to the level of the aortic bifurcation. Enhancing pancreas demonstrates mild pancreatic ductal dilatation. Splenic vein is chronically thrombosed and collateral vessels are present.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites.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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Two large pseudocysts in the pancreatic head and body. Small amount of ascites. Findings consistent with necrotizing pancreatitis. Chronic occlusion of the splenic vein.Multiple small hypodense lesions in the liver, some of which are too small to accurately characterize, but larger ones likely represent cysts.Large right-sided pleural effusion.
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Generate impression based on findings.
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63 year-old male history of head and neck cancer. Follow-up. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear except for right maxillary sinus retention cysts/polyps. Limited view of the intracranial structure is unremarkable. Examination shows an 18 x 18 mm ill defined, enhancing lesion underlying the right platysma muscle and between the right strap and SCM muscles. The lesion has increased in size since prior exam. There appears infiltration of the lesion into the muscles. Examination again shows a focus of soft tissue density at the right base of tongue is measuring 15 x 6 mm compared to 15 x 6 mm on the prior study. Reference lymph node measurements are given below:Right level 2 lymph node which measured 6 x 5 mm currently measures 6 x 5 mm (series 13, image 104)Left level 2/3 lymph node which measures 6 x 7 mm now measures 7 x 6 mm (series 13, image 101). Additional non-reference lymph nodes appear stable in size. The salivary glands are unremarkable. Mild edema and mucosal enhancement of the aerodigestive tract, likely treatment related. Lung apices are unremarkable although a dedicated chest CT is dictated separately. The cervical vascular structures, other than minimal atherosclerotic disease, are intact.
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1. Interval increase in size of a lesion underlying the right platysma muscle and between the right strap and SCM muscles. This may represent pathologic adenopathy. 2. Stable focus of soft tissue density at the right base of tongue.3. Stable reference cervical lymph nodes. 4. CT chest is dictated separately.
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Generate impression based on findings.
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Male, 73 years old, recurrent invasive base of tongue carcinoma status post partial resection. Redemonstrated is encephalomalacia in the right frontal lobe, also at the right temporo-occipital junction, consistent with chronic ischemic change, stable. A left frontal development venous anomaly is also stable. Mild age indeterminate small vessel ischemic disease is noted in the periventricular regions. No enhancing abnormality, focal mass or mass-effect is seen to suggest intracranial metastatic disease. The bones of the calvarium are intact.Volume loss affecting the left posterior aspect of the oral tongue is again seen similar to prior. Deficiency of the anterior hyoid is also unchanged.A heterogeneously enhancing mass at the left tongue base has increased in size now measuring 2.8 x 2.8 cm (image 34 series 6), previously 2.1 x 1.7 cm. The floor of mouth musculature is invaded and the lesion does now cross midline to the right. The left aspect of the vallecula is partially effaced as a result of increasing tumor size.No pathologic adenopathy is detected by size criteria. The salivary glands are free of focal lesions. Only a small amount of thyroid tissue is identified. Cervical vessels remain patent. The lung apices are significant for reticulation and scarring. No concerning osseous lesions are detected.
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1. Interval increase in size of a left tongue base/floor of mouth mass.2. No pathologic adenopathy in the neck.3. Stable examination of the brain with no evidence of intracranial metastatic disease.
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Generate impression based on findings.
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63-year-old female patient. Reason: severe emphysema from AATD and bronchiectasis. Hx of PTX as well (left) History: cough, sob, sputum LUNGS AND PLEURA: Severe panlobular emphysema with severe bullous disease most prominent at the lung bases.Interval resolution of pneumothorax. There is a small pocket of air underneath the pectoralis major muscle which may be secondary to recent instrumentation or procedure, as prior subcutaneous emphysema from 10/24/2013 should be resolved.Loculated fluid filled bullae in the left lower lobe that was not seen on prior examination.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion. Minimal coronary artery calcifications. Minimal atherosclerotic changes of the thoracic aorta.CHEST WALL: T7 vertebral body endplate depression is nonspecific.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Wedge-shaped hypodensity in the right lobe of the liver adjacent to the falciform ligament is not visualized and examination and may represent volume averaging as it is in the area of the gallbladder, as seen on examination from 2/22/2012.
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New loculated fluid-filled bullae in the left lower lobe. Recommend follow up in 6 weeks to clearance.No residual pneumothorax.
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Generate impression based on findings.
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56 showed female with metastatic colon cancer status post hepatic resection October 2013 complicated by bile leak. New Baseline CT prior to chemo. CHEST:LUNGS AND PLEURA: Trace right pleural effusion. New left upper lobe pulmonary nodule measures 1.4 x 1.2 cm (image 54, series #5). Two new right lung micronodules are also identified.MEDIASTINUM AND HILA: No mediastinal adenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Interval development of several hypodense lesions compatible with metastatic disease, largest in the right dome measuring 2.8 x 2.2 cm.Stable postsurgical changes of partial right lobe resection. No perihepatic fluid collection, with resolution of the previously seen fluid. Gallbladder is surgically absent with cholecystectomy clips in the gallbladder fossa. 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: Circumferential rectal wall thickening likely represents known primary malignancy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Interval development of several hepatic lesions and left upper lobe pulmonary nodule, consistent with progression of metastatic disease.2.Stable postsurgical changes of right hepatic lobe resection, with resolution of perihepatic fluid collection.
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Generate impression based on findings.
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Lung cancer on treatment CHEST:LUNGS AND PLEURA: Right paramediastinal mass has developed internal cavitation and is increased in size, 5.8 x 3.1 cm (3/42) compared to 3.1 x 1.9 cm. Length of the mass is now 9.5-cm (coronal image 23). The cavity is adjacent to a fluid filled bulla in the right apex, possibly indicating superinfection. Right upper lobe bronchus is now slightly narrowed proximally, while the anterior bronchus is ectatic. Interval development of septal thickening surrounding the postero-medial aspect of the mass. The anterior aspect of the right major fissure appears slightly nodular, but this is probably unchanged.Severe emphysema.Scattered subpleural an intrapulmonary lymph nodes unchanged. Flat peripheral subpleural nodule right lower lobe (5/59) not significantly changed, 7-mm compared to 6-mm previously. Small volume of loculated paramediastinal fluid on the right cranially.MEDIASTINUM AND HILA: ET tip above the level of the clavicular heads.Soft tissue thickening surrounding the right main bronchus has progressed, causing luminal narrowing. This thickening also extends along the bronchus intermedius and possibly along the lobar right middle and lower lobe airways for a short distance. Superior right lower lobe segmental artery abuts the mass.Necrotic subcarinal lymphadenopathy is similar to previous. Small enhancing contralateral paratracheal lymph nodes are only slightly larger. Mild right interlobar level lymphadenopathy is unchanged.CHEST WALL: Lytic subchondral lesions in in the left scapula unchanged from recent earlier films and may be degenerative. Right 10th rib sclerotic focus could be a bone island..ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted..SPLEEN: No significant abnormality noted..ADRENAL GLANDS: No significant abnormality noted..KIDNEYS, URETERS: Left renal vein is compressed between the aorta and superior mesenteric artery, correlate with renal function tests..PANCREAS: No significant abnormality noted..RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted..BONES, SOFT TISSUES: Left hemidiaphragm slightly nodular though not conclusive, this should be followed on subsequent exam..OTHER: No significant abnormality noted..
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Interval enlargement of right hilar mass which has now cavitated. The mass encases the right main bronchus causing narrowing and extends along the bronchus intermedius and middle/lower lobe are airways proximally. Fluid in a right apical bulla could indicate superinfection.
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Generate impression based on findings.
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dementia changes 9 months 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.There is subcortical hypodensity present.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.There is periventricular and subcortical white matter hypodensity present which is a nonspecific finding. This could be vascular related but could also be related to a neurodegenerative disorder. No focal lesions are appreciated intracranially though MRI is more sensitive in detection of intracranial lesions
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Generate impression based on findings.
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Reason: Pt is an 83 y/o female with met urothelial cancer, evaluate for PE given dyspnea, chest pain History: dyspnea, chest pain Examination mildly limited by patient motion.PULMONARY ARTERIES: Technically adequate examination. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Minimal centrilobular emphysema. Diffuse mild bronchial wall thickening suggestive of bronchiolitis.MEDIASTINUM AND HILA: Cardiac size is within normal limits without pericardial effusion. Mild coronary artery calcifications. Mild atherosclerotic changes of the thoracic aorta. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy.Status post left nephrectomy.Multiple left periaortic mass is incompletely visualized on this examination.
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1.Technically adequate examination without evidence of a pulmonary embolus.2.Minimal centrilobular emphysema with mild bronchial wall thickening suggestive of bronchiolitis.
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Generate impression based on findings.
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Epigastric pain. Patient with lymphadenopathy. CHEST:LUNGS AND PLEURA: Numerous scattered and largely calcified subcentimeter nodules bilaterally. No effusions or suspicious nodules or masses.MEDIASTINUM AND HILA: No distinct lymphadenopathy. The cardiac and pericardium are within limits of the been extensive heavy coronary calcifications and a possible stent in the LADSmall hiatal herniaCHEST WALL: Mild thoracic and upper lumbar spine degenerative changesABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Diffuse homogeneous appearance with a single 1.5 x 1.1 cm ill-defined nodular abnormality in the right hepatic lobe (image 83 series 3). Although this may be partially due to phase contrast, this focal hypodensities not distinctly benign appearing and may warrant dedicated follow up imagingSPLEEN: GranulomaADRENAL GLANDS: Small questionable nodularity in the right adrenal (image 85 series 3). Left adrenal unremarkableKIDNEYS, 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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1. Granulomatous disease exposure without discrete focal pulmonary abnormality2. Nonspecific hepatic focal hypodensity possibly warranting dedicated imaging
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Generate impression based on findings.
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48 year old man with family history of coronary artery disease referred for evaluation of coronary calcification.CPT: 75571 Calcium Score:LM: 0LAD: 327LCx: 0RCA: 0Total: 327, This represents the 96th percentile for this patients age and gender.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. 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 327; 96th percentile for age and gender.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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37-year-old male patient. Reason: interval change in opacities History: history of atypical pna, hiv+ LUNGS AND PLEURA: Significant interval decrease in lower lung zone predominant patchy groundglass opacities. Interval resolution of bilateral scattered subcentimeter nodules. Scattered pulmonary cysts are stable. Minimal atelectasis is stable.No new superimposed acute pulmonary abnormality.MEDIASTINUM AND HILA: Large main pulmonary artery along with prominent or dilated distal pulmonary arteries and arterioles is suggestive of pulmonary artery hypertension, stable.Moderate cardiomegaly with large right atrium.Interval placement of right-sided central line with catheter tip at the cavoatrial junction.No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Increased density of the spine is unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Left adrenal nodularity stable compared to prior.Enlarged spleen is incompletely visualized.
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Interval resolution of bilateral scattered subcentimeter nodules and significant interval decrease in lower lung zone predominant patchy ground glass opacities.
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Generate impression based on findings.
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Reason: 87 yo M with h/o malaise - treating for HCAP due to abnormal CXR, most recent 12/4 XR recommends CT chest for further evaluation History: PNA LUNGS AND PLEURA: Right upper lobe with multiple ill-defined air space opacities, bronchial wall thickening and bronchiectasis, suggestive of a multifocal infection.Scattered granulomas.Small bilateral pleural effusions with associated compressive atelectasis and dependent edema.MEDIASTINUM AND HILA: Cardiac size within normal limits with small amount of pericardial fluid versus thickened pericardium. Moderate coronary artery calcifications and annular calcifications. Moderate atherosclerotic changes of the thoracic aorta.Multiple large hypoattenuating lesions in the thyroid gland likely represent a multinodular goiter.CHEST WALL: Moderate multilevel degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Large left renal cyst is incompletely visualized.Moderate atherosclerotic changes of the abdominal aorta and its branches.
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1.Right upper lobe with multiple ill-defined air space opacities, bronchial wall thickening and bronchiectasis, suggestive of a multifocal infection. Continue follow-up to resolution.2.Small bilateral pleural effusions with compressive atelectasis.
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Generate impression based on findings.
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Large goiter, check for extent LUNGS AND PLEURA: Scattered micronodules with minimal edema-like changes in the dependent portions. A single 8 x 7 mm nodular density is observed in the superior right upper lobe (image 30 series 4) additional scattered nodules are also observed bilaterally and all appear relatively discrete and without definite calcifications. Continued follow up to ensure stability a be required in what most likely represents granulomatous disease exposure. No effusionMEDIASTINUM AND HILA: Extensive heterogeneous enlarged thyroid with extension into the upper mediastinum and middle mediastinum to the level of the pulmonary artery and carina. Please correlate with the neck CT given greater delineation and full extent of evaluation. Please note there is moderate to severe compression and displacement of the trachea most pronounced just below the thoracic inlet.No lymphadenopathy.The cardiac and pericardium are within limitsSmall hiatal herniaCHEST WALL: Incompletely visualized soft tissue focus in the upper right abdominal wall (image 84 series 3), possibly an injection site. Please correlate and consider dedicated imaging given incomplete evaluation.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Gallbladder largely collapsed artificially thickening gallbladder wall, if there is concern, consider dedicated ultrasound imaging. The remainder of the upper abdomen is otherwise unremarkable
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Large goiter with marked compression of the trachea and nonspecific scattered pulmonary nodules likely representing old granulomatous disease however serial imaging and/or stability is required to confirm.
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Generate impression based on findings.
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Mouth cancer, adenoid cystic carcinoma. Please reevaluate CHEST:LUNGS AND PLEURA: Scattered pulmonary nodules are again identified with the largest reference well marginated right upper lobe nodule showing mild increase. Currently measures 1.5 x 1.2 cm (image 20 series 4) from a prior measurement of 1.2 x 1.1 cm. Some nodules are pleural based and also larger; however the small mildly cavitary 4-mm right upper lobe nodule appears grossly unchanged (image 32 series 4).. Mild basilar atelectasis and probable mild aspiration the left lung base.MEDIASTINUM AND HILA: No lymphadenopathyThe cardiac and pericardium are within limitsMild hiatal herniaCHEST WALL: Minimal degenerative changes scattered throughout the thoracic spine without additional lytic or sclerotic osseous lesions.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: 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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Continued minimal slow growth of the multiple pulmonary nodules with the largest reference. Suspected indolent metastatic foci
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Generate impression based on findings.
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Head and neck cancer, follow-up LUNGS AND PLEURA: Postradiation change observed in both apices unchanged in appearance. No suspicious new nodules or masses. No effusions. Scattered micronodules and post aspiration and/or minimal scarring. No suspicious new acute intrapulmonary abdomen date.MEDIASTINUM AND HILA: . The lymph node in the midline between the thyroid and isthmus remains 1.2 cm in short axis unchanged (image 16 series 3). Borderline lymph nodes are otherwise observed without suspicious new abnormality. The reference left hilar lymph node remains 2.0 cm in short axis (image 36 series 3), previously 2.1 cm.The cardiac and pericardium are well within normal limits. SVC catheterCHEST WALL: Degenerative changes of the shoulders bilaterally mildly greater on the rightUPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. G-tube. No additional findings in the upper abdomen in this limited evaluation
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Postradiation change without suspicious new abnormality and stable minimal borderline lymph nodes. See reference measurement above
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Generate impression based on findings.
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Bladder cancer LUNGS AND PLEURA: Minimal left basilar scarring or atelectasis with additional acute abnormality. No effusions. No suspicious nodules or masses.MEDIASTINUM AND HILA: No lymphadenopathyThe cardiac and pericardium are within limits.Small hiatal herniaCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Partially visualized suspected renal ureteral catheters. No additional advise observed in this limited view of the upper abdomen
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Minimal scarring and or atelectasis without suspicious findings to suggest metastatic disease
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Generate impression based on findings.
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61-year-old male status post liver transplant with yellow nasal excretion. Evaluate for infection. CHEST:LUNGS AND PLEURA: Interval improvement in bilateral basilar opacities, right more than left, including subsegmental consolidation in the right base and centrilobular groundglass opacities in both bases, suspected to be due to infection and/or aspiration. Right apical opacities have also improved. Stable small right pleural effusion.MEDIASTINUM AND HILA: Tracheostomy tube in place. Right central venous catheter terminates in proximal SVC. Left central venous catheter terminates in distal SVC.Heart is normal in size without pericardial effusion. Multiple prominent mediastinal lymph nodes not significantly changed, and may be reactive in nature. Severe coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Status post liver transplant, with multiple surgical clips in porta hepatis region. Evaluation of vasculature not possible given lack of IV contrast. Interval removal of biliary stent, with no evidence of intra-or extrahepatic biliary ductal dilation.SPLEEN: Splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Again noted nonobstructing punctate calculi in calices of left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild increase in moderate amount of ascites fluid. No evidence of bowel obstruction. Gastrojejunostomy tube in place. NG tube is coiled on itself in the proximal duodenum, with tip in stomach antrum.BONES, SOFT TISSUES: Extensive degenerative changes in the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in place.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mild increase in moderate to large amount of ascites fluid. Rectal tube in place.BONES, SOFT TISSUES: Extensive degenerative changes in the lumbar spine.OTHER: No significant abnormality noted
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1.Improved basilar predominant lung opacities, most compatible with bronchiolitis and/or aspiration.2.Mild increase in moderate amount of ascites fluid.3.NG tube folded on itself in the proximal duodenum.
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Generate impression based on findings.
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51-year-old female with nausea and vomiting. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Subcentimeter hypoattenuating focus in right lobe too small to characterize, but likely cyst. Gallbladder is nondistended and appears unremarkable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable subcentimeter hypodensity left kidney, most compatible with cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval resolution of previously seen dilated loops of bowel, with no evidence of obstruction current exam. No bowel thickening, free fluid, or free intraperitoneal air.BONES, SOFT TISSUES: Stable compression deformity of L1 vertebral body.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Multiple lesions arising from uterus, some of which are calcified, most consistent with fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No evidence of bowel obstruction. Diverticulosis affects the distal colon, without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Resolution of previously seen obstruction, with no evidence of obstruction or other significant abnormality account for symptoms on current exam.
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Generate impression based on findings.
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76-year-old male with newly diagnosed advanced prostate cancer. ABDOMEN:LUNG BASES: Large right pleural effusion and associated complete right lower and partial right middle lobe consolidation/atelectasis. Trace left pleural effusion. Fluid and mucus material is present in the bronchus intermedius (series 4, image 11).Nonspecific punctate micronodule measuring less than 4 mm noted in the inferior aspect of right upper lobe (series 4, image 4).Status post median sternotomy. Moderate coronary artery calcifications. Heart size normal. Multiple prominent, nonspecific mediastinal lymph nodes.LIVER, BILIARY TRACT: Cyst is present in the liver dome. No intra-or extrahepatic delayed ductal dilation. Status post cholecystectomy. Lack of IV contrast limits evaluation for lesions.SPLEEN: No significant abnormality notedPANCREAS: Pancreas is atrophic.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral percutaneous nephroureterostomy tubes are in place. Deformity of left renal parenchyma most consistent with scarring. No hydroureter or hydronephrosis bilaterally.RETROPERITONEUM, LYMPH NODES: Multiple small retroperitoneal lymph nodes. Severe atherosclerotic calcifications affect the aorta and its branches, without evidence of aneurysmal dilation.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Nephroureterostomy tubes in place. Foley catheter in place.LYMPH NODES: Several mildly enlarged pelvic lymph nodes are noted; for reference, left internal iliac node measures 1.2 x 1.4 cm (series 3, image 134).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Femoral-femoral bypass graft and right common iliac artery stent noted (series 3, image 153).
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1.Large right pleural effusion and overlying right lower and right middle lobe consolidation/atelectasis.2.Bilateral percutaneous nephroureterostomy tubes are in place, without evidence of hydronephrosis.3.Several nonspecific prominent pelvic lymph nodes.4.Nonspecific punctate micronodule in right upper lung lobe
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Generate impression based on findings.
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39-year-old male patient with tachypnea and chest pain. Evaluate for a pulmonary embolus. PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Bilateral atelectasis, left greater than right.MEDIASTINUM AND HILA: Left sided PICC line with catheter tip at the cavoatrial junction.Cardiac size within normal limits without pericardial effusion.Mediastinal surgical clips in place with aortic valve replacement.No mediastinal or hilar lymphadenopathy.CHEST WALL: Median sternotomy wires with chronic osseous nonunion.No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of a pulmonary embolus.Median sternotomy wires with osseous nonunion may be within normal limits if the patient had recent surgery.
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Generate impression based on findings.
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62 year old female with lymphoma. CHEST:LUNGS AND PLEURA: Several micronodules are noted bilaterally, nonspecific but likely benign. Focal ground glass opacity in the right lower lobe likely represents subsegmental atelectasis (series 4, image 62). No consolidation or pleural effusions.MEDIASTINUM AND HILA: No pathologically enlarged mediastinal lymph nodes. The heart is normal in size without pericardial effusion.Nonspecific hypoattenuating nodule in left thyroid lobe.CHEST WALL: Status post right mastectomy and right axillary lymph node dissection.. No pathologically enlarged left axillary lymph nodes.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly. Decreased parenchymal attenuation consistent with hepatic steatosis, which decreases sensitivity for detecting lesions. Subcentimeter well-circumscribed hypodensity in the right lobe is too small to accurately characterize but most consistent with cyst (series 3, image 81).SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypodensity in superior left renal pole too small to characterize but most compatible with cyst.RETROPERITONEUM, LYMPH NODES: Several enlarged retroperitoneal lymph nodes; for reference, aortocaval node measures 1.1 x 1.5 cm (series 3, image 108). 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: Enlarged right external iliac node measures 1.0 x 1.7 cm (series 3, image 144). Mildly enlarged left external iliacBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Well-defined lucency in the left pubis most likely degenerative in nature.OTHER: No significant abnormality noted.
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1.Several enlarged retroperitoneal and pelvic lymph nodes.2.Status post right mastectomy and right axillary lymph node dissection. 3.4.Several punctate lung micronodules, nonspecific but likely benign in etiology.5.Hepatomegaly and hepatic steatosis.
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Generate impression based on findings.
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17 year-old female Reason: please evaluate for typhlitis or appendicitis History: mid to right lower quadrant abd pain x 1 week; today, has RLQ to mid abdominal tenderness; no fever CHEST:LUNGS AND PLEURA: Scattered upper lobe ground glass nodules, likely post infectious/inflammatory in etiology. Interval resolution of previously seen lung consolidation.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. No pericardial effusion. Central venous catheter tip in the distal SVC.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral incompletely evaluated hypoattenuating foci in the peripheral kidneys.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: The appendix is not definitively visualized. No inflammatory changes are identified in the right lower quadrant. A minimal amount of free fluid is noted in the right lower quadrant and pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. No specific evidence of typhlitis or appendicitis. Minimal nonspecific amount of free fluid in the right lower quadrant/pelvis, which may be physiologic in etiology.2. Bilateral hypoattenuating foci in the kidneys as discussed above. These are nonspecific and may represent scarring or focal pyelonephritis.
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Generate impression based on findings.
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50 year-old female with metastatic colon cancer to lung and liver. CHEST:LUNGS AND PLEURA: Centrally cavitary nodule in superior segment of left lower lobe measures 1.2 x 0.9 cm (series 5, image 43). Additional nodules noted in the left lower lobe along the posterior heart border (series 5, image 54). Several other punctate, nonspecific micronodules noted bilaterally (series 5, image 56, 77).MEDIASTINUM AND HILA: Multiple heterogeneous nodules in the right thyroid lobe. Heart is normal in size without pericardial effusion. Right port catheter tip in SVC/RA junction.No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple heterogeneous masses in both lobes of the liver, with associated mild intrahepatic biliary ductal dilation. For reference, the right lobe lesion measures 3.3 x 4.6 cm (series 3, image 3).Hepatic veins and portal veins appear patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Large cyst measuring 5.5 cm arising from left kidney, unchanged. Mild left hydronephrosis.RETROPERITONEUM, LYMPH NODES: Multiple enlarged retroperitoneal lymph nodes; for reference, pre-aortic node measures 1.1 x 1.3 cm (series 3, image 120).BOWEL, MESENTERY: Right lower quadrant ostomy in place. No bowel obstruction.BONES, SOFT TISSUES: Leftward thoracolumbar scoliosis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple hypoattenuating lesions are noted in the uterus, which may represent degenerating fibroids. Cystic lesions noted in region of the right adnexa are not entirely evaluated on this exam but may represent ovarian neoplasm, possibly seroma given close association with surgical clips; largest of these measures approximately 4.3 x 3.4 cm (series 3, image 168).BLADDER: No significant abnormalityLYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes in the rectum. Presacral soft tissue thickening likely postsurgical in nature.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Multiple hepatic metastasis.2.Lung nodules are not entirely specific but most likely represent metastases given patient's history of colon cancer.3.Postsurgical changes in the bowel.4.Multiple hypoattenuation lesions arising from uterus, which may represent degenerating fibroids.5.Cystic lesions in region of right adnexa are of unclear etiology; pelvic ultrasound should be considered for better characterization.6.Multiple heterogenous right thyroid nodules.
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Generate impression based on findings.
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44-year-old female patient with sharp left-sided chest pain, dyspnea and elevated d-dimer. Evaluate for possible left-sided pulmonary embolism. PULMONARY ARTERIES: Technically limited study with poor opacification of the pulmonary artery on repeat imaging. No evidence of a pulmonary embolus in the main pulmonary arteries.LUNGS AND PLEURA: Multiple scattered nonspecific micronodules. No focal opacity or pleural effusion.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.No mediastinal or hilar lymphadenopathy.CHEST WALL: Mild multilevel degenerative changes of the thoracic spine.Scattered bilateral mildly enlarged axillary lymph nodes.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia. Mildly thickened left adrenal gland is incompletely evaluated on this examination.
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No evidence of a pulmonary embolus in the main pulmonary arteries.No specific abnormality to account for patient's symptoms.
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Generate impression based on findings.
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Reason: please evaluate for pulmonary embolus History: POD2 s/p sacrocolpopexy, suddenly with intense chest pain PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolism. Normal caliber main pulmonary artery.LUNGS AND PLEURA: Impacted bronchioles right upper lobe suggestive of occult infection or aspiration.Small focus of consolidation just above the right hemidiaphragm could be scarring. MEDIASTINUM AND HILA: Moderate coronary artery calcification in the LAD is present.There is no mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative abnormalities of thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia. Cholelithiasis without evidence of cholecystitis.
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1. No evidence of pulmonary embolism.2. Impacted bronchioles right upper lobe could represent occult infection, or even minimal MAI.
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Generate impression based on findings.
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Reason: 64yoF s/p BiV-ICD, ESRD on HD, and NICM s/p LVAD placement. Currently w/persistent abdominal pain and emesis s/p feeding. Afebrile, abdominal exam benign. History: abdominal pain, emesis ABDOMEN: Lack of intravenous contrast limits evaluation of solid organs. Lack of enteric contrast limits evaluation of bowel. Streak artifact from LVAD limits examination.LUNG BASES: Basilar ground-glass opacities and consolidation compatible with aspiration/infection but appeared slightly increased when compared to the prior study. Note made of bilateral pleural effusions, which also appear slightly increased when compared to prior study. No evidence of pneumothorax.LIVER, BILIARY TRACT: Trace perihepatic ascites. Gallbladder sludge in the fundus.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left upper pole renal cyst. Again seen are nonspecific foci of curvilinear high attenuation within the left renal hilum, unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdominal aorta and its branches without aneurysmal dilatation.BOWEL, MESENTERY: No evidence of bowel obstruction. No drainable fluid collections. Gastrostomy tube in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: LVAD in place. Marked cardiomegaly. The pulmonary artery is dilated suggestive of pulmonary artery hypertension. The hepatic veins and IVC are dilated which can be seen in elevated right heart pressures.
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1.Basilar consolidation and bilateral pleural effusions compatible with infection/aspiration.2.No drainable fluid collections in the abdominal cavity.3.Gallbladder sludge without evidence of acute cholecystitis.
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