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Generate impression based on findings.
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Female 90 years old; Reason: eval for acute inflammatory process History: abdominal pain ABDOMEN:LUNGS BASES: A small bilateral effusions occupying less than 10% of the hemithoraces with associated basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic atrophy with pancreatic ductal dilatation measuring 4 mm. Within the tail of the pancreas, there is a 1.4 x 1.3 cm focal mass (image 31/series 4). No peri-pancreatic inflammation or infiltration.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild echogenicity lack of enhancement of the kidneys. No focal lesion is evident.RETROPERITONEUM, LYMPH NODES: Severe calcific arteriosclerotic disease affects the aorta .BOWEL, MESENTERY: Small bowel is normal in caliber. It is suboptimally evaluated due to the lack of enteric contrast.BONES, SOFT TISSUES: Degenerative changes affect the lumbar spine. Left paraspinal muscle lipoma.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified uterine fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Distended rectum measuring up to 8.2 cm with mild peri-rectal inflammation.BONES, SOFT TISSUES: Severe degenerative changes affect the right sacroiliac joint with subtle areas of erosion. OTHER: No significant abnormality noted.
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1.Findings a stercoral colitis with mild perirectal inflammation2.1.4-cm hyper vascular mass in the tail of the pancreas, follow up with CT pancreas protocol or MRI is suggested for further classification.3.Findings discussed with Dr.Kirilichin at the time of dictation via telephone.
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Generate impression based on findings.
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Reason: METASTATIC ANAL CANCER WITH LUNG METS ON CHEMOTHERAPY HOLIDAY History: ANAL CANCER CHEST:LUNGS AND PLEURA: Pulmonary nodules are no longer identifiable, there is now complete atelectasis of the right middle and lower lobes from central bronchial obstruction. A new moderate-sized right pleural effusion is also present.Calcified granuloma left lower lobe and prior wedge resection sutures are present. MEDIASTINUM AND HILA: Mediastinal lymph nodes have enlarged bilaterally.A right hilar mass is not defined enough to measure, but has increased in size now encroaching on the left atrium and obstructing the right descending bronchus.Mediastinal calcifications and surgical clips are unchanged. Small pericardial effusion, unchanged.CHEST WALL: Right chest wall port, tip at the SVC/RA junction level.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: New numerous hepatic metastases are present, the largest 17 x 19 mm segment IVa or IVb, image 91 series 3. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered renal cystlike hypodensities. 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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Disease progression in the chest and liver.
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Generate impression based on findings.
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Reason: eval for pancreatitis History: 14yo M with elevated pancreatic enzymes with abdominal distension ABDOMEN:LUNG BASES: Scattered patchy opacities are identified at the lung bases. No pleural effusion is seen. No pericardial effusion is identified.LIVER, BILIARY TRACT: The gallbladder is markedly distended. No focal hepatic lesions. No intrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: Minimal peripancreatic inflammatory stranding is present, compatible with clinical history of pancreatitis. No evidence of pancreatic necrosis, pseudocyst, or other sequelae of a complicated pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastrostomy tube is in the stomach.BONES, SOFT TISSUES: Severe dextroscoliosis of the thoracolumbar spine is again noted.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Gastrostomy tube in the stomach andBONES, SOFT TISSUES: Severe dextroscoliosis of the thoracolumbar spine. Chronic hip dislocation is again noted. OTHER: No significant abnormality noted
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1. Patchy opacities in the lung bases, which may represent infection or aspiration.2. Findings as above consistent with acute uncomplicated pancreatitis.3. Marked distention of the gallbladder without other CT findings of cholecystitis.
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Generate impression based on findings.
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33-year-old female patient with shortness of breath and chest pain. History of breast cancer status post mastectomy with flap reconstruction two weeks ago. Evaluate for a pulmonary embolus. PULMONARY ARTERIES: Technically adequate study without evidence of a pulmonary embolus.LUNGS AND PLEURA: Small scattered reticular opacities in the anterior right upper and right middle lobes are consistent with radiation change. No suspicious pulmonary nodules or lesions. No pleural effusion.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion.No mediastinal or hilar lymphadenopathy.CHEST WALL: Small fluid collections in the bilateral breast reconstructions, measuring up to 14 mm. There are bilateral surgical drains in both breasts, however the drains are not within these fluid collections. Fluid collections may represent postoperative seromas versus infectious fluid collection.No axillary lymphadenopathy.Two subcentimeter lucent foci in the T7 vertebral body.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Partially visualized surgical drain in the subcutaneous tissues of the right abdominal wall. Subcutaneous anterior abdominal wall soft tissue stranding.
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1.Technically adequate study without evidence of a pulmonary embolus.2.Small fluid collections in the bilateral breast reconstructions. Fluid collections may represent postoperative seromas.3.T7 vertebral body lucent foci are most likely benign, however recommend dedicated MR spine to further confirm.
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Generate impression based on findings.
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50 year old male. Seminoma. Reason: history of clinical stage 1 testicular cancer, assess for recurrence. CHEST:LUNGS AND PLEURA: Few scattered pulmonary nodules in the lingula as seen on image 29/MIP and right middle lobe images 39,46/MIP are nonspecific and stable. The pleural spaces remain clear. MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN: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: Stable left renal cystRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable negative examination.
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Generate impression based on findings.
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Thyroid goiter. There is diffuse enlargement of the thyroid gland, right greater than left lobes. The right lobe measures up to 5.0 AP x 5.2 RL x 10.0 SI cm and extends inferiorly into the superior mediastinum to the level of the T3 vertebra. The left lobe measures up to 2.4 AP x 3.7 RL x 7.7 SI cm. There is narrowing of the trachea to 7 mm in width. The thyroid is also diffusely heterogeneous with multiple predominantly hypoattenuating nodules and sparse calcifications. The left internal jugular vein is mildly displaced laterally and mildly effaced by the adjacent enlarged thyroid gland. The major cervical vessels are otherwise patent. There is no significant cervical lymphadenopathy. The major salivary glands are unremarkable. There are no lytic or blastic lesions. There is a 7 mm diameter midline nasopharyngeal hypoattenuating focus that may represent a retention cyst or Thornwaldt cyst. The partially imaged intracranial structures and orbits are grossly unremarkable. The imaged superior portions of the lungs are grossly clear.
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Diffuse heterogeneous enlargement of the thyroid gland, right greater than left, with numerous nodules is compatible with multinodular goiter that narrows the trachea to 7 mm in width.
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Generate impression based on findings.
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Recurrent BOT SCC treated with carbo/taxol, now on clinical trial (IRB 120161) who is receiving cetux only. Developed clinical progression after 17 cycles. Started MEHD 11/13/13. Head: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. Neck: There are post-treatment findings related to total glossectomy with graft reconstruction, neck resection, and tracheostomy. Superficial to the cluster of right-sided surgical clips at the graft pedicle, there is soft tissue stranding and skin defect that represents an ulceration. A previously described rim-enhancing fluid collection closely associated with this air collection has otherwise resolved. There is also an air-filled 10 mm wide defect in the left lateral parapharyngeal space. There is diffuse effacement of the parapharyngeal fat; however, no definite soft tissue mass is identified. There is no definite significant lymphadenopathy by CT size criteria. The airways are patent. The remaining thyroid and major salivary glands are unchanged. There is mild atherosclerotic plaque involving the bilateral carotid bifurcations. There is multilevel degenerative spondylosis.
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1.Extensive post-treatment findings without definite evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.2.Residual air-filled right neck skin defect at the surgical incision site and air-filled focus in the left parapharyngeal space, which may be related to tissue necrosis.3. No evidence of intracranial metastases.
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Generate impression based on findings.
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72-year-old male with metastatic colon cancer. CHEST:LUNGS AND PLEURA: Postoperative in the right lower lobe.Pleural based left lower lobe reference nodule unchanged, measuring 6 mm, previously measured 6 mm (series 4, image 40). Several other punctate micronodules unchanged. No new suspicious nodules. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Reference right hilar node is not significantly changed, measuring 1.3 x 1.5 cm, previously measured 1.3 x 1.4 cm (series 3, image 57).Heart is normal in size without pericardial effusion. Mild coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Mild intrahepatic and extrahepatic biliary ductal dilation appears similar. Status post resection of left lobe.New ill-defined area of hypoattenuation in inferior aspect of right lobe is nonspecific (series 3, image 115).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable left renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Stable nonenlarged reference mesenteric node measures 7 mm, previously measured 7 mm (series 3, image 150).No significant change in focal, centrally hypoattenuating wall thickening in the stomach cardia (series 3, image 99).BONES, SOFT TISSUES: Degenerative changes in lumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Unchanged homogeneous oval soft tissue attenuation in left inguinal canal likely represents retracted testicle (series 3, image 212).OTHER: No significant abnormality noted
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1.Stable reference lymph nodes.2.New ill-defined area of hypoattenuation in inferior edge of right liver lobe, of unclear etiology and continued follow-up recommended.3.No significant change in focal wall thickening in proximal stomach, which is nonspecific but may represent underlying neoplasm such as GIST.
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Generate impression based on findings.
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46-year-old female with history of gastric cancer. Reason: gastric cancer s/p resection ypT4N3M1 (peritoneum) R1 with disease left behind 7/10/13. Evaluate for interval change. CHEST:LUNGS AND PLEURA: Biapical fibrosis, unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Left sided venous access device is in the expected position. ABDOMEN:LIVER, BILIARY TRACT: There are multiple punctate hypodense lesions in the liver, stable.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Nodular lesion along the right hemidiaphragm measures 1 x 0.8 cm image number 99, series number 3.Index perigastric node is not seen on today's study. Index retroperitoneal lymph node measures 7-mm in diameter on image number 125, series number 3.BOWEL, MESENTERY: Diffuse wall thickening of the gastric antrum. Gastric wall thickness measurement is not a reliable reproducible measurement, therefore, was not obtained.Previously described peritoneal thickening is not well seen on today's study.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No measurable metastatic disease. No significant change from previous study.
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Generate impression based on findings.
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46-year-old female. History of left scapular subcutaneous NHL lymphoma. Please restage. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. Specifically, no evidence of pathologic size lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scoliosis. No lytic or blastic disease.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Peliosis degenerative changes. No lytic or blastic disease.OTHER: No significant abnormality noted.
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Stable examination. No measurable metastatic or recurrent disease.
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Generate impression based on findings.
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57-year-old male with history of non-Hodgkin lymphoma. Reason: DLBCL of neck, please restage. History: right clavicular swelling. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Unchanged small mediastinal lymph nodes.CHEST WALL: No significant abnormality notedABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver and cholelithiasis are unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: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: Bilateral fat-containing inguinal hernias.
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No significant change from previous study. No measurable metastatic disease or recurrence.
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Generate impression based on findings.
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Female 75 years old; Reason: kidney stones History: L flank pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver has a smooth contour. No evident lesion. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Prominence of the left proximal collecting system . No calcified stones are evident. No perinephric fluid collections or perinephric inflammatory changes.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: Colonic diverticulosis.BONES, SOFT TISSUES: Degenerative changes of the lower lumbar spine.OTHER: No significant abnormality noted.
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1.No evident nephrolithiasis or hydronephrosis.
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Generate impression based on findings.
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Male 86 years old; Reason: History metastatic renal cancer, on observation, assess for progression History: none CHEST:LUNGS AND PLEURA: No suspicious lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: Left second rib lytic changes and expansion unchangedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Suboptimal evaluation of the hepatic parenchyma without contrast. The right hepatic lobe lesion is not evident.SPLEEN: No significant abnormality notedPANCREAS: Hyperdense uncinate process mass measures 3.9 x 2.3 cm (image 105/series 3) previously, 3.5 x 2.4 cm. There is mild age-related pancreatic atrophy. There is fullness of the pancreatic tail, unchangedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left nephrectomy. Hyperdense lesions in right kidney without evident change. These are suboptimally evaluated without contrast.RETROPERITONEUM, LYMPH NODES: Calcific arthrosclerotic disease of the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Focal chronic defect of the left ilium is unchanged and may be congenital.OTHER: No significant abnormality noted.
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1.Slight increase in the size of the uncinate process mass. 2.Right kidney hyperdense lesions, unchanged.
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Generate impression based on findings.
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62 year-old male with rectal cancer. CHEST:LUNGS AND PLEURA: Stable micronodule along right major fissure. No new suspicious nodules. Subsegmental atelectasis in the right lung base. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Stable mild cardiomegaly. No lymphadenopathy.CHEST WALL: Healed left rib fractures. 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: Stable bilateral subcentimeter hypodensities, most compatible with cysts. Stable volume loss in upper left kidney, consistent with scarring.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of recurrence or metastatic disease.
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Generate impression based on findings.
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71-year-old male with metastatic prostate cancer. CHEST:LUNGS AND PLEURA: Stable micronodules. No new suspicious nodules.MEDIASTINUM AND HILA: No significant change in reference lymph nodes. Pretracheal node measures 1.0 x 1.0 cm, previously measured 1.0 x 0.8 cm (series 3, image 36). Right hilar node measures 1.4 x 1.2 cm, previously measured 1.4 x 1.3 cm (series 3, image 50).Heart is normal size without pericardial effusion.CHEST WALL: Multiple sclerotic lesions in osseous structures, compatible with known metastatic disease and appearing similar.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephroureterostomy stent proximal tip in the superior calix of right kidney. The left nephroureterostomy stent has migrated slightly inferiorly, with tip now located in the inferior most aspect of left renal pelvis (series 3, image 115). No hydronephrosis bilaterally.Subcentimeter hypoattenuating foci in both kidneys too small to characterize but unchanged and most compatible with cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple sclerotic lesions in osseous structures consistent with known metastatic disease and appearing similar.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes including multiple clips bilaterally.BONES, SOFT TISSUES: Multiple sclerotic lesions in osseous structures consistent with known metastatic disease and appearing similar.OTHER: No significant abnormality noted
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1.No significant change in extensive osseous metastatic disease; please refer to bone scan report for better evaluation. 2.No significant change in mediastinal reference lymph nodes.
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Generate impression based on findings.
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Papillary carcinoma thyroid with prior recurrences. There are postoperative findings related to total thyroidectomy and bilateral neck dissection. There is a 4 x 6 mm right level 6 lymph node and two right level 2 lymph nodes that measure up to 7 x 11 mm, which correspond to the hypermetabolic nodes on PET. There is mild circumferential thickening of the esophageal wall at the level of the thyroidectomy bed, which likely represents treatment-related edema. There is unchanged nonspecific prominence of the adenoids. The airways are otherwise patent. The major salivary glands are unremarkable. There are no lytic or blastic lesions. There are air-fluid levels and bubbly secretions within the paranasal sinuses. The partially imaged intracranial structure are grossly unremarkable. The partially imaged lungs are clear.
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The 4 x 6 mm hyperattenuating node in the right level 6 lymph node and two right level 2 lymph nodes that measure up to 7 x 11 mm, which demonstrated corresponding hypermetabolism on PET, although FNA was negative for malignancy.
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Generate impression based on findings.
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39 year old female with history of necrotizing pancreatitis and pseudocyst, completion of 4 weeks of IV antibiotics. ABDOMEN:LUNG BASES: Interval decrease in small left pleural effusion and overlying atelectasis/consolidation.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Pancreatic parenchyma enhances homogeneously. No pancreatic duct dilation. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Enteric tube terminates in the jejunum.Interval removal of transgastric drain from peripelvic fluid collection. Collection anterior to the pancreas has significantly decreased in size, currently measuring 6.5 x 1.6 cm, previously measured 10.5 x 2.9 cm; the previously seen gas within this collection has resolved (series 3, image 37). The extension of this fluid collection into the left pericolic gutter has also decreased, currently measuring 1.6 x 3.3 cm in greatest transaxial dimension, previously measured 3.7 x 4.3 cm (series 3, image 53); the left lower quadrant percutaneous drain continues to be present within this portion of the collection.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: IUD again noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Previously measured collection in the upper pelvis is nearly completely resolved and is not accurately measurable (series 3, image 85). A small collection continues to be seen posterior to the uterus, measuring approximately 3.4 x 1.6 cm (series 3, image 89).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval decrease in abdominal and pelvic fluid collections, as described above.
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Generate impression based on findings.
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56-year-old male with metastatic renal carcinoma. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No adenopathy. Coronary artery calcifications. Heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal resected. Nodular thickening of inferior right adrenal unchanged.KIDNEYS, URETERS: Status post nephrectomy. No evidence of local recurrence.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: New haziness around the root of mesentery with multiple associated prominent mesenteric nodes nonspecific, which may be due to sclerosing mesenteritis (series 6, image 134).BONES, SOFT TISSUES: Stable compression deformity of L1 vertebral body.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No evidence of disease recurrence or metastases.2.New mild haziness and prominent lymph nodes in root of mesentery are nonspecific but may be due to inflammatory etiology such as sclerosing mesenteritis.
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Generate impression based on findings.
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69-year-old female with history of gingival cancer status post mandibulectomy, chemoradiation therapy, reevaluate Streak artifact from dental hardware limits evaluation of the adjacent structures. Postoperative findings related to resection of the right marginal mandibulectomy with bone graft, metallic plate reconstruction and right neck dissection.Interval decrease in the ill-defined heterogeneous soft tissue in the right parapharyngeal and medial masticator spaces. Unchanged patchy sclerosis of the right mandible adjacent to the surgical margins without evidence of erosions to suggest tumor involvement.Reference right level 1a lymph node measures 6 x 6 mm (series 5 image 37), previously measured 8 x 9 mm. No pathologically enlarged by CT criteria lymph nodes are present.Hyperemia of the salivary glands is likely post therapeutic. Hypoattenuating left thyroid lesion unchanged. No exophytic mass or focal effacement of the aerodigestive tract. No soft tissue masses are present in the neck. Bilateral atherosclerotic calcifications at the carotid bifurcations. The major cervical vasculature is patent. The left internal jugular vein is small and faintly opacifies, unchanged.Partially visualized left central venous catheter. Increased peripheral reticulation, volume loss and fibrotic changes at the right lung apex likely secondary to prior radiation therapy. Mild left apical scarring.Mild degenerative changes of the visualized cervicothoracic spine without suspicious osseous lesions.Limited intracranial and orbital views are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear.
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1. No enhancing measurable soft tissue lesions are present in the neck. 2. No cervical lymphadenopathy by CT size criteria.
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Generate impression based on findings.
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55-year-old female with cholangiocarcinoma. CHEST:LUNGS AND PLEURA: Several lung nodules appear similar, largest in right lower lobe measuring 7 mm (series 5, image 59). MEDIASTINUM AND HILA: Right chest wall port catheter tip in distal SVC. Mild coronary artery calcifications. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Innumerable heterogeneous lesions throughout the liver parenchyma, predominantly in left lobe, are decreased in size with associated decrease in size of entire left lobe. Reference segment IV lesion measures 3.0 x 2.2 cm, previously measured 3.6 x 2.9 cm (series 3, image 86).Reference segment II lesion is difficult to measure, measuring approximately 3.8 x 3.1 cm, previously measured 4.6 x 3.5 cm (series 3, image 19).Nonvisualization of left portal vein unchanged and consistent with thrombosis.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: Reference portacaval node does not appear significantly changed, measuring approximately 1.9 x 1.4 cm, previously measured 2.1 x 1.6 cm (series 3, image 112). Reference paraesophageal node also unchanged in measures 9 mm, previously measured 10 mm (series 3, image 78).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.Decreased size of liver lesions. 2.No significant change in retroperitoneal adenopathy and lung nodules.
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Generate impression based on findings.
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Midline neck mass. There is a well-defined homogenously fluid attenuation (15 to 20 HU) lesion in the midline subcutaneous tissues inferior to the body of the hyoid that measures 22 AP x 39 RL x 22 SI mm. Thre may be a small track that extends superior from the lesion. There are no solid-appearing components within the lesion. Likewise, there is no stranding of the surrounding fat to suggest inflammation or infection. The thyroid gland itself is unremarkable. There is no significant cervical lymphadenopathy. The airways are patent. The major cervical flow voids are intact. The osseous structures are unremarkable. The partially imaged intracranial structures and orbits are grossly unremarkable. There is left tympanomastoid opacification. The paranasal sinuses are clear. The imaged portions of the lungs are clear.
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1. A well-defined homogenously fluid attenuation (15 to 20 HU) lesion in the midline subcutaneous tissues inferior to the hyoid that measures up to 39 mm likely represents a thyroglossal duct cyst and less likely a dermoid/epidermoid or venolymphatic malformation. 2. Left tympanomastoid opacification may represent otomastoiditis in the appropriate clinical setting.
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Generate impression based on findings.
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69-year-old male patient. Reason: s/p excision of basal cell CA from R nose and melanoma from R cheek, 50 pack year smoker History: hypoxia PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Moderate centrilobular emphysema.Mild septal thickening and basilar ground glass interstitial opacities consistent with edema. Trace left pleural effusion.Interval resolution of numerous micronodules in the right lung. Few scattered nonspecific micronodules remain.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Mild coronary artery calcifications. Moderate atherosclerotic changes of the thoracic aorta.Mild interval increase in mediastinal lymphadenopathy. Reference precarinal lymph node measures 2.7 x 1.4 cm (series 7 image 108), previously 2.2 x 1.4 cm. no significant hilar lymphadenopathy.CHEST WALL: Mild degenerative changes of the thoracic spine.No significant axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis without evidence of cholecystitis.Nodule on the lateral limb of the left adrenal gland measures 16 x 10 mm (7 image 283), unchanged.Right renal cyst unchanged. Mild atherosclerotic changes of the abdominal aorta and its branches.
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No evidence of a pulmonary embolus.Septal thickening, basal ground glass opacities and trace left pleural effusion consistent with edema.
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Generate impression based on findings.
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58-year-old male with history of right tongue base and left lateral tongue cancer, reevaluate Stable postsurgical changes of a resection of the right submandibular gland and right neck dissection. Volume loss at the right tongue base, unchanged. No evidence of enhancing soft tissue lesions in the neck. No lymphadenopathy by CT size criteria. The left puriform sinus is not well aerated, unchanged. The vocal cords are abducted similar to prior studies, correlate clinically for vocal cord paralysis. The thyroid gland, left submandibular gland and parotid glands are free of focal lesions.The major cervical vasculature is patent. The visualized lung apices are clear. Multi-level degenerative changes and straightening of the cervical spine without identification of suspicious osseous lesions. Mild grade 1 retrolisthesis of C6 on C7.Limited intracranial and orbital views are unremarkable. The visualized mastoid air cells and paranasal sinuses are clear.
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Stable post-treatment changes without evidence of tumor recurrence or cervical lymphadenopathy.
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Generate impression based on findings.
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76 year-old female with altered mental status. There is patchy hypoattenuation in the cerebral white matter and foci of hypoattenuation in the left basal ganglia. The ventricles, sulci, and cisterns are symmetric and prominent, representing volume loss. 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 calcification. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. Right lens prosthesis.
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1. No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Small vessel ischemic disease left basal ganglia lacunar infarcts of indeterminate age.
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Generate impression based on findings.
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49-year-old female with borderline tumor of the ovary and left for quadrant pain. ABDOMEN:LUNG BASES: Subcentimeter hypodensities in right lobe are too small to characterize but most compatible with benign cysts. No suspicious lesions identified.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensity in right kidney too small to characterize but most compatible with benign cyst (series 3, image 42).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis. No obstruction or other acute abnormality.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: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No specific abnormality to account for symptoms.2.Diverticulosis without evidence of diverticulitis.
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Generate impression based on findings.
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Diagnosed 2010 with stage 1A DLBCL of the jaw, 70% DLBCL/30% grade 3B follicular lymphoma. Received 4 cycles R-CHOP c/b neutropenia, but no XRT. Clavicular swelling. There is unchanged volume loss of the fat in the left submental space and diffuse sclerosis within the left mandibular body without evidence of discrete mass lesions or significant cervical lymphadenopathy. The Waldeyer ring structures are unremarkable. The thyroid and major salivary glands appear unchanged. The major cervical vessels are patent. The partially imaged intracranial structures are grossly unremarkable. The imaged portions of the lungs are clear.
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Stable post-treatment findings without evidence of tumor recurrence or significant cervical lymphadenopathy.
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Generate impression based on findings.
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Reason: h/o tongue cancer ; eval for mets History: none LUNGS AND PLEURA: Stable benign appearing micronodules without evidence of metastases in the lungs or pleura.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Mild/moderate LAD coronary calcifications identified.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of metastases, or other significant abnormality.
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Generate impression based on findings.
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75-year-old male patient. Reason: patient with lung CA, COPD presenting worsening SOB, cough, hypoxia and new hemoptysis History: evaluate for PE or other etiology re hemoptysis PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus in the left lung. There is little blood flow to the right lung.LUNGS AND PLEURA: Redemonstrated are postoperative changes of a right upper lobectomy with volume loss and mediastinal shift. There is complete atelectasis and consolidation of the right lung with bronchiectasis.Severe centrilobular emphysema in the left lung. New trace left-sided pleural effusion with compressive atelectasis.MEDIASTINUM AND HILA: Mediastinum shifted to the right. Heart size within normal limits with trace pericardial effusion. Severe coronary artery calcifications. Severe atherosclerotic changes of the thoracic aorta.No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Right rib surgical fractures are unchanged. Partial collapse of multiple thoracic vertebral bodies, stable.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Right renal cysts are not significantly changed. Severe atherosclerotic changes of the abdominal aorta and its branches.
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No evidence of a pulmonary embolus in the left lung.Persistent atelectasis and consolidation of the residual right lung.
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Generate impression based on findings.
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Reason: lung cancer s/p 9 weeks of chemo. pls evaluate for disease and compare with previous scans History: lung cancer CHEST:LUNGS AND PLEURA: Postsurgical changes are again identified, compatible with a left upper lobectomy and right upper lobe wedge resection.Mild interval increase in centrilobular nodules and bronchial wall thickening, compatible with aspiration/bronchiolitis.No new suspicious pulmonary nodules or masses.Small left pleural effusion, minimally increased from the prior exam.Previously noted groundglass opacity in the right upper lobe (image 89, series 5) is unchanged and may represent atypical adenomatous hyperplasia (AAH).MEDIASTINUM AND HILA: Again identified are multiple enlarged mediastinal lymph nodes with reference prevascular lymph node (image 27, series 3) measuring 14 mm, previously, measuring 15 mm.Other prominent mediastinal lymph nodes are stable to minimally increased in size.Calcified mediastinal lymph nodes are compatible with a prior granulomatous disease.Cardiac size is normal without evidence of a pericardial effusion.Severe coronary artery calcification.CHEST WALL: Prominent left axillary lymph node with a fatty hilum is unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered calcifications compatible with prior granulomatous disease.SPLEEN: Scattered calcifications compatible with prior granulomatous disease.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable left renal cyst.New, somewhat wedge-shaped hypodensity involving the inferior pole of the left kidney may represent an acute renal infarct .Malrotation of the right kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic changes of the aorta and its branches. New aortic iliac bypass graft.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Subchondral degenerative changes in the lumbar spine.OTHER: No significant abnormality noted.
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1.No evidence of recurrent disease or pulmonary metastases.2.Stable mediastinal lymphadenopathy.3.Increasing centrilobular nodules and bronchial/bronchiolar wall thickening, compatible with aspiration bronchiolitis.4.New regional area of hypodensity involving the inferior pole of the left kidney, most likely representing acute renal infarct may be related to interval aortic iliac bypass graft.5.Stable groundglass opacity in the right upper lobe, compatible with atypical adenomatous hyperplasia.
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Generate impression based on findings.
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42 year-old female with abdominal pain for two weeks worse in the past one week. Rule out diverticulitis. No hematuria, melena or hematochezia. ABDOMEN:LUNG BASES: No focal consolidation, pleural effusion, or pneumothorax.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Probable subserosal uterine fibroid along the anterior wall of the uterus measures 3.6 x 3.2 cm in the transverse dimension and 3.6 cm in the craniocaudal dimension. Subcentimeter left adnexal cystic lesion likely represents a physiologic cyst/corpus luteum, in a menstruating patient.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Probable uterine fibroid. Otherwise, no findings to account for patient's pain. No evidence of diverticulitis, as clinically questioned.
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Generate impression based on findings.
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61-year-old male with pancreatic cancer. CHEST:LUNGS AND PLEURA: Stable lung micronodules, which are likely benign in nature. No new suspicious nodules.MEDIASTINUM AND HILA: No lymphadenopathy. Multiple surgical clips. Heart size normal. Moderate to severe coronary calcifications. Right chest wall port catheter tip in distal SVC.CHEST WALL: Status post median sternotomy. Right chest wall port.ABDOMEN:LIVER, BILIARY TRACT: Significant interval increase in size of multiple liver lesions. Reference right inferior lobe lesion measures 5.2 x 4 .8 cm, previously measured 3.8 x 3.7 cm (series 3, image 120).SPLEEN: No significant abnormality notedPANCREAS: Marked atrophy of pancreas and pancreatic duct dilation. Ill-defined pancreatic head mass is difficult to measure but is increased in size, measuring 2.5 x 3.8 cm, previously measured 2.3 x 2.8 cm (series 3, image 108).ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Reference portacaval node not significantly changed, measuring all 1.0 x 2.3 cm, previously measured 1.1 x 2.2 cm (series 3, image 101).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Unchanged L5 hemangioma.OTHER: No significant abnormality noted
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Significant increase in size of hepatic metastases.
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Generate impression based on findings.
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69-year-old male with history of squamous cell carcinoma of the right neck. Limited intracranial views and orbital views are unremarkable. Limited views of the mastoid air cells again demonstrate partial opacification of the right mastoid air cells, likely post-therapeutic in etiology. The visualized left mastoid air cells are clear. The visualized paranasal sinuses are clear. Irregularity, calcification and thickening of the inferior aspect of the right ear, unchanged. At the site of the previously present right level 2 neck mass, there remains faint strandy scar-like opacity which appears less prominent than on the most recent examination. For reference, this finding measures approximately 7 x 13 mm (series 80452 image 29), previously measured 7 x 16 mm. No new pathologic adenopathy is present.No soft tissue masses are present in the neck. No exophytic mass or focal effacement of the aerodigestive tract. The thyroid gland, submandibular glands, and parotid glands are free of focal lesions.Atherosclerotic calcification at the level of the right carotid bifurcation. The major cervical vasculature is patent. The visualized lung apices are clear. Please see dedicated chest CT from today's date for further details.Multilevel degenerative disk disease is redemonstrated in the cervical spine including vertebral body fusion hardware at C3-C4. Healed left clavicular fracture and left humeral head prosthesis, unchanged. Healed old rib deformities. No suspicious lesions are present.
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1. Interval decrease in size of small residual right neck mass. No new lesions or new pathologic adenopathy are present.2. Soft tissue irregularity of the right ear, unchanged.
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Generate impression based on findings.
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42-year-old male status post Whipple surgery for pancreatic neuroendocrine tumor complicated by fistula. Increased leukocytosis and high drain output. ABDOMEN:LUNG BASES: Persistent large right pleural effusion with overlying right lower lobe consolidation/atelectasis. Trace left pleural effusion and improved left basilar atelectasis.Partially visualized central venous catheter tip in distal SVC.LIVER, BILIARY TRACT: Interval insertion of percutaneous drain into right subdiaphragmatic fluid collection, with associated interval decrease in size.Status post hepaticojejunostomy, with stable small amount of pneumobilia.SPLEEN: No significant abnormality notedPANCREAS: Status post Whipple surgery. Several foci of gas are seen immediately superior to the pancreaticojejunal anastomosis, suspicious for anastomotic leak, especially given the large amount of retroperitoneal fluid.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Decrease in large amount of retroperitoneal fluid, predominantly on the right; this fluid appears more loculated and peripherally enhancing, best appreciated in inferior aspect of anterior right perirenal space (series 4, image 80).BOWEL, MESENTERY: Status post Whipple surgery. Free fluid and stranding is again seen in the upper abdominal mesentery, appearing decreased. No loculated mesenteric fluid. Stable position of two percutaneous mesenteric drains.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: Postsurgical changes in lower lumbar spine.OTHER: No significant abnormality noted
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1.Interval insertion of percutaneous drain into loculated perihepatic fluid collection, which has decreased in size.2.Interval decrease in amount of partially loculated retroperitoneal fluid.
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Generate impression based on findings.
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Reason: history metastatic prostate cancer, rising PSA, assess for progression History: none CHEST:LUNGS AND PLEURA: Scattered areas of scarring and subsegmental atelectasis are noted in both lungs and unchanged from the prior exam.Stable calcified and noncalcified micronodules.No suspicious pulmonary nodules or masses.Mild pleural thickening and nodularity similar in appearance to the previous exam.MEDIASTINUM AND HILA: Bone enlarged. Mediastinal lymph nodes some with calcification suggesting prior granulomatous disease.Mild cardiac enlargement without evidence of a pericardial effusion.CHEST WALL: Degenerative changes in the thoracic spine.Increased density in the T11 vertebrae suggestive of metastatic disease.Cortical thickening and increased density in the right seventh rib in its posterior aspect has been present on previous exams dating back to 11/7/11 and may represent osseous metastatic disease .Focal sclerotic foci in the anterior aspects of the right eighth and left sixth and ninth ribs have also been present on previous exams. ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Ill-defined hepatic hypodensities incompletely characterized.SPLEEN: No significant abnormalities noted.ADRENAL GLANDS: Stable right adrenal nodule with internal fat density compatible with a myolipoma.KIDNEYS, URETERS: Markedly enlarged right kidney with multiple large cysts, calcification, and interval increase in right perinephric stranding.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evidence of pulmonary metastatic disease.2.Areas of bone sclerosis involving the multiple ribs bilaterally and the T11 vertebrae, most likely representing previous osseous metastatic disease. Correlation with nuclear bone imaging is advised.3.Large cysts with calcification and perinephric stranding surrounding the right kidney are compatible exam are compatible with xanthogranulomatous pyelonephritis.
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Generate impression based on findings.
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75 year-old female with flank pain. ABDOMEN:LUNG BASES: Nonspecific punctate calcified and noncalcified micronodules in the lung bases, measuring 4 mm or less.Focal superior herniation of fat through right hemidiaphragm.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left nephroureteral stent is in place. Calcific density measuring 6 mm present in the inferior calix of left kidney, consistent with nonobstructing stone. No evidence of obstructing stones. Mild dilation of proximal left ureter/renal pelvis but otherwise no significant collecting system dilation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Heterogeneity in uterus likely due to fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Nonobstructing stone in inferior calix of left kidney. No evidence of obstructing stones. Left nephroureteral stent in place.2.Nonspecific but likely benign calcified and uncalcified micronodules in the partially visualized lung bases.
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Generate impression based on findings.
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42-year-old male with kidney stones and recurrent UTI. 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 evidence of obstructing stones or hydronephrosis. Punctate calcific density measuring 1 mm in inferior pole of right kidney consistent with nonobstructing stone (series 3, image 48).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extraluminal collection of the air and fluid measuring 3.3 cm located posterior to proximal stomach most consistent with gastric diverticulum (series 3, image 22).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Small focus of gas in the bladder most compatible with recent instrumentation. Diffuse bladder wall thickening, which may be partially due to under distention.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Punctate nonobstructing stone in inferior calix of right kidney but no obstructing stones or hydronephrosis.2.Small focus of gas in bladder, likely due to recent instrumentation.
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Generate impression based on findings.
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42 year old female with colon cancer. CHEST:LUNGS AND PLEURA: Punctate calcified and noncalcified lymph nodes unchanged, likely benign. No suspicious nodules or masses.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Peripheral area of hypoattenuation in the liver dome and is of unclear etiology but likely benign in nature, possibly vascular in nature (series 3, image 83).Subcentimeter hypodensity in the right lobe is too small to characterize and was not definitely seen on prior exam (series 3, image 97).Stable cyst in left lobe.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple small retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: Status post colectomy with right lower quadrant ostomy in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.New peripheral area of hypoattenuation in the liver dome, likely benign and possibly vascular in etiology.2.Subcentimeter hypodensity in the right liver lobe was not definitely seen on prior exam and is too small to characterize. Continued follow-up is recommended.
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Generate impression based on findings.
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Female 71 years old; Reason: eval for progression History: metastatic RCC, on therapy Lack of intravenous contrast limits evaluation for renal metastases which tend to be hypervascular.CHEST:LUNGS AND PLEURA: The right upper lobe pulmonary nodule measures 11-mm (image 39/series 5) previously, 10 mm. The lingular nodule is unchanged. There are multiple other scattered pulmonary nodules in both lungs without evident change.The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Calcific arteriosclerotic disease affects the coronary vessels.CHEST WALL: Post operative changes from median sternotomy.ABDOMEN:LIVER, BILIARY TRACT: The right hepatic lobe lesion measures 3.3 x 2.6 cm (image 90/series 3) previously, 2.5 x 2.0 cm.There are multiple other hepatic lesions and possibly new hepatic lesions is suboptimally evaluated without contrast.There is a new right perihepatic mass as seen on image 105/series 3.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy.RETROPERITONEUM, LYMPH NODES: Retroperitoneal mass measures 1.6-cm (image 131/series 3) previously, 1.0-cm. It is located posterior to the ascending colon.Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Absent or atrophicBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lucent lesion in the L5 vertebral body is unchanged.OTHER: No significant abnormality noted.
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1.Increase in the size of the existing hepatic lesions with possible new hepatic lesions.
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Generate impression based on findings.
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Reason: 67yo F with CPFE, tobacco history, following RUL nodule. Please re-evaluate. History: DOE, oxygen use LUNGS AND PLEURA: Severe emphysema.There is mild interval decrease in an irregularly shaped consolidation in the right upper lobe in compared to examination on 4/25/2013 and stable compared to examination on 8/8/2013.Basilar predominant honeycombing with traction bronchiectasis and architectural distortion is not significantly changed from prior.Right middle lobe nodule, stable compared to 7/25/2011.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Mild coronary artery calcifications. Mild atherosclerotic changes of the thoracic aorta. No mediastinal lymphadenopathy. Heterogeneous right hilar lymph node measures 13 mm (series 3 image 43), unchanged from recent examinations and measured 10 mm on 7/25/2011.CHEST WALL: Mild degenerative changes in the thoracic spine. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Medium-sized hiatal hernia.Multiple hypoattenuating subcentimeter foci within the liver parenchyma are too small to characterize and are unchanged compared to examination on 7/25/2011.
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Mild interval decrease in an irregularly shaped atelectasis/consolidation in the right upper lobe, and may be the result of previous inflammation/infection.Stable right middle lobe pulmonary nodule since 7/25/2011.Stable combined severe emphysema with stable basilar pulmonary fibrosis.
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Generate impression based on findings.
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53 year old male. Reason: eval for metatases History: metastatic prostate cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy. For reference, the aortocaval node at image 53, series 3 measures 11 x 17 mm. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse sclerotic metastases throughout the skeleton.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Diffuse bilateral adenopathy. The largest, for reference, is in the left obturator region that measures 1.2 x 3 cm at image 97 series 3. BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse sclerotic metastases.OTHER: No significant abnormality noted
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Diffuse skeletal and lymph node metastases.
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Generate impression based on findings.
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67-year-old male. Metastatic prostate cancer. Reason: prostate cancer, evaluation of disease after receiving investigational therapy. ABDOMEN:LUNG BASES AND PLEURA: Scattered calcified and noncalcified micronodules are unchanged. LIVER, BILIARY TRACT: Calcified granulomata. Left lateral segment hepatic lesion with irregular margins and peripheral enhancement is not significantly changed at 3.4 x 2.5 cm (image 24, series 3). This is most likely due to a hemangioma.No new hepatic lesions. No biliary ductal dilatation. Patent hepatic vasculature.SPLEEN: Calcified splenic granulomata. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Left-sided IVC below the level of the renal vein, normal variant anatomy. No retroperitoneal lymphadenopathy. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No focal osseous lesion.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Surgically absent.BLADDER: No significant abnormality notedLYMPH NODES: Multiple pelvic surgical clips consistent with lymph node dissection.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis.OTHER: Surgical clips at the omentum. No measurable metastases.
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No significant interval change with no new lesions identified. Unchanged solitary liver lesion.
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Generate impression based on findings.
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62 year old male status post resection of retroperitoneal sarcoma. CHEST:LUNGS AND PLEURA: Reference lingular nodule is not significantly changed, measuring 7 x 9 mm, previously measured 6 x 8 mm; this appears scar-like in etiology (series 5, image 62). Right lower lobe nodule unchanged (series 5, image 52). No new suspicious nodules.MEDIASTINUM AND HILA: Severe coronary artery calcifications. No lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post right nephrectomy.RETROPERITONEUM, LYMPH NODES: Multiple prominent retroperitoneal lymph nodes are not significantly changed.BOWEL, MESENTERY: Soft tissue lesion anterior to greater curvature of stomach is increased in size, measuring 1.2 x 2.2 cm, previously measured 1.0 x 1.5 cm (series 3, image 89). Interval increase in size of right paracolic gutter oval mesenteric haziness, measuring 3.9 x 5.3 cm (series 3, image 140).Haziness along root of mesentery has not significantly changed.Laxity in anterior abdominal wall with protrusion of small bowel loops unchanged, without evidence of obstruction.BONES, SOFT TISSUES: Recurrent fat-containing mass arising from right upper quadrant abdominal wall has increased in size, currently measuring 7.3 x 7 .3 cm, previously measured 5.1 x 3.8 cm (series 3, image 110). Associated mass effect on underlying lesion.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Increase in size of recurrent fat-containing mass in right upper quadrant adjacent to liver.2.Increased size of soft tissue lesion adjacent to greater curvature of stomach and oval area of mesenteric haziness in the right pericolic gutter, suspicious for multifocal recurrent tumor.
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Generate impression based on findings.
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8 year-old female with 1 month increasing tender submental mass despite antibiotic. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. There are a few oval shaped prominent nodes in the submental and submandibular spaces. One of them in the submental space measures 17 x 12 mm. There is no evidence of infection in the region. There are also multiple prominent nodes along the bilateral jugulodigastric chains and in the posterior triangles. There is prominent adenoids. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. No mass is noted. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The parotid, submandibular, and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. Limited view of the chest shows prominent axillary fossa lymph nodes.
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Numerous prominent lymph nodes throughout the neck soft tissue including most prominent ones in the submental and submandibular spaces. Etiology may including reactive lymphadenopathy, infection, autoimmune disease and lymphoproliferative disorder. No evidence of abscess, cellulitis or mass.
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Generate impression based on findings.
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36-year-old female with history of metastatic breast cancer. CHEST:LUNGS AND PLEURA: Numerous bilateral lung nodules suspicious for metastatic disease appear decreased in size when compared to the prior study. An index nodule in the right lower lobe measures 1.1 cm, previously 1.6-cm in diameter image number 53, series number 6. Interval resolution of previously described small pleural effusions.MEDIASTINUM AND HILA: No significant abnormality noted. No evidence of mediastinal or hilar lymphadenopathy.CHEST WALL: Nonspecific small axillary lymph nodes. Right chest port tip terminates in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse sclerotic bone lesions throughout the axial and proximal appendicular skeleton consistent with metastatic disease, appearing similar to the prior study. Small fat containing umbilical hernia.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted. Subcentimeter cystic lesion in the left adnexa is likely physiologic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse sclerotic bone lesions throughout the axial and proximal appendicular skeleton consistent with metastatic disease, appearing similar to the prior study. OTHER: No significant abnormality noted.
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Persistent diffuse bone metastases with interval decrease in size of the previously described lung metastases, as described above.
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Generate impression based on findings.
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Male 45 years old; Reason: Pt is a 44 y/o male with h/o met seminoma, s/p chemotherapy, evaluate for recurrence, attention to lymph nodes in chest History: testicular cancer, paratracheal LN CHEST:LUNGS AND PLEURA: Micronodule along the left major fissure is unchangedMEDIASTINUM AND HILA: Small mediastinal lymph node measures 1.0 x 0.9 cm (image 37/series 3) previously, 1.1 x 1.1 cm.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology without suspicious hepatic lesion. Focal thickening of the gallbladder fundus is unchanged and may represent focal adenomyomatosis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Left para-aortic lymph node measures 1.8 x 1.2 cm (image 127/series 3) previously, 1.8 x 1.3 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Post operative changes in the left inguinal canal.
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1.No evident size change in the reference notes.
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Generate impression based on findings.
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34-year-old male with history of Beckwith Wiedman syndrome. Surveillance CT. ABDOMEN:LUNG BASES: Cysts in bilateral lower lobes are again noted. The right base cystic lesion contains several internal solid nodules, appearing unchanged (series 6, image 9).Stable cardiomegaly. Mitral valve prosthesis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral hypoattenuating lesions compatible with cysts, some of which contain thin internal septa. Several of these lesions have increased in size, best appreciated in the right upper kidney lesion which currently measures 4.0 x 3.0 cm, previously measured 2.9 x 2.3 cm (series 5, image 39). No solid component is identified.Multiple non obstructing stones are present in the calices of both kidneys, measuring up to 3 mm. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No pathologically enlarged retroperitoneal lymph nodes. Again seen is obliteration of infrarenal inferior vena cava, with associated retroperitoneal collateral vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes in the lumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Multiple renal cysts, some of which have increased in size.
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Generate impression based on findings.
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Cellulitis of neck soft tissues. There is diffuse stranding of the right suprahyoid neck and face subcutaneous fat, as well as the right buccal fat pad and submandibular space. There is no discrete rim-enhancing fluid collection. The parapharyngeal fat pad is preserved. The major salivary glands are grossly unremarkable. There is no evidence of sialolithiasis. There is no significant cervical lymphadenopathy. There is no enlargement of the Waldeyer ring structures. The airways are patent and there is no thickening of the epiglottis. The osseous structures are unremarkable without lytic or blastic lesions. The major cervical vessels are intact. There is partial opacification of the paranasal sinuses. The mastoid air cells are clear. The partially imaged intracranial structures and orbits are grossly unremarkable. There is partially imaged nonspecific patchy opacification in the right upper lung, although the images are degraded by motion.
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1. Diffuse right suprahyoid neck and face cellulitis without evidence of drainable fluid collection or airway narrowing. 2. Partially partially imaged nonspecific patchy opacification in the right upper lung, which may represent hypoinflation or reactive airway disease, although pneumonia cannot be excluded. Dedicated chest imaging can be performed for further evaluation, if clinically indicated.Discussed with Dr. Munitz at 2 PM on 12/5/13.
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Generate impression based on findings.
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70 yo male with severe dementia, a fib, DM, sz disorder, new dx colon CA with likely mets with R pleural effusion, small r apical pneumo. Please evaluate for tumor, infiltrate, loculate pleural effusion, pneumo. Signs and Symptoms: seizures, new CA dx 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.Patient status post left-sided craniotomy.There is encephalomalacia present in the left middle cerebral artery territoryThe 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.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 early detection of nonhemorrhagic CVA.3.No evidence for brain metastases4.As the compatible with encephalomalacia in the left middle cerebral artery distribution most likely related to prior infarction.5.Status post left-sided craniotomy
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Generate impression based on findings.
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85 year old male. Reason: Evaluate for any complex cysts. History: Stage IV CKD, HTN now c/o hematuria. H/o bilateral renal cysts ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenule at the inferior pole. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral simple renal cysts. Moderate atrophy. No masses or nephrolithiasis. The renal cysts were present in RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Infrarenal abdominal aortic aneurysm with maximum diameter of 3.4 cm. PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate with median lobe. BLADDER: Mild wall thickening in distended bladder may be post-obstructive. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Renal atrophy and cysts bilaterally. No specific acute abnormality to explain hematuria was found.
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Generate impression based on findings.
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48 year old male. Reason: Stage IV pancreas cancer. Please provide index lesion measurments for pancreas and up to lesions for liver for RECIST, enrolled on study that requires distant measurable disease. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Common bile duct stent with pneumobilia.SPLEEN: No significant abnormality notedPANCREAS: A pancreatic head mass measures 3.3 x 3.7 cm axial image 101 of series 3. Common bile duct stent is in place. The adjacent main portal vein is almost completely occluded at the level of the pancreatic head mass. Peripancreatic lymph node measures 12 x 18 mm at axial image 96 of series 3.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy. For reference a left periaortic lymph node at the level of the left renal hilum measures 1.4 x 1.5 cm at image 132 series 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Bilateral fat containing inguinal hernias.
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Pancreatic head mass. Near-total occlusion of the main portal vein. Retroperitoneal lymphadenopathy.
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Generate impression based on findings.
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49 year-old male with history of head and neck cancer. Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. A left-sided level 2 lymph node now measures 8 x 4 mm axial dimensions (previously measuring 8 x 4 mm). Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.The patient's tongue base mass is not readily seen on this exam. There is some thickening of the pharyngeal mucosal space soft tissues which could be posttreatment related. The airway appears patent.Within the visceral space the thyroid gland appears intact with small hypodense foci in the left thyroid gland lobe.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits and paranasal sinuses demonstrate mucus retention cysts/polyps in the maxillary sinuses. The paranasal sinuses and mastoid air cells are otherwise clear.The parotid and 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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No cervical lymphadenopathy or mass. Stable left level 2 reference node.
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Generate impression based on findings.
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69-year-old male. Reason: h/o HNC, CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules, unchanged no suspicious nodules or masses to suggest metastatic disease.Small focus of scarring and traction bronchiectasis in the medial left lower lobe is stable.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion. Left ventricular apex calcification consistent with prior infarct with stable associated thrombus. Moderate coronary artery calcifications with LAD stent. Moderate atherosclerotic changes thoracic aorta.Surgical clips in the mediastinum. No mediastinal or hilar lymphadenopathy.CHEST WALL: Moderate multilevel degenerative changes in the thoracic spine. Numerous bilateral chronic appearing rib deformities, which may be postsurgical in origin.Left shoulder arthroplasty.No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable mild intra-and extrahepatic biliary ductal dilatation. Status post cholecystectomy.SPLEEN: Status-post splenectomy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged lobulated kidneys with bilateral cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes of the abdominal aorta and its branches. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Clonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Moderate multilevel degenerative changes in the lumbar spine. Postsurgical changes in the L4-L5 vertebral bodies, partially visualized.OTHER: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Reason: lung Ca, not currently on chemo. Followup of lung and liver lesions. History: none CHEST:LUNGS AND PLEURA: Motion degrades sensitivity.Small right apical nodule (image 21, series 4) measures 7 mm x 5 mm, previously, measuring 7 mm x 3 mm.New right upper lobe ill-defined nodule (image 35, series 4) measuring 13 mm x 11 mm with associated right perihilar fibrotic changes may represent post radiation reaction.Right basilar bullae and some rounding air space opacity obscured by respiratory motion.Upper lobe predominant paraseptal emphysema.No pleural effusions.MEDIASTINUM AND HILA: Stable minimally enlarged mediastinal and right hilar lymph nodes.Cardiac size is normal without evidence of pericardial effusion.Severe coronary artery calcification.Right chest Port-A-Cath with its tip in the SVC.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypodense lesion near the hepatic dome is unchanged, however is difficult to accurately compare due to motion artifact. No new lesions identified.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Right adrenal nodule unchanged.KIDNEYS, URETERS: Stable right renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: IVC filter in place , atherosclerotic changes of aorta. new from the prior exam.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Interval repair of ventral abdominal wall hernia. With soft tissue density identified in the subcutaneous fat and a small air-containing pocket noted subcutaneously. Infection cannot be excluded.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Right apical nodule without significant interval change.2.Right perihilar fibrotic changes and new ill-defined adjacent nodule may represent post radiation changes. However, metastatic disease cannot be excluded.3.Stable hepatic metastasis.4.No new sites of disease identified.5.Interval surgical repair of ventral hernia with soft tissue postsurgical changes containing air and fluid in the anterior abdominal wall raises the question of abscess formation.
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Generate impression based on findings.
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Relapsed CML, neutropenic fever, r/o sinusitis. There is interval decrease in the degree of right maxillary sinus mucosal thickening and retention cyst formation. There is partial opacification of the right infundibulum. There is persistent mild mucosal thickening within the left maxillary sinus with suggestion of an air-fluid level and bubbly secretions. There is mild scattered ethmoid sinus opacification bilaterally, which has decreased since the prior exam. There is mild mucosal thickening and bubbly secretions within the right sphenoid sinus. There is a small retention cyst and probable small osteoma within the left sphenoid sinus. The frontal sinuses are clear. There is bilateral conchae bullosa. The optic canals and carotid grooves are covered by bone. The ethmoid roofs are intact and nearly symmetric. There is a small air-fluid level within a medial mastoid air cell. There is a cavum septum pellucidum. The partially imaged intracranial structures are otherwise grossly unremarkable.
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Overall interval decrease in the degree of paranasal sinus opacification. However, a small air-fluid level within the left maxillary sinus may indicate acute sinusitis. Likewise, a small air fluid-level within a single left mastoid air cells may indicate early mastoiditis.
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Generate impression based on findings.
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49 year-old female patient with asthma and shortness of breath. LUNGS AND PLEURA: Right lower lobe predominant bronchitis and mild bronchial wall thickening. No evidence of interstitial lung disease. No evidence of air trapping on expiratory imaging.Nonspecific scattered micronodules.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Mild coronary artery calcifications.Scattered small mediastinal lymph nodes. No hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia.Well circumscribed hypoattenuating lesion within the liver parenchyma likely represents a cyst.
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Lower lobe predominant bronchial wall thickening and bronchiectasis could represent reactive airway disease.
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Generate impression based on findings.
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45 year-old female with cirrhosis status post liver transplant. Renal artery aneurysm seen on MRI. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post liver transplant. No suspicious lesion. Hepatic vasculature appears patent.There is fusiform aneurysmal dilation of 2 cm segment of extrahepatic proper hepatic artery, measuring 7 mm in maximal diameter (coronal series 80781, image 60; axial series 10, image 43).SPLEEN: Splenomegaly with multiple peri-splenic collateral vessels.PANCREAS: 9 mm hypodense focus in pancreatic head is unchanged, possibly representing IPMN (series 11, image 55).ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is a 11 x 0.9 cm aneurysm arising from the posterior aspect of the distal right renal artery, appearing not significantly changed in size compared to 10/2011 exam (series 10, image 54). The more proximal aspect of the right renal artery appears somewhat beaded, raising possibility of fibromuscular dysplasia (coronal series 80782, image 29).No hydronephrosis or suspicious renal lesions.RETROPERITONEUM, LYMPH NODES: Multiple prominent retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Tubular structures immediately superficial to the left gluteus maximus muscle are of unclear etiology but not significantly changed since 2011, likely vascular in etiology (series 11, image 114).OTHER: No significant abnormality noted
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1.Distal right renal artery aneurysm, not significantly changed in size since 10/2011.2.Somewhat beaded appearance of right renal artery raises possibility of fibromuscular dysplasia.3.Fusiform aneurysmal dilation of proper hepatic artery in porta hepatis. 4.Nonspecific tubular structures in left buttock, possibly vascular in etiology. Not significantly changed since 2011.
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Generate impression based on findings.
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49-year-old male patient. Reason: h/o HNC, CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Nonspecific scattered micronodules, unchanged.Small area of scarring along the anterior minor fissure is unchanged. New very small area scarring along the major fissure in the posterior right lower lobe. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Cardiac size is within normal limits. Mild coronary artery calcifications. Minimal atherosclerotic changes of the thoracic aorta.No mediastinal lymphadenopathy. Left calcified hilar lymph nodes consistent with prior granulomatous disease.CHEST WALL: Mild multilevel degenerative changes in the thoracic spine. T5 vertebral body hemangioma. Healed left sixth and seventh rib fractures. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Numerous centimeter hypoattenuating foci within the liver parenchyma are too small to characterize and likely represent cysts.SPLEEN: Splenic granuloma.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.BONES, SOFT TISSUES: Multilevel degenerative changes in the lumbar spine. Very small fat filled umbilical hernia.OTHER: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Gait disorder. Communicating hydrocephalus. There has been interval stability in the size of ventricular system which demonstrates a severe degree of dilatation including the third and fourth ventricles which is out of proportion to the degree of overlying sulcal prominence. There is no convincing periventricular hypoattenuation suggestive of acute hydrocephalus. There is no intracranial mass, hemorrhage, or edema. The midline is intact. There is no extraaxial fluid collection.
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Interval stability of significant ventricular dilatation out of proportion to overlying sulcal atrophic change. Differential considerations could include normal pressure hydrocephalus especially given the provided history, versus chronic communicating hydrocephalus of other etiology. Please correlate clinically.
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Generate impression based on findings.
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Reason: 70 yo male with severe dementia, a fib, DM, sz disorder, new dx colon CA with likely mets with R pleural effusion, small r apical pneumo. Please evaluate for tumor, infiltrate, loculate pleural effusion, pneumo History: unilateral pleural effusion, apical pneumo LUNGS AND PLEURA: Moderate right anterior pneumothorax.Large right pleural effusion and smaller left effusion with associated compressive atelectasis.Calcified granuloma in the right middle lobe.No suspicious nodules.MEDIASTINUM AND HILA: Calcified lymph nodes compatible with previous infection.Severe coronary artery calcification.Moderate cardiomegaly.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Very limited scan showing extensive partly confluent hypodensities in the liver, mainly involving the right lobe, compatible with metastatic disease.Small amount of ascites in the upper abdomen.
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1.Bilateral pleural effusions with associated atelectasis and moderate right pneumothorax.2. Extensive metastatic disease in the liver.
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Generate impression based on findings.
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Reason: 80y male with COPD, bronchiectasis, concern for lung abscess and M. kansasii infection History: lung abscess LUNGS AND PLEURA: Thickwalled cavity with air-fluid level in the right lower lobe is redemonstrated and compatible with an abscess and/or a large infected bulla.. Adjacent nodules and subpleural thickwalled cavities are compatible with infection as well. Surgical sutures are noted in this region.Compared to the prior exam there may be slightly decreased surrounding ground glass and interstitial opacities.Stable right upper lobe and left lung nodules.Severe emphysema with subpleural calcifications noted in both lungs.Basilar traction bronchiectasis and fibrosis.MEDIASTINUM AND HILA: Mildly prominent mediastinal and right hilar lymph nodes some of which are calcified.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable hepatic hypodensities.Cholelithiasis.
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1. Redemonstration of thickwalled, fluid-filled cavitary/cystic large lesion in the right lower lobe compatible with an abscess or infected large bullae. Mild interval decrease in surrounding ground glass and interstitial opacities.2.Stable right upper lobe and left upper lobe nodules most likely inflammatory in origin.3.Severe emphysema with basilar fibrosis .
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Generate impression based on findings.
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Reason: RLL peripheral lung nodule and PET positive lymph nodes, assess for Superdimension bronchoscopy History: hemoptysis LUNGS AND PLEURA: Right lower lobe some pleural complex nodular opacity containing cysts and dilated bronchi (series 6/56) measuring 24 x 46 mm slightly increased since the outside scan of 8/26/2013 including solid and ground glass components. Small scar like opacities elsewhere.MEDIASTINUM AND HILA: Enlarged lower right paratracheal lymph node measuring 16 mm in short axis, slightly increased from 40 mm previously.Status post saphenous vein coronary bypass. Extensive and severe calcification of the native coronary arteries.CHEST WALL: Severe degenerative disease of the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Porcelain gallbladder with cholelithiasis.
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Complex superior segment of the right lower lobe nodule, slightly increased compared to the previous scan, suspicious for primary carcinoma.
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Generate impression based on findings.
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Altered mental status, nausea/vomiting; evaluate for acute intracranial hemorrhage. There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. There are hypodensities within the right frontal white matter and right pons that correspond to the lesions on MRI, which are compatible with chronic infarcts. Additional mild hypodensities within the periventricular white matter are compatible with age-indeterminate small vessel disease. The ventricles are diffusely enlarged reflecting cerebral volume loss. In particular, there is disproportionate cerebellar volume loss, which is nonspecific. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unchanged, including vascular calcifications.
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1.No evidence of acute intracranial hemorrhage.2.Age-indeterminant small vessel ischemic disease and chronic right pontine and right frontal lobe infarcts. However, non-contrast CT is insensitive for acute nonhemorrhagic stroke and MRI is recommended for further evolution, if clinically indicated. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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55 year old female with diverting loop ileostomy, scleroderma, and colonic pseudoobstruction. Patient presents with abdominal distention, pain, nausea. ABDOMEN:LUNG BASES: Subsegmental basilar atelectasis. Dilation of the distal esophagus.LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. Peripheral hypodensity in right lobe is incompletely characterized but likely not significantly changed (series 3, image 30).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple dilated loops of bowel with diameter measuring up to 4 cm (series 3, image 105). The dilated loops of bowel extend to ostomy site in right lower quadrant; given that catheter is present in ostomy is supportive of chronic bowel pseudoobstruction rather than mechanical etiology.No loculated fluid collections to suggest abscess. Multiple mildly enlarged mesenteric lymph nodes are noted. The colon is decompressed.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: Multiple dilated loops of small bowel, as noted above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Multiple dilated loops of small bowel extending to ostomy. Given that the percutaneous catheter traverses ostomy, the small bowel dilation is most likely due to chronic pseudoobstruction/peristaltic abnormality associated with scleroderma rather than mechanical obstruction.
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Generate impression based on findings.
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ICH, AVM resection sp craniotomy, evaluate for changes. There are postoperative findings related to right frontal craniotomy with unchanged encephalomalacia in the superior right frontal gyrus. There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. The ventricles are stable in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There are multiple unchanged areas of skin thickening in the apical scalp region.
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1. No evidence of acute intracranial hemorrhage.2. Unchanged non-specific scalp skin lesions. Correlation with dermatological exam is recommended.
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Generate impression based on findings.
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54 year old female. Reason: r/o CAD for pre-operative risk assessment. History: fatigue, pre liver transplant evaluation, HCV cirrhosis. Height: 67 inWeight: 169 lbsBSA: 1.9 m^2BMI: 26.5 kg/m^2Calcium Score:LM: 0LAD: 23.8LCx: 0RCA: 0Total: 23.8, This represents the 90% for this patient's age and gender.Cardiac Morphology:Left Ventricle:EDV: 151 ml The left ventricle is normal in size, shape, wall thickness, and volume. Right Ventricle:EDV: 140 ml The right ventricle is normal in size, shape, wall thickness, and volume. Left Atrium: The left atrial volume minus the pulmonary veins is 127 cc, within normal limits. There are four distinct pulmonary veins which drain normally into the left atrium.Right Atrium: The right atrial volume is within normal limits. The right atrium is structurally normal. Cardiac Veins: The coronary sinus is normal.Cardiac Valves: There are no aortic calcifications. There is no mitral annular calcification.Great Vessels: Aorta: The aortic arch is left sided. The brachiocephalic vessels branch normally from the arch. Visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. Largest dimensions of the thoracic aorta are as follows:Sinuses of Valsalva: 27 mm Ascending: 26 mm Sinotubular Junction: 24 mm Descending: 22.7 mmPulmonary Artery: Main PA: 27 mmRight PA: 23 mmLeft PA: 23 mmVena Cavae: The SVC is normal in size and without structural abnormality. The IVC is normal in size and without structural abnormality.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary Artery Anatomy:LM: The left main coronary artery arises normally from the left sinus of valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is no significant plaque in the left main.LAD: The LAD gives rise to the diagonal and septal branches. There is focal eccentric calcification in the proximal LAD with associated ~20% stenosis with no associated soft plaque.LCx: The left circumflex artery gives rise to the obtuse marginal branches. There is no significant plaque or stenosis in the LCx.RCA: The RCA arises normally from the right sinus of valsalva. It is the dominant coronary artery giving rise to the posterior descending artery and a posterolateral branch. There is no significant plaque or stenosis in the RCA. EXTRACARDIAC CHEST
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1. Normal ventricular volume and morphology.2. Total Calcium score was 23.8; 90% for age and gender.3. Focal calcification at the LAD origin with associated ~20% stenosis.
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Generate impression based on findings.
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66 year old female with urothelial cancer status post 4 cycles of chemotherapy. CHEST:LUNGS AND PLEURA: Overall mild increase in innumerable centrilobular and groundglass nodular opacities.Mucous plugging is seen in the bronchiectatic right middle lobe bronchi.MEDIASTINUM AND HILA: No significant change in multiple mildly enlarged mediastinal lymph nodes; reference left paratracheal node measures 0.9 x 1.3 cm, previously measured 0.6 x 1.2 cm (series 6, image 37). Right hilar node measures 1.0 x 1.5 cm, previously measured 1.0 x 1.6 cm (series 6, image 46).Normal in size. Right port catheter tip terminates in right atrium.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensities are too small to characterize but unchanged and in most likely represent benign cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuating lesions in both kidneys, most likely benign cysts. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Although the distal right ureter does not fill with contrast on delayed images, limiting evaluation of this segment, no filling defects are identified to suggest neoplasm.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.Mild increase in multiple centrilobular and groundglass nodular opacities throughout both lungs; while distribution and morphology is more suggestive of infectious or inflammatory etiology, continued follow-up is recommended. 2.No significant change in mediastinal and hilar lymphadenopathy.3.No evidence of significant intra-abdominal or pelvic abnormality.
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Generate impression based on findings.
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79 year-old female with leiomyosarcoma. Motion artifact limits evaluation of the abdomen.CHEST:LUNGS AND PLEURA: Resolution of bilateral pleural effusions. Multiple peripheral reticular opacities not significant changed, compatible scarring and subsegmental atelectasis. Several punctate micronodules, nonspecific but likely benign in etiology. Nonspecific cluster of cysts noted in left upper lobe, without evidence of solid nodular component (series 4, image 37).MEDIASTINUM AND HILA: Multiple prominent mediastinal lymph nodes are nonspecific, may be reactive (series 3, image 40). Moderate cardiomegaly. Mild to moderate coronary artery calcifications. Marked mitral valve calcifications. Enlarged main pulmonary artery measures 2.6 cm in diameter, consistent with pulmonary arterial hypertension.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple small retroperitoneal lymph nodes are not significantly changed.BOWEL, MESENTERY: Previously seen distal small bowel lesion has been resected. No evidence of recurrent mass. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Hypoattenuating lesion in the left adnexa measures 1.8 cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Peripherally hypoattenuating lesion in left labia measures 1.4 cm, most consistent with abscess (series 3, image 193).OTHER: No significant abnormality noted.
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1.Interval resection of previously seen distal ileal mass.2.Small abscess in left labia.3.1.8-cm nonspecific lesion in left adnexa; recommend pelvic ultrasound for better characterization.4.Nonspecific lung micronodules, likely benign in etiology.5.Enlarged main pulmonary artery consistent with pulmonary arterial hypertension.
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Generate impression based on findings.
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Female 72 years old; Reason: Met breast cancer needs re-evaluation and compare to prior scans from 1/10/2010. History: Met breast cancer needs re-evaluation and compare to prior scans from 1/10/2010. CHEST:LUNGS AND PLEURA: New centrilobular nodules in the right middle lobe , possibly infectious.Nodular density left lung base measures 0.6 x 0.5 cm (image 71/series 5) previously, 0.8 x 0.6 cm.Right posterior medial nodule measures 0.8 x 0.5 cm (image 73/series 5) previously, 0.9 x 0.5 cm.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: Tracheostomy terminates within the upper trachea. Mucous in the right lower lobe airways.Right hypodense thyroid nodules.ABDOMEN:LIVER, BILIARY TRACT: Liver has a smooth contour. No suspicious lesions have developed. Multiple calcified gallstones within a nondistended gallbladder.Hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: The adrenal glands are nodular.KIDNEYS, URETERS: Small left upper pole renal contour deforming lesion which is indeterminate. Multiple small probable renal cysts.RETROPERITONEUM, LYMPH NODES: Portacaval node measures 1.9 x 1.3 cm (image 103/series 3) previously, 2.1 x 1.2 cm. Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: Colonic diverticulosis.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: Extensive colonic diverticulosis. The peri-colonic inflammation has resolved.BONES, SOFT TISSUES: Degenerative changes affect the right hip. Ventral abdominal hernia containing portion of fat and small bowel.OTHER: No significant abnormality noted.
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1.Resolution of the right-sided peri colonic inflammation.2.No change in the index lesions.3.Small questionable left upper pole renal contour deforming mass. Follow up dedicated renal imaging preferably by MRI is suggested.4.New centrilobular pulmonary nodules in the right lung possibly infectious., Follow up is suggested.
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Generate impression based on findings.
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T1 N2b SCCA of the right tonsil treated with surgery and then Chemo/radiation therapy. Completed CRT in Feb 2009. Head: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is mild mucosal thickening within the left maxillary sinus. The skull and extracranial soft tissues are unremarkable. Neck: There are stable post-treatment findings without evidence of recurrent tumor. There is no significant cervical lymphadenopathy. The airways are patent. The remaining major salivary glands appear unchanged. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. The subcentimeter low attenuation lesion in the left lobe of the thyroid gland is unchanged. There is unchanged right apical scarring and a right apical micronodule.
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1.Stable post-treatment findings without evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.2.No evidence of intracranial metastases.
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Generate impression based on findings.
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64-year-old male with history of nephrolithiasis; evaluate for stone burden/obstruction ABDOMEN:LUNG BASES: No significant abnormality.LIVER, BILIARY TRACT: No significant abnormality.SPLEEN: Splenule.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple renal calculi are seen in the collecting systems bilaterally. There is no associated hydronephrosis and hydroureter. No obstructing stone or hydronephrosis/hydroureter is seen in the left kidney. Left renal cysts. No perinephric stranding is seen bilaterally.RETROPERITONEUM, LYMPH NODES: Multiple retroperitoneal lymph nodes, none pathologically enlarged.BOWEL, MESENTERY: No significant abnormality noted. Normal-appearing appendix. No evidence of free abdominal air or bowel obstruction.BONES, SOFT TISSUES: Mild degenerative changes affect the visualized spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No obstructing renal calculi. No hydronephrosis and hydroureter. Multiple nonobstructive renal calculi are seen in the collecting systems bilaterally.
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Generate impression based on findings.
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74-year-old male. Reason: Pt with metastatic rectal cancer, evaluate for progression. History: Metastatic rectal cancer. CHEST:LUNGS AND PLEURA: Reference right lower lobe nodule, series 5 image 55, 1 x 1 cm, smaller. Reference left lower lobe nodule in the left costophrenic angle is smaller at 1.1 x 0.9 cm on image 88, series 5.All the other nodules are stable; no new nodules are seen.MEDIASTINUM AND HILA: Pathologic size nodes. Atherosclerotic calcifications.CHEST WALL: Port-A-Cath right in the right anterior chest wall at the expected position.ABDOMEN:LIVER, BILIARY TRACT: Several hypodense lesions are seen in the liver are probably simple cysts rather than metastases. Reference metastatic lesions measured as follows:Lesion in segment 2 measures 3 x 3 cm series 4 image 87, smaller. Reference lesion in segment 4 seen crossing into the lateral segment measures 5 x 3.5 cm, series 3 image 96, smaller. Other lesions are liver cysts. Cholelithiasis. No biliary dilatation. No evidence of hepatic or portal venous thrombus.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nodular thickening unchanged.KIDNEYS, URETERS: Extensive fat stranding and fluid around the left kidney is decreased compared to the prior exam. There is no evidence of hydronephrosis. The nephrograms are symmetric. Minimal perinephric fat stranding around the right kidney.RETROPERITONEUM, LYMPH NODES: Scattered small lymph nodes are redemonstrated. Index portacaval node ill-defined estimated at 1.5 x 1.7 cm, series 3 image 107 is smaller. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Surgically absent.BLADDER: Bladder wall thickening is stable.LYMPH NODES: Small pelvic lymph nodes are not pathologic in size.BOWEL, MESENTERY: Rectal stent. Left lower quadrant colostomy. Stable fat stranding in the perirectal fat. The rectal fossa fat is normal. Mesenteric haziness without discrete ascites or measurable carcinomatosis.BONES, SOFT TISSUES: Degenerative changes, no lytic or blastic disease.OTHER: No significant abnormality noted
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No new sites of disease. Index lesions are smaller in size, especially in the liver and lung. Resolved fat stranding and fluid around the left kidney. Other findings are stable.
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Generate impression based on findings.
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Reason: r/o growth of lesions History: h/o met thyroid cancer LUNGS AND PLEURA: Diffuse pulmonary fibrosis involving subpleural reticulation, traction bronchiectasis, honeycombing, is unchanged.Pulmonary nodules are similar in size and number to the prior exam with reference right lower lobe nodule (image 60 series 5) now measuring 14 mm x 15 mm, previously, measuring 14 mm x 15 mm.. No new pulmonary nodules identified.MEDIASTINUM AND HILA: Stable mediastinal lymphadenopathy with reference prevascular lymph node (image 26, series 4) measuring 15 mm x 10 mm previously measuring 15 mm x 9 mm.Cardiac size is normal without evidence of a pericardial effusion.Redemonstration of an aberrant right subclavian artery.Status post thyroidectomy.CHEST WALL: Stable left supraclavicular lymph node. Stable sclerotic focus in the spinous process of T2 most likely representing a bone island.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.Pulmonary metastases without significant interval change in size or number.2.Stable mediastinal lymphadenopathy.3.No new sites of metastatic disease identified.4.Pulmonary fibrosis, stable.
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Generate impression based on findings.
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72-year-old female with metastatic neuroendocrine carcinoid tumor. CHEST:LUNGS AND PLEURA: Small right pleural effusion with overlying basilar atelectasis/consolidation. No suspicious lung nodules or masses identified.MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes; for reference pretracheal node measures 1.0 x 1.6 cm (series 7, image 32).Mildly enlarged main pulmonary artery suggestive of pulmonary arterial hypertension. Moderate cardiomegaly. Small pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple heterogeneous liver lesions, some of which are internally calcified, consistent with metastases; for reference segment 8 lesion measures 5.6 x 4.5 cm, not significantly changed (series 6, image 27).Status post cholecystectomy. Portal veins and hepatic arteries are patent.SPLEEN: Extensive atherosclerotic calcifications affect the splenic artery. Peripherally calcified splenic artery aneurysm measures 1.2 cm (series 7, image 110). Additional smaller, round peripherally calcified lesion in the splenic parenchyma likely represents additional aneurysm (series 6, image 46). PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral subcentimeter hypodensities too small to characterize but most likely represent benign cysts. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcifications throughout aorta and its branches.BOWEL, MESENTERY: Increased large amount of ascites fluid. Postsurgical changes in the right lower quadrant.BONES, SOFT TISSUES: Diffuse anasarcaOTHER: 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: Diffuse anasarcaOTHER: No significant abnormality noted.
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1.Multiple hepatic metastases not significantly changed.2.Increase in large amount of ascites fluid.3.Small right pleural effusion and diffuse anasarca.4.Peripherally calcified splenic artery aneurysm.
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Generate impression based on findings.
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52-year-old male patient. Reason: hx of tonsil ca, s/p CRt, eval for dz, compare to previous History: as above CHEST:LUNGS AND PLEURA: Stable scattered bilateral nonspecific micronodules, some of which are calcified. No suspicious appearing pulmonary nodules or lesions.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. No mediastinal or hilar lymphadenopathy.Punctate hypoattenuating lesion in the left thyroid gland is unchanged.CHEST WALL: Mild multilevel degenerative changes in the thoracic spine. No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Stable subcentimeter hypodensity in the pancreatic body without 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: Moderate multilevel degenerative changes in the lumbar spine.OTHER: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Female 74 years old; Reason: colon cancer restaging History: colon cancer CHEST:LUNGS AND PLEURA: Reference left lower lobe pulmonary micronodule measures 0.5 x 0.5 cm (image 64/series 5) , unchanged. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Indeterminate hypodense lesion upper pole of the left kidney measuring 1.1 x 1.1 cm on image 90/series 3.Several other hypodense lesions likely represent small cysts. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Portacaval lymph node which measures 2.5 x 0.9 cm (image 98/series 3), unchanged.BOWEL, MESENTERY: Post operative changes in the small bowel and colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Prolapse of small bowel loops with mild bowel wall thickening. The prolapsed hernia measures at least 8.6 x 7.7 cm. There is mild soft tissue thickening in the region of the rectum. No fluid collections. No bowel obstruction is evident. The hernia neck about the sacrum measures 3.7 x 3.4 cmBONES, SOFT TISSUES: Left lower abdominal colostomy.OTHER: No significant abnormality noted.
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1.Progression of the rectal prolapse involving small bowel loops.2.Stable indeterminate left upper pole renal lesion.3.No new sites of disease.4.Findings discussed with Elaine Hamm PAC at the time of the dictation
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Generate impression based on findings.
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Reason: 41 male with relapsed CML, neutropenic fever. r/o infiltrate History: Neutropenic fever LUNGS AND PLEURA: Interval resolution of right pleural effusion and right middle and lower lobe consolidation. Mild residual scarring/discoid atelectasis identified within the right middle lobe.Mild scarring/discoid atelectasis at the left lung base.Residual left upper lobe subpleural opacity, decreased from the prior exam (image 21, series 5).Scattered areas of ground glass opacities in the right upper lobe and left lung base.MEDIASTINUM AND HILA: Decrease in soft tissue stranding within the anterior mediastinum.Prominent right paratracheal lymph node (image 29, series 3) measuring 8 mm in its short axis has decreased in size compared to the prior exam, measuring 14 mm.Hypoattenuating blood pool compatible with anemia.Cardiac size is normal without evidence of pericardial effusion.CHEST WALL: Median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post splenectomy.
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1.Scattered areas of nonspecific mild ground glass opacity may be inflammatory in origin. No convincing evidence of pneumonia.2.Interval clearing of a right pleural effusion and right middle and lower lobe. Areas of consolidation. Mild residual scarring/atelectasis noted.3.Interval improvement in soft tissue stranding within the mediastinum and mild lymphadenopathy most likely related to previous sternotomy.
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Generate impression based on findings.
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61-year-old male with hepatocellular carcinoma and iliac crest lesion on bone scan. CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema. Nonspecific lung nodules noted bilaterally; right lower lobe nodule measures 5 mm (series 11, image 79). No consolidation or pleural effusions.MEDIASTINUM AND HILA: No pathologically enlarged mediastinal lymph nodes. Heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology.Segment 6 lesion measures 4.3 x 3.7 cm, demonstrating arterial enhancement and washout, consistent with hepatocellular carcinoma, not significantly changed since prior exam (series 7, image 31). Multiple nodules measuring approximately 1 cm or less are scattered throughout right liver lobe, which also demonstrate arterial enhancement and washout, consistent with satellite nodules. Several other nodules in the left and right liver lobes demonstrate arterial enhancement but no definite washout, and may represent dysplastic nodules (series 7, image 18, 22).Hepatic and portal veins are patent, without evidence of invasion by tumor. Hepatic arteries are patent.Cholelithiasis. No ascites. No significant splenomegaly or collateral vessels to suggest portal hypertension.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications throughout the aorta and its branches, with ectasia of common iliac arteries bilaterally; right common iliac artery measures 1.6 cm in diameter (series 9, image 153).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No suspicious bone lesions identified. Sclerotic focus in superior left sacrum is most consistent with bone island (series 9, image 159). Severe degenerative changes at L5-S1.OTHER: Right hydrocele.
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1.Multifocal hepatocellular carcinoma as described above.2.Sclerotic focus in left superior sacrum most compatible with bone island; no evidence of suspicious bone lesions.3.Nonspecific bilateral lung nodules, largest in right lower lobe measuring 5 mm.
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Generate impression based on findings.
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Reason: evaluate for bronchiectasis History: productive cough LUNGS AND PLEURA: Moderate diffuse bronchial wall thickening throughout all lobes.No evidence of bronchiectasis.No sign of air trapping on the expiration scan.MEDIASTINUM AND HILA: No significant lymphadenopathy.Residual thymic tissue in anterior mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Moderate diffuse bronchial thickening suggestive of bronchitis or asthma.No sign of bronchiectasis.
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Generate impression based on findings.
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Reason: 56 yo M with esophageal/GEJ adenocarcinoma needing re-staging scan History: esophageal/GEJ adenoCa CHEST:LUNGS AND PLEURA: Right apical reference solid nodule measures 5 mm (series 5 image 20), unchanged. Second reference right apical ground glass nodule measures 5 mm (series 5 image 18), unchanged. The groundglass nature of this nodule makes metastasis unlikely and it is more consistent with atypical adenomatous hyperplasia or primary adenocarcinoma in situ.No new suspicious nodules.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Minimal atherosclerotic changes of the thoracic aorta. Right-sided chest port with tip at the cavoatrial junction.Index subcarinal lymph node measures 12 mm (series 3 image 48), stable. Otherwise, small scattered mediastinal lymph nodes. No hilar lymphadenopathy.Nonspecific distal esophageal thickening below the GE junction is not significantly changed.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Bilateral enlarged adrenal glands are not significantly changed and compatible with metastases.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy is unchanged.Index gastrohepatic lymph node measures 19 mm (series 3 image 98), previously 17 mm.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Esophageal thickening extending into proximal stomach is not significantly changed.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable mediastinal and retroperitoneal lymphadenopathy with mild increase of index gastrohepatic lymph node.Stable right upper lobe nodules.Stable adrenal metastases.Stable esophageal thickening extending into the proximal stomach.
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Generate impression based on findings.
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Solitary pulmonary nodule LUNGS AND PLEURA: A previously described sharply defined and somewhat elongated nodular opacity in the anterior segment of the right upper lobe is unchanged. Comparable measurements in both axial and coronal planes are essentially identical to those on the scan of 7/3/2013. The lack of change together but the morphology are compatible with a post infectious scar possibly with organizing pneumonia. Neoplasm is considered very unlikely.MEDIASTINUM AND HILA: No significant lymphadenopathy.No visible coronary artery calcification on this non-gated scan.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Stable anterior right upper lobe nodule with features most consistent with a benign morphology. One additional follow-up scan in approximately 12 months is recommended to confirm stability.
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Generate impression based on findings.
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59 year old male with history of pancreatitis, abdominal pain. Evaluate for pseudocyst. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is intrahepatic and extrahepatic biliary ductal dilatation to the level of the pancreatic head, appearing slightly increased compared to prior exam. Status post cholecystectomy.The portal vein and its branches with extensive thrombosis, increased from 11/2013 exam. Numerous small collateral vessels forming are seen. There is heterogeneous attenuation of the left hepatic lobe, favor flow abnormality over tumor infiltration. SPLEEN: No significant abnormality notedPANCREAS: There is again fat stranding about pancreas. There is a new intraparenchymal fluid collection, measuring 3.0 x 1.7 cm (image 56, series 3). There is an area of low attenuation the tail of the pancreas, increased from prior exam. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal subcentimeter hypoattenuation is too small to characterize, most likely represents a cyst, and is unchanged.RETROPERITONEUM, LYMPH NODES: Expected regional adenopathy. Atherosclerotic calcification of the abdominal aorta. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes in the lumbar spine.OTHER: Small amount of free fluid in the abdomen.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes in the lumbar spine.OTHER: No significant abnormality noted
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1. Findings compatible with acute on chronic pancreatitis with interval development of fluid collection which could represent pseudocyst/post inflammatory cyst. We cannot exclude underlying neoplasm. Continued surveillance is recommended once acute pancreatitis has resolved. 2. Intrahepatic and extrahepatic biliary ductal dilatation to the level of the pancreatic head, slightly increased from prior exam.3. Extensive thrombosis of portal vein and its branches, significantly increased from November 2013, with decrease in perfusion of the left hepatic lobe, favor flow abnormality over tumor infiltration.
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Generate impression based on findings.
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Female, 5 years old, status post accidental fall from chair with knee to eye socket. Concern for zygomatic bone fracture. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.The bones of the calvarium and skull base are intact. The maxillofacial and orbital bones are intact. No fractures are demonstrated. In particular, the zygomatic processes are intact bilaterally.The globes are round and symmetric. The lenses are normally positioned. The extraocular muscles and optic nerves demonstrate a normal CT appearance. There may be mild left periorbital soft tissue swelling.
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1. No acute intracranial abnormality.2. No maxillofacial or orbital fractures.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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94 year-old patient. Reason: eval for pulmonary disease, cxr shows possible fibrotic disease vs. atypical infection History: 94 yo M with h/o severe aortic stenosis now with worsening dyspnea on exertion LUNGS AND PLEURA: Upper lung predominant patchy areas of reticular and groundglass opacities with associated bronchiectasis. Possible pulmonary edema.Moderate pleural effusions, right greater left.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Moderate coronary calcifications. Calcified aortic valve. Mild atherosclerotic changes of the thoracic aorta.Nonspecific mild thickening of the proximal esophagus.Mildly enlarged mediastinal lymph nodes. Calcified subcarinal lymph node consistent prior granulomatous disease.CHEST WALL: Moderate to severe multilevel degenerative changes in the thoracic spine. Dextroscoliosis of the thoracic and lumbar spine. Compression fracture of the T8 vertebral body without evidence of spinal canal stenosis. This vertebral body was not included in the field-of-view on prior examinations. Lucent lesion in the manubrium is most likely benign.No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Splenic granulomata.Moderate atherosclerotic changes of the abdominal aorta and its branches.
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Upper lung predominant patchy areas of reticular and groundglass opacities with associated bronchiectasis. Findings are suggestive of a hypersensitivity pneumonitis, however pleural effusions are not typically associated with this process.Bilateral moderate pleural effusions, right greater than left, and superimposed pulmonary edema is possible.T8 vertebral body compression fracture, age indeterminate.
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Generate impression based on findings.
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52-year-old female patient with shortness of breath. Evaluate for a pulmonary embolus. PULMONARY ARTERIES: Technically adequate examination. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Nonspecific scattered micronodules, some of which are calcified. Trace bilateral dependent atelectasis.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Mild atherosclerotic changes of the thoracic aorta.No mediastinal or hilar lymphadenopathy. Calcified hilar lymph node consistent with prior granulomatous disease.CHEST WALL: Moderate multilevel degenerative changes of the thoracic spine.Scattered small axillary lymph nodes.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Technically adequate examination without evidence of a pulmonary embolus.No evidence of an acute cardiopulmonary abnormality to account for patient's symptoms.
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Generate impression based on findings.
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65-year-old female with right lower quadrant pain. Evaluate for colitis, appendicitis. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Orally administered contrast passes freely throughout the bowel without evidence of obstruction or ileus. The appendix is visualized, nondilated no inflammatory changes, and fills normally with contrast.The root of the left mesentery demonstrates generalized haziness (best appreciated on coronal images 41 to 52), with small mesenteric lymph nodes, not seen on prior study. Appearance favors an inflammatory over neoplastic process. History of autoimmune hepatitis raises question of IgG4 sclerosing disease as underlying etiology.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis of the sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Haziness of the left mesenteric root favors inflammatory mesenteritis over a neoplastic etiology, and may represent spectrum of IgG4 sclerosing disease given the patient's history of autoimmune hepatitis.2.No evidence of colitis or appendicitis, as clinically questioned.
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Generate impression based on findings.
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59-year-old with possible NG, perforation LUNGS AND PLEURA: Moderate left pneumothorax with adjacent atelectasis. Endotracheal tube extends to the carina. Pulmonary interstitial emphysema along the left main bronchus, minimal.MEDIASTINUM AND HILA: Extensive pneumomediastinum tracking superiorly into the neck and inferiorly into the abdomen.No specific site of esophageal perforation is identified. Hiatal hernia.CHEST WALL: Marked subcutaneous emphysema tracking superiorly beyond the field-of-view.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Pneumoperitoneum. Cholelithiasis.
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Extensive pneumomediastinum subcutaneous emphysema tracking superiorly beyond the field-of-view as well as into the peritoneum. Left pneumothorax. Assessment for site of perforation is limited without oral contrast, however, no fluid collections are identified.
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Generate impression based on findings.
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Male, 11 years old, status post fall with head injury. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.The bones of the calvarium and skull base are intact.
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No acute intracranial abnormality.
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Generate impression based on findings.
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89-year-old male status post fall for evaluation of dislocation. Anterior dislocation of the humeral head relative to the glenoid. The humeral head is perched upon the anterior margin of the glenoid and situated immediately lateral to the coracoid process. Anterior to the humeral head is an approximately 1.5 cm fragment of bone situated beneath the anterior aspect of the deltoid muscle that represents a fracture fragment off the tip of the coracoid process. Additional densities are seen adjacent to the glenoid which may represent very small fracture fragments, perhaps chronic in etiology if there is a history of repeated dislocation. No discrete fracture line is seen extending through the glenoid. There is distention of the subdeltoid bursa with multiple calcific densities which are of uncertain etiology but may represent small fragments from repeated dislocations. The pectoralis minor muscle appears enlarged and of low density likely representing edema. Furthermore, there is nonspecific low to intermediate density material surrounding most of the humeral head. This is of uncertain etiology but could represent hemorrhage within the glenohumeral joint and surrounding tissues or perhaps synovitis. Multiple small calcifications are seen within this material which are of uncertain etiology but once again may represent small chronic fracture fragments or intraarticular bodies.The coracobrachialis muscle has low density suggesting edema. Please note that evaluation of the rotator cuff is limited particularly due to distorted anatomy resulting from dislocation. Mild enthesopathic changes along the greater tuberosity. Degenerative disk disease affects the visualized spine. Dependent atelectasis in the right lung base.
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Anterior dislocation of the humeral head, coracoid process fracture, and other findings as described above.
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Generate impression based on findings.
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55-year-old male with pain. Evaluate for pancreatitis. ABDOMEN:LUNG BASES: Right pleural effusion with mild atelectasis. There is some nodularity of the underlying pleura on the right.A1.1 x 1.9 cm low paracardiac lymph node on the left.LIVER, BILIARY TRACT: Ill-defined low-attenuation area at the hepatic dome measuring 1.5 x 2.8 cm on image 17/167. This does deform the hepatic capsule and therefore is suspicious for underlying mass.SPLEEN: No significant abnormality notedPANCREAS: Relatively atrophic with prominence of the duct in the region of the head.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 1.4 x 1.8 cm low-attenuation mass in the upper pole of the left kidney on image 38/167 measures higher than water density material this may represent a complex cyst, dedicated renal CT if indicated. Other, scattered low-attenuation foci too small to characterize in both kidneys.RETROPERITONEUM, LYMPH NODES: Multiple small retroperitoneal lymph nodes.BOWEL, MESENTERY: Evaluation limited by ascites.Postsurgical change in the anterior, upper abdomenBONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate ascites. There is ill -- defined soft tissue seen in the region of the perineum/omentum on the right on image 78/167, and I cannot exclude underlying peritoneal metastatic disease. Similar thickening in the right pelvis as noted on image 122/167.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical change in the anterior, upper abdomen. Evaluation of the mesentery limited by ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate ascites. There is ill -- defined soft tissue seen in the region of the perineum/omentum on the right on image 78/167, and I cannot exclude underlying peritoneal metastatic disease. Similar thickening in the right pelvis as noted on image 122/167.
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pleural effusion with underlying pleural nodularity. Ascites with question peritoneal/omental metastases.Right pleural effusion with pleural nodularity.Prominence of pancreatic duct in the region of the head.Report discussed with ED 12/6/13 at 8:45 AM
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Generate impression based on findings.
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73-year-old female with drop in hemoglobin, unknown source. ABDOMEN:The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:LUNGS BASES: Small bilateral pleural effusions with associated compressive atelectasis versus consolidation. Coronary artery calcifications and mild atherosclerotic calcification of the thoracic aorta. LIVER, BILIARY TRACT: The gallbladder is surgically absent with cholecystectomy clips in the gallbladder fossa.SPLEEN: Ill-defined hypodensity in the periphery of the spleen approximates fluid density and may represent old infarct.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: Mild atherosclerotic calcification of the abdominal aorta and its branches.BONES, SOFT TISSUES: Severe anasarca.OTHER: Splenic artery calcifications are 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: Severe anasarca.OTHER: No significant abnormality noted.
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1.No evidence of hemorrhage, as clinically questioned.2.Severe anasarca.
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Generate impression based on findings.
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68-year-old male with cough and fever, history of OHT, + RSV, r/o consolidation LUNGS AND PLEURA: Patchy left lower lobe airspace opacities consistent with pneumonia. Right basilar atelectasis or scarring. Mild right pleural thickening.MEDIASTINUM AND HILA: Postoperative changes of heart transplantation. Atherosclerotic changes of the aorta. Mild right paratracheal lymphadenopathy. 14-mm low left paratracheal lymphadenopathy and mild left hilar lymphadenopathy. CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Atherosclerotic calcifications of the aorta and its branches.
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Left lower lobe pneumonia. Contralateral high paratracheal lymphadenopathy, atypical in distribution and should be followed by CT in 3 months.
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Generate impression based on findings.
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52-year-old male with recurrent pancreatitis. Low hemoglobin, concern for malignancy. ABDOMEN:LUNG BASES: Small left pleural effusion. Bibasilar atelectasis.LIVER, BILIARY TRACT: Perihepatic ascites. There is severe narrowing of the portal vein, but it is patent. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: Peripancreatic inflammation compatible with pancreatitis. There is an intraparenchymal fluid collection in the pancreatic head measuring 4.2 x 2.9 cm (image 56 series 11). There is an additional peripancreatic loculated fluid collection in the lesser sac measuring 4.5 x 3.7 cm (image 55 series 11). There is fat stranding in the adjacent omentum. No pancreatic ductal dilatation. Pancreatic tissue enhances without evidence of necrosis. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: There is expected regional adenopathy.BOWEL, MESENTERY: There is thickening of the duodenum and stomach, due to inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Percutaneous gastrojejunostomy tube in place with tip at the ligament of Treitz. Ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Pelvic ascites.
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1. Pancreatitis, with intrapancreatic and pancreatic fluid collections.2. Gastric and duodenal thickening and inflammation.3. Severe narrowing of the portal vein.4. Ascites and small left pleural effusion.5. Gastrojejunostomy tube with tip at the ligament of Treitz.
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Generate impression based on findings.
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54 year old male with question of Richter's hernia, lower abdominal pain, evaluate for bowel obstruction. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Nodular liver contour, and fissural prominence. Large collateral paraumbilical veins are noted. The portal vein is patent. No focal hepatic lesion. SPLEEN: The spleen is enlarged and measures 19.6 cm in craniocaudal dimension.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Expected regional adenopathy. BOWEL, MESENTERY: No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No ascites. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small fluid collection, measuring 2.7 x 1.6 cm adjacent to the right anterior abdominal wall. Right femoral hernia containing fat and small amount of fluid.
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1. Small fluid collection adjacent to right anterior abdominal wall. 2. Cirrhotic liver morphology, with large collateral paraumbilical vein and splenomegaly. 3. Small right inguinal hernia containing fat and small amount of fluid.
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Generate impression based on findings.
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52-year-old male with chest pain, rule out dissection. CHEST:LUNGS AND PLEURA: A filling defect is seen near the bifurcation of the right pulmonary artery and likely represents chronic, organizing thrombus versus artifact.No evidence of acute pulmonary embolism. MEDIASTINUM AND HILA: Pacemaker leads are noted in the expected location. The aorta and its branches fill normally. No evidence of aortic dissection.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: The aorta and its branches fill normally, without evidence of aortic dissection.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No evidence of aortic dissection, as clinically questioned.2.Chronic organizing thrombus versus artifactual filling defect near the right pulmonary artery bifurcation. No evidence of acute pulmonary embolism.Findings were relayed via telephone to Dr. Blumen in the emergency department at 10:37 a.m. on December 6, 2013.
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Generate impression based on findings.
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31-year-old female with persistent epigastric pain status post MAL release. Evaluate for any fluid collections or source of continued gastric pain postop. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Short segment, focal high-grade celiac axis narrowing immediately distal to the ostium, measuring 3 mm in diameter. The ostium and distal artery are normal in caliber. Contrast filling of the distal artery is normal. Surrounding soft tissue may represent adenopathy versus postsurgical changes.
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Focal high-grade narrowing of the celiac artery measuring 3 mm in diameter immediately distal to the ostium. Normal caliber ostium and distal artery, which fills normally.
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Generate impression based on findings.
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Female 71 years old; Reason: Stage IV gastric cancer please compare to previous scan and provide index lesion measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: Stable scarring in the right lung base.Stable calcifications of the trachea. Stable mild micronodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Stable right port a cath with its tip in the cavoatrial junction. Small filling defect at the tip of the port-a-cath likely represents small thrombus.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: The previously seen 7-mm soft tissue density left renal/perirenal lesion has decreased in size now measuring 5mm on image number 91 on series number 80380. Follow-up imaging is still recommended.RETROPERITONEUM, LYMPH NODES: Severe atheromatous calcifications of the aorta with ulcerative plaque (series 80292 image 43) is noted. BOWEL, MESENTERY: Postsurgical changes secondary to partial gastrectomy. Fat stranding without measurable soft tissue lesion in the greater omentum and gastrocolic ligament has decreased, still consistent with peritoneal carcinomatosis. No definite nodule detected. Small amount of ascites is present.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. Postsurgical changes secondary to gastrectomy. Decrease in findings of peritoneal carcinomatosis.2. Ulcerative plaque with severe atheromatous calcifications in the abdominal aorta.
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Generate impression based on findings.
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Female 80 years old; Reason: metastatic breast cancer - evaluate response to treatment, compare with previous History: known lung mets with rising tumor marker CHEST:LUNGS AND PLEURA: Subpleural fibrotic changes worst in the lingula are stable.Right upper lobe nodule is stable measuring 0.8 x 0.8 cm (image 30/series 5) previously, the same.Right middle lobe lesion with measures 1.9 x 1.0 cm previously 2.0 x 1.0 cm (image 55/series 3).Scatter ground glass opacities and micro nodules are stable.No new suspicious lesions. Pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.Right chest wall port terminates at the cavoatrial junction.CHEST WALL: Postoperative and radiation changes in the left chest with multiple clips in the left axilla.Small right axillary lymph nodes persist.ABDOMEN:LIVER, BILIARY TRACT: Liver is diffusely hypodense compatible with fatty infiltration. No suspicious hepatic lesions.Hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy. Calcific arteriosclerotic disease affects the aorta .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: Colonic diverticulosis.BONES, SOFT TISSUES: Degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted.
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1.Stable pulmonary findings with no new metastatic disease detected.
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Generate impression based on findings.
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Pneumococcal pneumonia, evaluate right lower lobe opacity. LUNGS AND PLEURA: Severe paraseptal and mild centrilobular emphysema with peripheral/paramediastinal bullae bilaterally. No pneumothorax. Compared to the 2007 exam, solid scarlike opacity in the right upper lobe has not significantly changed with the exception of its most caudal aspect which has increased in density on series 6 image 28. New nodular opacity in the posterior medial right lower lobe (6/47-48) measures fluid density and likely reflects fluid within one of the cystic air spaces. Significant interval development of scarring, volume loss and groundglass opacity in the right lower lobe. On sagittal image 24, one of these solid areas of consolidation is somewhat rounded in appearance measuring 2-cm in craniocaudal length by approximately 3.1-cm transverse (5/262). On the prior examination of 2007, there was a small nodular scarlike opacity in this region, nonspecific in appearance at the time. Within costophrenic angle regions, left greater than right, dependent atelectasis and minimal consolidation is present .Left apical calcific scarring not significantly changed. Left lower lobe focal scarlike opacity posteriorly (6/70) is new but nonspecific in appearance.5-mm right lower lobe peribronchial nodular opacity in the periphery of the lung (5/23) new from previous. Similar micronodule left lung base (6/90).Subpleural paramediastinal consolidation in the right upper lobe is new (6/24).MEDIASTINUM AND HILA: Bilateral thyroid gland enlargement consistent with goiter. Atherosclerotic calcification of the thoracic aorta. Main pulmonary artery appears enlarged, 3.5-cm (4/54). Severe left anterior descending coronary artery calcifications. Small volume of pericardial fluid. Upper normal heart size. Calcified mediastinal lymph nodes.CHEST WALL: Degenerative changes of the spine. Chronic deformity of the right posterior upper ribs with bony bridging.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. Granulomata in the spleen. Atherosclerotic calcifications of the aorta and its branches.
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1. No conclusive signs of active infection, though the basilar opacities could potentially reflect an evolving or resolving infectious process. 2. Nonspecific appearing new or enlarging areas of subpleural consolidation. Multifocal cryptogenic organizing pneumonia is favored however neoplastic process cannot be entirely excluded. Caudal aspect of the right upper lobe scar has increased intensity since the prior examination; this could be the result of evolution of scar/COP however scar carcinoma cannot be excluded with a further follow-up. If prior outside CT scans can be obtained and submitted by the referring clinical service for comparison purposes, an addendum to this report can be made if formally requested. Otherwise, 3-month CT follow-up recommended unless there is a high level of clinical suspicion for malignancy in which case PET scan would be more definitive.3. Nonspecific pulmonary micronodules for which 6-12 month CT follow-up is recommended.4. Signs of pulmonary arterial hypertension and severe coronary artery disease.5. Severe emphysema.
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Generate impression based on findings.
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68-year-old female with lung cancer status post chemotherapy CHEST:LUNGS AND PLEURA: Status post right upper lobectomy. Numerous pulmonary nodules have decreased in size or resolved. Reference right lower lobe nodule is no longer visualized. Right pleural thickening and calcification is unchanged.MEDIASTINUM AND HILA: Reference high right paratracheal lymph node measures 5 mm and previously measured 10 mm (image 24 series 4). Numerous additional small lymph nodes are decreased in size. Normal heart size. No pericardial effusion. Surgical clips are again noted.CHEST WALL: Multiple sclerotic osseous metastases, unchanged in number. Multiple small bilateral subpectoral and axillary lymph nodes. The reference right subpectoral lymph node measures 6 mm and previously measured 6 mm (image 24, series 4). Right lateral chest wall subcutaneous scarring/soft tissue is unchanged in thickness, measuring 18 mm in thickness and measured 19 mm (image 92, series 4). Right lateral chest wall postsurgical changes and bony rib bridging again identified.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis without evidence of inflammation.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.Scattered soft tissue nodules in the right hemiabdomen are not increased in number.BONES, SOFT TISSUES: Multiple sclerotic osseous metastases, unchanged in number. OTHER: No significant abnormality noted.
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Interval decrease in size and resolution of the multiple pulmonary nodules. Unchanged osseous metastases.
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Generate impression based on findings.
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77-year-old female. Reason: evaluate for lymphadenopathy History: recent diagnosis of AML LUNGS AND PLEURA: Diffuse mild septal thickening and ground glass opacities suggestive of mild pulmonary edema. Scattered ground glass centrilobular nodules.There is an irregularly shaped, mostly solid nodule in the left lower lobe measures 7 mm (series 4 image 61). Two solid nodules in the right upper lobe each measure 5 mm (series 4 image 40).Bibasilar scarring.MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Severe left anterior descending coronary artery calcification and probable left main stent. Aortic valve calcifications. Moderate atherosclerotic changes of the thoracic aorta.Scattered mildly enlarged mediastinal lymph nodes with subcarinal lymph node measuring 13 mm (series 3 image 43). Upper right paratracheal lymph node measures 13 mm (series 3 image 18). No significant hilar lymphadenopathy.CHEST WALL: Mild multilevel degenerative changes of the thoracic spine. Left humeral head fixation hardware in place.No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia.Mild left or scar changes of the abdominal aorta. Scattered small retroperitoneal lymph nodes.
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Mildly enlarged mediastinal lymph nodes with measurements provided.Nodules in the left lower and right upper lobe measuring between 5 and 7 mm in addition to groundglass centrilobular nodules, most consistent with atypical infection such as viral pneumonia such as CMV. Consider follow-up imaging after appropriate medical management.
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