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Generate impression based on findings.
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50 year-old male with gist tumor. Evaluate for stability of disease. CHEST:LUNGS AND PLEURA: Pleural scarring/thickening along the right hemithorax without change. Mild apical emphysematous change.MEDIASTINUM AND HILA: Small thyroid nodule again noted. Increased attenuation in the the mediastinal fat is stable. Presumably this represents thymus.CHEST WALL: Conglomerate left axillary adenopathy measuring 1.3 x 2 . 4 cm, not significant change.ABDOMEN:LIVER, BILIARY TRACT: Segment 5 somewhat ovoid low-attenuation reference mass measures 0.7 x 1.3 cm without significant change. No new focal hepatic abnormalities.SPLEEN: Post splenectomyPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small left renal cyst.RETROPERITONEUM, LYMPH NODES: Para-aortic adenopathy is to see noted now measures 1 x 1.7 centimeters on image 131/220 unchanged or slightly increased.BOWEL, MESENTERY: There is again noted a small nodule abutting the peritoneum in the left upper quadrant anteriorly measuring 0.9 x 1.3 cm on image 1/220, increased in size. No new abnormalities identified.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedstable hepatic mass.Increasing size of peritoneal nodule.No change or slight increase in retroperitoneal adenopathy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable axillary adenopathyStable hepatic mass.Increasing size of peritoneal nodule.No change or slight increase in retroperitoneal adenopathy.
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Generate impression based on findings.
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Malignant neoplasm of colon. Metastatic disease to supraclavicular area, mediastinum and liver. CHEST:LUNGS AND PLEURA: Scattered micronodules should be followed. Left pleural effusion with overlying compressive-type atelectasis.MEDIASTINUM AND HILA: Right supraclavicular lymph node measures 1.7 x 2.0 cm (image 15; series 3). Multiple enlarged mediastinal lymph nodes are noted.CHEST WALL: Right chest port. Bilateral breast implants.ABDOMEN:LIVER, BILIARY TRACT: Innumerable hepatic metastases. For reference purposes, a metastasis at the tip of the left lateral segment (segment two) measures 3.0 x 3.3 cm (image 78; series 3) No intrahepatic biliary ductal dilatation. Perihepatic ascites.SPLEEN: Spleen measures 15.1-cm in AP dimension.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Numerous enlarged retroperitoneal lymph nodes. For reference purposes, a left para-aortic lymph node (image 114; series 3) measures 2.6 x 2.5 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Abdominal ascites.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: Pelvic ascites.
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Widespread metastatic disease with reference measurements given above.
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Generate impression based on findings.
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Hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Mildly enlarged prostateBLADDER: 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 GU related abnormality. Specifically, no evidence for renal mass on this noncontrast study. No evidence for acute inflammatory process, obstruction, or stone
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Generate impression based on findings.
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HNC, CRT compared to previous. CHEST:LUNGS AND PLEURA: 4-5 mm flat subpleural nodular density with linear margins, previously 4-mm, not conclusively changed since the patient's study of 7/24/12 and most likely a benign subpleural lymph node. This measurement should be dropped on subsequent examinations. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No significant lymphadenopathy. Normal heart size. Normal variant anatomy.CHEST WALL: Multiple small sub-pectoral/high axillary region lymph nodes bilaterally unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Numerous large lamellated gallstones in the gallbladder. No intrahepatic biliary ductal dilatationSPLEEN: No significant abnormality noted.ADRENAL GLANDS: Mild thickening of the left adrenal gland not significantly changed.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Unchanged 9-mm left periaortic lymph nodeBOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastatic disease. Cholelithiasis.
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Generate impression based on findings.
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Prostate carcinoma with rising PSA and weight loss 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: Stable right renal cystRETROPERITONEUM, LYMPH NODES: Stable aneurysmal dilatation of the abdominal aorta with maximal AP diameter of 2.7 cmBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomyBLADDER: No significant abnormality notedLYMPH NODES: Interval appearance of 1.1 x 0.7 cm left external iliac lymph node best seen on image 76 of series 4.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Status post prostatectomy. Interval appearance of mildly enlarged left external iliac lymph node; best considered indeterminate. Would pay special attention to this node on future surveillance scans
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Generate impression based on findings.
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Female 57 years old; Reason: SBO History: abdominal pain, recent diagnosis ABDOMEN:LUNG BASES: No significant abnormality detected.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Indeterminate left adrenal nodule is unchanged in size.KIDNEYS, URETERS: Bilateral nephroureteral scans. Left greater than right hydronephrosis, stable from the prior exam.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post omentectomy and partial small bowel resection. Dilated loops of small bowel in the mid abdomen adjacent to the surgical clips noted measuring up to 3.1 cm (series 3 image 86). Feces noted within the small bowel in the left lower quadrant. No definite transition point noted.Reference peritoneal soft tissue nodule in the left anterior pelvis is not well visualized on this examination, and measures 2.1 x 1.4cm previously 2.5 x 1.4 cm (series 3, image 109). Subcentimeter peritoneal nodules at the level of the hepatic flexure, also stable. No evidence of bowel obstruction, pneumoperitoneum, or mesenteric free fluid.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. Small bowel dilation with small bowel feces sign suggestive of small bowel obstruction. The transition point appears to be in the right lower quadrant secondary to peritoneal carcinomatosis.2. Peritoneal nodularity compatible with carcinomatosis without significant interval change.3. Left greater than right hydronephrosis, stable from the prior exam.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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39 year-old female status post heart transplant experiencing recurrent headaches with neuropathic symptoms. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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Negative noncontrast head CT. Specifically, there are no CT findings to explain the patient's symptoms.
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Generate impression based on findings.
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16 year-old male experiencing headache with brain mass, postop, evaluate for hemorrhage. There has been interval biopsy via a posterior frontal approach with concurrent placement of a right ventriculostomy catheter. A tiny amount of subarachnoid hemorrhage, pneumocephalus, intraventricular air, as well as a tiny amount of dependent blood within the occipital horns is consistent with the postoperative status. There are no significant postoperative hemorrhages.Redemonstrated is a known, predominantly hypoattenuating mass with peripheral hyperdense nodules centered at the right thalamus and pineal region with extension into the superior cerebellar cistern. The mass compresses the third and right lateral ventricles, although there has been no significant interval change in ventricular sizes. Mild leftward midline shift is unchanged. The cerebellar tonsils appear minimally low lying, unchanged. The gray-white matter differentiation is maintained. The paranasal sinuses and mastoid air cells are essentially clear.
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There has been interval biopsy via a posterior frontal approach with concurrent placement of a right ventriculostomy catheter. A tiny amount of subarachnoid hemorrhage, pneumocephalus, intraventricular air, as well as a tiny amount of dependent blood within the occipital horns is consistent with the postoperative status. There are no significant postoperative hemorrhages.
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Generate impression based on findings.
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35-year-old female with rapidly progressive erythema, pain laterally around the knee, evaluate for gas, soft tissue infection There is reticulation and edema of the subcutaneous soft tissues and fat that extends from the knee to the foot. There is induration of the skin along the lateral aspect of the proximal one third of the lower leg as well as the medial aspect of the distal one third of the lower leg. No evidence of subcutaneous gas to suggest necrotizing fasciitis. Bones appear unremarkable.
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Subcutaneous reticulation edema without evidence of soft tissue gas compatible with cellulitis.
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Generate impression based on findings.
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78-year-old male sepsis and ARDS CHEST:LUNGS AND PLEURA: Interval development of bilateral large pleural effusions and dependent atelectasis. Endotracheal tube is in place.MEDIASTINUM AND HILA: Mediastinal adenopathy, not significant changed. Mild cardiomegaly, unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodule, not significant changed.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy, not significantly changed.BOWEL, MESENTERY: Mesenteric borderline enlarged lymph nodes, not significant changed. Small ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval development of bilateral large pleural effusions and dependent atelectasis.Interval development a small amount of ascites.Mediastinal retroperitoneal and mesenteric lymph nodes, stable.
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Generate impression based on findings.
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53-year-old male with abdominal pain. Rule out cholecystitis. ABDOMEN:LUNGS BASES: Patchy right lower lobe groundglass opacities may represent early infection or atelectatic changes.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. The gallbladder is contracted. Small amount of pericholecystic fluid is nonspecific in the setting of ascites.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral atrophic kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Peritoneal dialysis catheter enters from the right lower anterior abdominal wall and coils in the mid pelvis. Moderate amount of ascites throughout the abdomen. No loculated fluid collection.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No CT evidence of cholecystitis, as clinically questioned. If clinical concern remains, recommend right quadrant ultrasound for complete evaluation of the gallbladder.2.Moderate ascites throughout the abdomen likely due to peritoneal dialysis.3.Early infection versus atelectatic changes in the right lower lobe. Clinical correlation is recommended.
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Generate impression based on findings.
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70 year-old male with recurrent small cell lung cancer with hypoxia and new pleural effusion PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus. The distal arteries are diminutive due to compression from surrounding mass. The main pulmonary artery measures 3.6 cm indicating pulmonary arterial hypertension.LUNGS AND PLEURA: Large right perihilar mass encases the right pulmonary artery and bronchi with invasion into the mediastinum compression of the right pulmonary veins. Multiple additional pulmonary nodules on the right. There is associated postobstructive atelectasis and consolidation in the right middle and upper lobes. Patchy groundglass opacities in the right middle and upper lobes with septal thickening suggest edema. Moderate underlying centrilobular emphysema. Nodular pleural metastases in the right lower lobe. Small right and trace left pleural effusions.MEDIASTINUM AND HILA: Marked mediastinal, hilar and supraclavicular/subpectoral lymphadenopathy. A high left paratracheal lymph node measures 1.4 cm (image 60 series 4). AP window and left hilar lymphadenopathy. Small pericardial effusion and cardiophrenic lymph nodes. Left ventricle and atria are enlarged. Severe atherosclerotic calcification of the coronary arteries. Atherosclerotic calcification of aorta. Distended debris filled proximal esophagus.CHEST WALL: Degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Upper abdominal lymphadenopathy/masses partially visualized, one which possibly involves the left adrenal gland.
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1. Technically adequate exam without evidence of pulmonary embolus.2. Large right perihilar mass invading the mediastinum and compressing the proximal bronchi, pulmonary arteries and inferior pulmonary vein. Multiple pulmonary nodules, mediastinal lymphadenopathy and upper abdominal lymphadenopathy/mass consistent with metastatic disease.3. Small right pleural effusion and edema in the right lung likely from venous compression.
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Generate impression based on findings.
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34-year-old female with history of abdominal pain. Evaluate for cause of pancreatitis. ABDOMEN:Exam is limited by significant motion artifact.LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Exam is significantly limited by motion artifact. There is probably mild pancreatic edema, with minimal peripancreatic fat stranding. While no pancreatic necrosis, peripancreatic fluid collection, pseudoaneurysm, or venous thrombosis is identified, cannot rule out due to exam limitations.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral subcentimeter hypodensities are too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Mild inflammatory changes consistent with acute pancreatitis without evidence of complication in this limited exam.
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Generate impression based on findings.
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Sickle cell disease, evaluate from his enteric ischemia ABDOMEN:LUNG BASES: Linear atelectasis at the lung basesLIVER, BILIARY TRACT: Dilated common bile duct. Mild intrahepatic biliary dilatation. Status post cholecystectomy.SPLEEN: Calcified small spleen.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted. Normal abdominal aorta and major branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic changes in bones consistent with patient's known history of sickle cell disease.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Wall thickening of the bladder so distal cystitis.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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Normal CT angiography of the abdomen and pelvis.Calcified small spleen.Intra-and extrahepatic biliary dilatation. Etiology is unknown.Bone changes secondary to sickle cell disease.Mild wall thickening of the bladder with very compatible with cystitis.
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Generate impression based on findings.
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48-year-old female with wheezing and PEA arrest PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Evaluation of the lungs is limited due to motion artifact. Extensive bilateral upper lobe predominant interstitial opacity with septal thickening and patchy multifocal basilar consolidation involving the left upper and bilateral lower lobes. Moderate underlying emphysema.MEDIASTINUM AND HILA: Swan-Ganz catheter extends to the left pulmonary artery. Enteric tube extends to the stomach. Endotracheal tube at the thoracic inlet with cuff near the vocal cords. Calcified mediastinal and hilar lymph nodes compatible with prior granulomatous disease PICCCHEST WALL: No acute abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Upper abdomen is poorly evaluated due to significant respiratory motion. No acute abnormality noted.
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1. Technically adequate exam without evidence of pulmonary embolus.2. Extensive bibasilar consolidation suggesting massive aspiration. 3. Diffuse interstitial opacities indicating pulmonary edema with underlying emphysema.4. High placement of endotracheal tube.
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Generate impression based on findings.
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Female 52 years old; Reason: Eval fluid colletions seen on previous CT: 10 x 8.1-cm collection in the pelvic cul-de-sac, 4.1 x 4.3 cm fluid collection L flank History: On IV abx, doing well at home. Need to f/u fluid collections before d/c abx ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No suspicious hepatic lesions. Previously seen hepatic hypodensity at the hilum is not well visualized on this examination.SPLEEN: The spleen is normal in size.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Post operative changes from Roux-en-Y gastric bypass with an antecolic limb. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Interval removal of the bilateral mesenteric drains. The previously seen left paracolic abscess has resolved in the interim.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Air in the bladder presumably reflect recent instrumentation.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Please see aboveBONES, SOFT TISSUES: No significant abnormality noted.OTHER: Previously seen abscess in the pelvic cul de sac has resolved in teh interim.
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1. Interval resolution of the previously seen fluid collections and removal of the surgical drains.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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64 year-old female with right lung cancer, new dysphagia and right-sided shoulder pain. LUNGS AND PLEURA: Small right pleural effusion. Right upper lobe nodule measures 8 x 8 mm (image 16 series 6). Linear and nodular opacities in the right lung and subsegmental right middle lobe atelectasis.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. Mildly enlarged mediastinal lymph nodes. One high right paratracheal lymph node measures 6 mm (image 14 series 4). Patulous distal esophagus with diffuse wall thickening.CHEST WALL: Mild degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic dome hypodensity likely represents a cyst.
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1. Marked distal esophageal wall thickening suggesting esophagitis although underlying mass cannot be excluded.2. Right upper lobe nodule and small pleural effusion consistent with the patient's underlying lung cancer.3. Few mildly enlarged mediastinal lymph nodes.
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Generate impression based on findings.
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60 year-old female with chest pain, rule out PE PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Large left pneumothorax with collapse of the left lung. Moderate upper lobe predominant centrilobular emphysema. The collapsed left lung contains several foci of consolidation as well as possible apical bullae with associated nodular opacity. A small defect suggest a ruptured bulla. MEDIASTINUM AND HILA: The mediastinum is mildly shifted to the right. The heart size is normal. No pericardial effusion. Mild coronary arterial calcification.CHEST WALL: Status post left mastectomy. Faint nonspecific sclerotic focus in the posterior right T4 vertebral body.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic hypodensities are incompletely characterized due to contrast phase and motion. Right renal cyst. Punctate cholelithiasis.
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1. No pulmonary embolus. 2. Large left pneumothorax with collapse of the left lung and mild rightward mediastinal shift. Nodular opacity adjacent to a left apical bulla may represent atelectasis although follow up imaging may be considered following lung reexpansion, when clinically appropriate.
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Generate impression based on findings.
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Malignant neoplasm of cheek mucosa CT neck:The patient is status post left sided mandibulectomy with placement of a prosthesis and the patient is status post removal of the left submandibular gland. In general the appearance of the left cheek and the left submandibular space remains stable when compared to the prior exam. A number of surgical clips present at the site as well as infiltration of the fat planes along the left suprahyoid neck there is some infiltration and now into the tongue base and left to vallecula and right vallecula present which was not present on the prior exam with thickening along the mucosal lining.Since the prior exam a mass in the right infrahyoid neck has been removed. There are surgical clips now present in the right neck to this infrahyoid mass was present. There is infiltration of the fat planes surrounding the right carotid space and the right sternocleidomastoid muscle extending from the C1 vertebral level down to the level of the thyroid gland .At the angle of the right mandible the right jugulodigastric node currently measures 14 x 11 mm in axial dimensions and previously measured 12 x 10 mm axial dimensions. There is a measurable pseudo lesion on axial imaging but not coronal or sagittal imaging measuring 14 x 12 mm axial dimensions at the right retropharyngeal space at the level of the right node of Rouviere which is suspected to represent a pseudolesion created by some fat plane infiltration and adjacent tortuous vessels.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Right submandibular space lymph nodes remaining at approximately 7 mm short axis dimensionWithin the visceral space the thyroid gland appears intact.The airway appears patent.The parotid lands appear intact. The right parotid gland it is obscured by some infiltration of fat planes into the right submandibular space where the patient's had recent surgeryThe visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are some degenerative changes present at C5-6 with small uncovertebral osteophytes and a disk bulge.The visualized portions of the paranasal sinuses demonstrate some mucosal thickening in the right maxillary sinus which was also present on prior exams. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.No evidence for neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy.2.There is some thickening along the mucosal lining of the oropharynx and vallecula and epiglottis which has developed since the prior exam. It is suspected to be post-treatment related. A follow-up exam would help confirm.3.the patient is status post recent removal of a mass in the right neck. There is infiltration of the fat planes in the right neck extending from the C1 vertebral level down to the level of the thyroid gland with some of the infiltration extends into the right submandibular space. This is suspected to represent posttreatment change. A follow-up exam would help confirm.
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Generate impression based on findings.
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Female 58 years old; Reason: Rule out cholecystitis History: Abdominal pain, diffuse ABDOMEN:LUNGS BASES: Cardiomegaly with vascular congestion, status post AICD placement. No nodule or mass detected.LIVER, BILIARY TRACT: No focal lesion detected. Granuloma noted in the liver. Small amount of perihepatic fluid. Status post cholecystectomy. SPLEEN: No significant abnormality noted.PANCREAS: Small low attenuating lesion in the tail of the pancreas, incompletely characterized.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Non specific mesenteric fat stranding in the right upper quadrant extending around the hepatic flexure, pylorus and duodenum. No drainable fluid collections, obstruction, or free air.BONES, SOFT TISSUES: Marked degenerative changes in the spine.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: Marked degenerative changes in the spine.OTHER: Small amount of free fluid in the pelvis.
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1.Non specific inflammation in the right upper quadrant with fluid in the pelvis. Status post cholecystectomy. 2.Small hypoattenuating lesion in the right upper quadrant, MRI/MRCP advised for full characterization.
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Generate impression based on findings.
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60 year-old female with chest pain status post trauma LUNGS AND PLEURA: Low lung volumes with bilateral linear opacities suggest atelectasis and scarring. No pneumothorax or pulmonary contusion.MEDIASTINUM AND HILA: The heart size is normal. No mediastinal or hilar lymphadenopathy.CHEST WALL: No rib fractures are identified.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No acute abnormality. No rib fracture or pneumothorax.
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Generate impression based on findings.
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Jaundice ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is intra-and extra hepatic biliary dilatation. Distal common bile duct is normal in caliber. The etiology is unknown but this may be secondary to stones or a neoplasm involving the distal common bile duct. Distended gallbladder with mild fat stranding around the gallbladder. This may represent early cholecystitis. Ultrasound may helpful for further evaluation.SPLEEN: No significant abnormality notedPANCREAS: Mildly enlarged pancreas with low density in the head of the pancreas, likely representing mild pancreatitis. An underlying neoplasm cannot be excluded. M.R.C.P. is recommended for further evaluation.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Intra next hepatic biliary dilatation. Distended gallbladder with mild fat stranding around the gallbladder. The etiology is unknown. These findings there is secondary to a stone in the distal common bile duct, however, an underlying neoplasm cannot be excluded. M.R.C.P. is recommended for further evaluation.Mildly enlarged pancreas which may be compatible with mild pancreatitis.
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Generate impression based on findings.
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69-year-old male with abdominal pain and continued intolerance of feeding ABDOMEN:LUNG BASES: Right-sided small pleural effusion. Partially visualized metastases in the lung bases.LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: GJ tube is in place. No evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of bowel obstruction.Pulmonary metastases.Cholelithiasis.Bilateral renal cysts.
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Generate impression based on findings.
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r/o recurrent tumorSigns and Symptoms: headaches, otalgia, neck pain, cellulitis to anterior neck CT neck:The patient is status post tracheostomy tube placement and a laryngectomy since the prior exam. There is a soft tissue mass present above the tracheostomy site measuring 45 x 33 mm axial dimensions no and 40 x 26 mm sagittal dimensions. There is some some remaining thyroid cartilage and a small piece of hyoid bone present at the surgical site.The patient is also status post sternotomy repair.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear with some pleural thickening which is similar to the prior examThe carotid and vertebral vasculature visualized on this exam appears intact. Atherosclerotic calcifications are present at the carotid bifurcations.The cervical vertebral bodies in general are intact with no evidence for canal stenosis.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No acute intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.
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1.The patient status post recent total laryngectomy and tracheostomy tube placement. There is a soft tissue mass present at the surgical site at the level of the remaining thyroid cartilage above the tracheostomy tube and at the hypopharynx. Please correlate with clinical findings. The possibility this represent malignancy cannot be excluded on the basis of this exam. 2.No evidence for brain metastases.
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Generate impression based on findings.
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63 year-old female, possible retained PICC line fragment LUNGS AND PLEURA: Right middle lobe loculated fluid collection with air fluid level consistent with an intrapulmonary abscess. Moderate bilateral pleural effusions with compressive atelectasis. Additional multifocal bronchial wall thickening and airspace opacities consistent with pneumonia as well as interstitial thickening suggesting overlying edema. No evidence of retained foreign body.MEDIASTINUM AND HILA: Diffuse mediastinal and hilar lymphadenopathy, likely reactive. Some calcified mediastinal lymph nodes likely related to prior granulomatous disease. Pericardial effusion. The heart size is normal. Low density blood pool consistent with anemia.CHEST WALL: Anasarca.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Mild mesenteric edema.
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1. Air fluid collection in the right middle lobe consistent with an intrapulmonary abscess. Additional multifocal air space opacities and moderate bilateral pleural effusions consistent with pneumonia with mild overlying edema.2. No evidence of retained foreign body.
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Generate impression based on findings.
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52-year-old male with carcinoid tumor, compare prior exam CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema and multiple pulmonary cysts appear similar to the prior exam.Cavitating left upper lobe nodule with peripheral nodular density and 3-mm wall thickness (previously 3 mm) is not significantly changed (image 22 series 5).Stable lesion abutting the anterior pleura measures 2.2 x 1.2 cm and previously measured 2.3 x 1.2 cm (image 43 series 5). Superior and lateral to this lesion at the site of a previously noted groundglass nodule several nodular opacities, possibly postinflammatory (image 38 series 5).Reference medial left lower lobe nodule measures 1.1 x 0.8 cm and previously measured 1.1 x 0.9 cm (image 86 series 5), unchanged. Additional small scattered pulmonary nodules are unchanged.MEDIASTINUM AND HILA: Index left hilar mass encasing and narrowing the left upper lobe bronchus measures 3.5 x 2.2 cm and previously measured 3.5 x 2.1 cm (image 43 series 3). Index paratracheal lymph node measures 1.7 cm and previously measured 1.9 cm (image 38 series 3). Index left paraspinal mass measures 1.5 x 2.3 cm and previously measured 1.5 x 2.3 cm (image 74 series 3).Venous catheter tip extends to the SVC. Unchanged low paraesophageal lymph node.CHEST WALL: Right chest wall port. Mild degenerative changes of the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypodense hepatic lesions are not significantly changed.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral renal hypodensities likely represent cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Ill-defined mesenteric haziness is not significantly changed, nonspecific.BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.
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1. Unchanged reference lesions.2. Multiple non-reference pulmonary nodules and cavitary left upper lobe lesion appear unchanged. Two new pulmonary nodules near a previously noted groundglass opacity may represent recurrent aspiration are identified for which continued 3 month follow up is recommended to exclude malignancy.
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Generate impression based on findings.
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52 year-old female with thymoma Morvan's syndrome CHEST:LUNGS AND PLEURA: Right lower lobe nodule measures 10 x 11 mm and previously measured 10 x 8 mm (image 39 series 4. Adjacent nodular opacity suggesting post posttreatment changes again identified. Left lung volume loss and paramediastinal clips. No new nodules or masses. Paramediastinal post radiation changes are unchanged.Volume loss and postsurgical changes involving the left hemithorax.Right lung base nodule measures 7 x 6 mm and previously measured 8 x 6 mm (image 76 series 4).MEDIASTINUM AND HILA: Heart size is normal. No significant mediastinal or hilar lymphadenopathy. Multiple left paramediastinal surgical clips are again noted. Tricuspid annuloplasty with right atrial dilatation again noted. Unchanged right hilar lymph node.CHEST WALL: Postoperative changes of the left hemithorax. Old right rib fracture.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy. No focal hepatic lesions.SPLEEN: Multiple hypoattenuating lesions are nonspecific but unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Intrathecal infusion pump and catheter are unchanged.OTHER: No significant abnormality noted.
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Pulmonary nodules and associated treatment effect without significant interval change. Multiple nonspecific hypoattenuating splenic lesions appear similar to the prior exam.
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Generate impression based on findings.
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60 year-old female with history of second degree heart block progressing to complete heart block and cardiac MRI suggesting possible inflammation scarring evaluate for sarcoidosis LUNGS AND PLEURA: Mild basilar atelectasis or scarring. No evidence of interstitial lung disease or sarcoidosis.MEDIASTINUM AND HILA: Pacemaker leads in expected position. Scattered normal sized mediastinal lymph nodes. No pericardial effusion. The ventricular septum appears hypertrophic although the cardiac phase cannot be confirmed. Mild coronary arterial calcificationsCHEST WALL: Left chest wall generator.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No findings to suggest sarcoidosis. 2. Possible left ventricular septal hypertrophy, although the cardiac phase cannot be confirmed.
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Generate impression based on findings.
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18 year-old female with metastatic lung cancer status post chemo and radiation therapy CHEST:LUNGS AND PLEURA: Postsurgical changes of right pneumonectomy and pleurectomy are again identified. Residual peripheral nodularity and thickening appears similar to the prior exam. Reference paramediastinal thickening corresponding measures 7 mm in depth and previously measured 6 mm in depth (image 43 series 3). Reference lateral thickening measures 8 mm and previously measured 8 mm (image 72 series 3). The left lung is clear. Unchanged peri-fissural nodule on the left, probably benign.MEDIASTINUM AND HILA: Changes of left supraclavicular lymph node dissection. Unchanged mildly enlarged supraclavicular lymph nodes with the reference lymph node measuring 6 mm and previously measuring 6 mm (image 3 series 10). The right heart chambers are compressed from the pneumonectomy cavity fluid. Diaphragmatic mesh again noted.CHEST WALL: Postoperative changes of the right hemithorax. Subcentimeter axillary lymph nodes are unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Heterogeneous hypoattenuating right cortical lesion with volume loss may appears similar to the prior exam and a metastasis cannot be excluded.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small unchanged subcentimeter retroperitoneal lymph nodes.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Status post right pneumonectomy and pleurectomy with unchanged reference lesions as detailed above.2. Right renal cortical lesion for which a metastasis cannot be excluded and dedicated MRI may be considered for further characterization.
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Generate impression based on findings.
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55-year-old male with head and neck cancer, restaging LUNGS AND PLEURA: Right upper lobe micronodule is unchanged. No suspicious nodules or masses.MEDIASTINUM AND HILA: Several prominent mediastinal lymph nodes are unchanged. Right port catheter extends to the cavoatrial junction. The heart size is normal. No pericardial effusion.CHEST WALL: Degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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62-year-old male with epiglottic cancer LUNGS AND PLEURA: Severe diffuse centrilobular and paraseptal emphysema with apical bullae. Scattered punctate micronodules some of which are calcified consistent with prior granulomatous disease.MEDIASTINUM AND HILA: Moderate coronary arterial calcification and atherosclerotic calcifications of the aorta. Scattered mediastinal lymph nodes measuring up to 7 mm (image 37 series 3).CHEST WALL: Degenerative changes of the thoracolumbar spineUPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of metastatic disease. Severe centrilobular and paraseptal emphysema.
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Generate impression based on findings.
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62 year-old female with lung cancer, evaluate and compare with prior CHEST:LUNGS AND PLEURA: Two mildly large enhancing right internal mammary lymph nodes measuring 5 mm diameter were not present on the exam dated 7/1/13 (image 35 series 3). Additional high density nodular anterior paramediastinal and posterior pleural thickening appears more pronounced than on the prior exam, although this was not present or FDG avid on the PET/CT dated 6/4/13. This is suspicious for metastatic disease, rather than pleural plaques. No suspicious pulmonary nodules or masses. Apical scarring/pleural thickening worse on the right appears similar to the prior exam. MEDIASTINUM AND HILA: The heart size is normal. Lower paraesophageal lymph node is unchanged. Several mildly enlarged cardiophrenic lymph nodes are reidentified. No new mediastinal or hilar lymphadenopathy. Scattered atherosclerotic calcifications of the aortic arch. Small hiatal hernia. CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy. No focal hepatic lesions.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small hypodensities and punctate left renal calcification are unchanged. Left cortical scarring, unchanged. 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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Increased pleural nodularity and right internal mammary lymph nodes as detailed above for which continued close followup is recommended to exclude metastatic disease.
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Generate impression based on findings.
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Female 71 years old; Reason: evaulate for ventral hernia recurrence vs seroma vs sarcoma. prev incisional hernia repair in 11/2011 History: LLQ soft mass ABDOMEN:LUNGS BASES: Nonspecific or less opacification noted in the bilateral lung bases.LIVER, BILIARY TRACT: The liver is normal in morphology and size. No focal lesion detected.Gallstones in gallbladder without evidence of inflammation. No intrahepatic or extrahepatic biliary ductal dilation.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. Minimal atherosclerosis of the aorta and branch vessels.BOWEL, MESENTERY: Small hiatal hernia.Midline ventral hernia in the pelvis is noted containing loops of bowel. Contrast progresses past this point, without evidence of obstruction, strangulation, or free contrast extravasation.Fat interspersed in the sigmoid colon submucosa suggests prior history of colitis.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.Small midline ventral hernia containing loops of bowel without evidence of strangulation or obstruction.2.Non specific ground glass opacities in the lungs.3.Cholelithiasis
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Generate impression based on findings.
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8-month-old male with history of meningitis and chronic seizure disorder now vomiting for 7 days Right-sided subdural catheter is been removed, and the previously demonstrated right subdural fluid collection has nearly resolved. Prominent left-sided subdural CSF fluid has decreased over the interim as well measuring 8 mm (previously 10 mm). There has also been slight increase in size of the lateral ventricles, however it should be noted that this may be secondary to resolution of mass effect previously induced by the right subdural collection.There is no evidence of acute intracranial hemorrhage. The brain parenchyma appears grossly unremarkable. There is persistent complete left tympanomastoid opacification. The skull and extracranial soft tissues are otherwise unremarkable.
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1.Right-sided subdural catheter is been removed, and the previously demonstrated right subdural fluid collection has nearly resolved. 2.Prominent left-sided subdural CSF fluid has decreased over the interim as well measuring 8 mm (previously 10 mm). 3.Slight increase in size of the lateral ventricles, however it should be noted that this may be secondary to resolution of mass effect previously induced by the right subdural collection.
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Generate impression based on findings.
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Male 39 years old; Reason: eval for stones, s/p perc stone treatment, now with increased drainage and pain History: eval for stone remnants no contrast needed 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: Minimal bibasilar atelectasis.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: Patient status post percutaneous nephroureterostomy without residual stones, hydronephrosis, or perinephric fluid collections in the left kidney. Cortical scarring and probable upper pole cyst in the right kidney. No hydronephrosis or perinephric fluid collection seen. RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: Submucosal fat in the colon likely relates to history of prior colitis, correlate.BONES, SOFT TISSUES: Compression deformity of T8 vertebral body.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No distal ureteral or bladder calculi. Foci of gas in the bladder dome is likely iatrogenic.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Status post percutaneous nephroureterostomy on the left without residual stones or hydronephrosis. No perinephric fluid collections or hematoma seen.
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Generate impression based on findings.
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Male 83 years old; Reason: AAA vs hernia History: LLQ abd pain ABDOMEN:LUNGS BASES: Coronary artery calcifications. No nodular mass detected.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: Minimal atherosclerosis of the aorta and branch vessels. No evidence of aneurysmal dilation.BOWEL, MESENTERY: No evidence of bowel obstruction, free air, or contrast extravasation.BONES, SOFT TISSUES: Intra-abdominal scar noted from prior surgical intervention. There is atrophy of the right rectus muscle. No ventral hernia identified.There is severe degenerative disease in the lumbosacral spine. Metallic fragment, likely a bullet noted in the right paraspinal muscle. Small calcification anterior to the descending colon (series 3 image 104) is likely related to a remote history of epiploic appendicitis. No acute findings.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is severe degenerative disease in the lumbosacral spine. Metallic fragment, likely a bullet noted in the right paraspinal muscle.Small calcification anterior to the descending colon (series 3 image 104) is likely related to a remote history of epiploic appendicitis. No acute findings.OTHER: Bilateral fat containing inguinal hernias noted.
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1.No CT evidence of the left lower quadrant pain. In particular, no AAA, hernia, obstruction, or diverticulitis.
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Generate impression based on findings.
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Male 58 years old; Reason: 58 yo being worked up for heart transplant. colonoscopy revealed large polyp unable to be totally removed. please assess size and location of colonic mass; assess for possible mets History: see above ABDOMEN: Lack of IV contrast limits evaluation of solid organs and the vasculature. Given these limitations, the following findings were made. LUNGS BASES: Cardiomegaly with pacemaker leads noted. Bibasilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Diffuse thickening of the left adrenal gland compatible with hyperplasia.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild to moderate atherosclerotic disease of the aorta and branch vessels is noted.BOWEL, MESENTERY: Evaluation of the bowels is limited given the oral contrast only progresses to the distal ileum. Previously seen polyp near the IC valve is not definitely visualized.No evidence of obstruction, free air, or contrast extravasation noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Incomplete characterization of previously seen polyp on the IC valve. No definite evidence of metastatic disease on this limited noncontrast examination.
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Generate impression based on findings.
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Male 43 years old; Reason: Question of malignancy, chest, abdominal pain History: chest pain, abdominal pain, Extremely elevated white count (42) CHEST:LUNGS AND PLEURA: Bilateral small pleural effusions and dependent atelectasis, more on the left compared to the right side. Multiple villous, more in the upper lobes.MEDIASTINUM AND HILA: Borderline enlarged mediastinal lymph nodes. Index pretracheal node measures 1.4 x 1.2 cm on image number 38, series number 3.CHEST WALL: Bilateral axillary adenopathy. An index right axillary lymph node measures 1.8 by 1.9 cm on image number 16, series number 3.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly.SPLEEN: Splenomegaly.PANCREAS: Pancreas cannot be well differentiated from the surrounding peripancreatic adenopathy.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy.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: Pelvic adenopathy. An index right inguinal lymph node measures two .7 by 1.2 cm on image number 197, series number 3.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of fluid in the pelvis.
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Limited study due to lack of intravenous contrast. Hepato- splenomegaly. Axillary, mediastinal, retroperitoneal and pelvic adenopathy. These findings are suggestive of lymphoma.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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Female 46 years old; Reason: eval for bowel obstruction vs bowel ischemia History: eval for bowel obstruction vs bowel ischemiaTECHNIQUE Axial CT images are obtained through the chest, abdomen and pelvis after administration of oral contrast and 90 ml intravenous Omnipaque 350. Coronal reformats were also generated and reviewed. CHEST:LUNGS AND PLEURA: Diffuse groundglass opacities are seen throughout the lungs with additional consolidation the lung bases. These findings may be secondary to pneumonia, pulmonary edema, drug reaction, ARDS or diffuse alveolar hemorrhage. Endotracheal tube is in place. Bilateral small pleural effusions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Heterogeneous low density of the liver, consistent with fatty infiltration. Focal liver lesions cannot be excluded with this single phase CT. may portal vein and its branches are patent. There is small amount of fluid around the liver. This appearance is not significantly changed from previous study. Cholelithiasis.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: Small retroperitoneal lymph nodes are unchanged.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: Thickwalled bladder with Foley catheter.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.Interval though no floor of bilateral groundglass opacities of uncertain etiology. Infection, ARDS, alveolar hemorrhage or drug reaction can be considered in differential diagnosis.2.Heterogeneous low density of enlarged liver. An underlying neoplasm cannot be excluded. MRI of the liver is recommended for further evaluation.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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14-week-old female with seizure disorder and history of intracranial hemorrhage, now vomiting A previously demonstrated depressed fracture has healed with that region the calvarium demonstrating an anatomic configuration. Previously demonstrated subgaleal hemorrhage, subdural hemorrhage and interventricular hemorrhage have resolved. There are no new hemorrhages. One caveat is that portions of the inferior posterior fossa are compromised secondary to artifact from overlying monitoring equipment. Although there has been slight increase in lateral ventricular sizes, they remain within normal size and morphology. Parenchymal density is unremarkable. Fluid is noted within bilateral middle ear cavities.
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1.A previously demonstrated depressed fracture has healed with that region the calvarium demonstrating an anatomic configuration. 2.Previously demonstrated subgaleal hemorrhage, subdural hemorrhage and interventricular hemorrhage have resolved.3.There are no new hemorrhages. although one caveat is that portions of the inferior posterior fossa are compromised secondary to artifact from overlying monitoring equipment.
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Generate impression based on findings.
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Male; 64 years old. Reason: Assess for surgical state s/p OHT and AICD removal; assess for possible source of infection History: Pt meets SIRS criteria; no organism found. LUNGS AND PLEURA: Patchy upper lobe air space consolidation, right greater than left, with air bronchograms. The findings are nonspecific but most likely secondary to infection rather than edema, considering lack of interlobular septal thickening and predominant upper lobe involvement. Moderate bilateral pleural effusions with overlying compressive atelectasis.Nonspecific left lower lobe micronodules seen on prior exam are not clearly visualized.MEDIASTINUM AND HILA: Patient is status post heart transplant with mild pericardial effusion. ICD has been removed but epicardial pacing wires and median sternotomy hardware are noted. Scattered aortic calcifications are present. Tracheostomy is unchanged. Nodular, heterogeneous thyroid gland. Reference right paratracheal lymph node measures 10 mm, previously 12 mm (series 3, image 37) and may represent two confluent lymph nodes. Additional mediastinal lymph nodes are not significantly changed since the prior study.CHEST WALL: Surgical clips in the right pectoral area. Multilevel degenerative changes in the visualized spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Enteric tube terminates in the stomach. Significant abdominal ascites is partially visualized. Fatty infiltration of the liver.
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1.Patchy upper lobe air space consolidation with air bronchograms, right greater than left and most compatible with multifocal infection.2.Significant upper abdominal ascites and moderate bilateral pleural effusions.3.Postsurgical changes as described above.
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Generate impression based on findings.
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Female 58 years old; Reason: evaluate for recurrence of hernia at umbilicius. pt s/p repair 9/2013 History: small abdominal mass on exam ABDOMEN:LUNGS BASES: A valve replacement noted with cardiomegaly. Mild vascular congestion. No nodule detected.LIVER, BILIARY TRACT: No significant abnormality noted. Patient status post cholecystectomy. No residual biliary dilatation.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: Two paramedian collections noted in the anterior abdominal wall with inflammatory reaction. One of these collections is fluid attenuation, likely represents a postoperative seroma. The other is likely residual paramedian focal hernia. No loops of bowel or obstruction identified.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: 7.7 x 5.9 cm thick rimmed loculated fluid collection in the pelvis, adjacent to the bladder. This is new since previous exam. Minimal inflammatory change to the perivesicular fat noted.
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1.Loculated fluid collection in the pelvis, abscess cannot be excluded.2.Small anterior abdominal paramedian collections, likely a seroma and residua ventral hernia.3.Dr. Hedburg notified of the findings at 8:30 on 12/15/13
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Generate impression based on findings.
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Female 46 years old; Reason: SBO History: pain and distension 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: Benign renal cyst on the right side.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Focally dilated small bowel loops measuring up to 3.3 cm is seen in the mid abdomen (series 8024 image 62). A transition point just proximal to the bowel to bowel anastomosis is suggested. Proximal and distal loops of ileum are collapsed. Minimal amount of perienteric fluid is noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Leiomyomatous uterus is unchanged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of ascites.
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1. Findings are compatible with early bowel obstruction, however, although much less likely, closed loop obstruction cannot entirely be ruled out given the decompression of most proximal and distal small bowel loops..
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Generate impression based on findings.
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Female 63 years old; Reason: rule out infection, elevated transaminitis History: n/v ABDOMEN:LUNGS BASES: Bilateral atelectasis and subpleural scarring. Mild cardiomegaly.LIVER, BILIARY TRACT: The liver is normal in size and morphology. No intrahepatic or extrahepatic biliary ductal dilation noted. The gallbladder is contracted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 1.1-cm obstructing calculus in the proximal right ureter. Moderate to severe hydronephrosis with cortical thinning. Very mild perinephric stranding without evidence of drainable fluid collection noted. Nonobstructing left renal calculi without hydronephrosis, perinephric stranding, or perinephric fluid collections noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Obstructing right ureteral calculus with resultant hydronephrosis. No drainable fluid collections.2.Non obstructing left renal calculi3.Findings discussed with Dr. Nguyen at 8:37 on 12/15/13
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Generate impression based on findings.
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History of recurrent lymphoma. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No evidence of enlarged mediastinal lymph nodes.CHEST WALL: Right-sided Port-A-Cath terminates at the SVC.ABDOMEN:LIVER, BILIARY TRACT: Mild hepatomegaly. No evidence of intra-or extrahepatic biliary duct dilatation. Normal enhancement of the liver parenchyma.SPLEEN: Minimal splenomegaly. Normal enhancement of the spleenPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of hydronephrosis. Both kidneys enhance symmetrically.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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Improvement in previous report is right lateral tracheal lymph nodes which are normal in their visualized.Mild hepatosplenomegaly.
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Generate impression based on findings.
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Male; 20 years old. Reason: rule out PE History: chest pain and history of sickle cell disease. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Focal right lower lobe airspace consolidation, compatible with infection and/or aspiration. No pleural effusions. MEDIASTINUM AND HILA: Cardiomegaly without significant pericardial effusion. Multiple mediastinal lymph nodes are noted but not enlarged. Hypodense material near the cavoatrial junction may represent thrombus. CHEST WALL: Enlarged axillary lymph nodes may be reactive in nature. Vertebral body changes compatible with sickle cell disease.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Small auto infarcted spleen.
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1.No evidence of pulmonary embolism.2.Right lower lobe airspace consolidation, compatible with pneumonia or acute chest syndrome.
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Generate impression based on findings.
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History of ovarian cancer CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Sclerotic focus involving the T3 vertebral body, unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Multiple hypodense splenic lesions, unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Index left para-aortic lymph node measures 1.6 x 1.2 cm image number 111, series number 3, slightly smaller compared to previous study.BOWEL, MESENTERY: The thickness of the omental soft tissue measures 1.2-cm image number 113, series number 3, not significantly changed from previous study. There incisional hernia in the midline pelvis containing nonobstructed sigmoid colon.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: Pelvic adenopathy, unchanged. Right external iliac lymph node measures 2.3 by 1.5-cm image number 169, series number 3. Previously, it was measuring two by 1.5-cm image number 163, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Minimal interval decrease in the size of the index left paraortic lymph node.Peritoneal Carcinomatosis and pelvic adenopathy, not significantly changed.Stable hypodense splenic lesions and T3 vertebral body sclerotic lesion of uncertain etiology.
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Generate impression based on findings.
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50 year-old male with history of follicular cell sarcoma CHEST:LUNGS AND PLEURA: Bilateral metastatic lesions are again noted. Index lesion in the right lower lobe measures 4 by 2.9 cm on image number 62, series number 5, increased in size compared to previous study. Other numerous metastatic lesions are also increased in size within the internal. Bilateral small pleural effusions.MEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged.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: 1.1-cm in diameter, intermediate density lesion in the midpole of the right kidney on image number 115, series number 3, not significantly changed from previous study. The etiology of this lesion is unknown.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Ill-defined, presacral soft tissue density mass eroding the anterior cortex of the sacrum measures 4.1 by 2.7-cm image number 174, series number 3, not significantly changed compared to previous study.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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Interval increase in the size of the bilateral lung metastases.Destructive lesion involving the sacrum and right renal indeterminate hypodense lesion, unchanged.
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Generate impression based on findings.
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Female 72 years old; Reason: diverticulitis History: abd pain and diarrhea ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted. Incidental focal fatty infiltration next is falciform ligament seen.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The kidneys are atrophic. Left calcified renal artery aneurysm noted, measuring 1.3-cm in diameter.. A few too small to characterize lesions in the kidneys are noted bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Fat stranding and colonic wall thickening of the descending colon is compatible with nonspecific colitis. No free air, obstruction, or contrast extravasation is seen. No drainable fluid collections, abscesses, or diverticula are noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Focal colitis of the descending colon. Differential considerations might include inflammatory versus infectious. Ischemic is thought to be less likely 1.1.2-cm left the artery enters.
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Generate impression based on findings.
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Hodgkin lymphoma disease CHEST:LUNGS AND PLEURA: The apical scarring. There is also scarring in bronchiectasis in the right middle lobe. No lung nodules.MEDIASTINUM AND HILA: Minimal infiltrative soft tissue density in the anterior/superior mediastinum. An index retrocaval lymph node measures 9 mm in diameter image number 26, series number 3. A second nodular density in the anterior mediastinum measures 7 x 1.1 cm image number 31, series number 3.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: 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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Biapical scarring . Bronchiectasis and scarring involving the right middle lobe.Mediastinal borderline enlarged lymph nodes and infiltrative minimal soft tissue density in the upper/superior mediastinum.
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Generate impression based on findings.
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Female 20 years old; Reason: r/o appy History: RLQ pain with rebound 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: The appendix is not clearly visualized. Fat stranding adjacent to the descending colon contain central fat density (series 3 image 71) which is more likely to represent omental infarction versus epiploic appendagitis. No drainable fluid collections, obstruction, free air, or abscess collections noted.Few mesenteric nodes in the right lower quadrant are noted measuring approximately by 5.5 mm in short axis.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: Trace free fluid in the pelvis pelvic which may be physiologic.
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1.No definite evidence of appendicitis, although the appendix is not clearly visualized. Focal area of inflammation in the ascending colon may be related to epiploic appendagitis versus omental infarction. Few mesenteric nodules right lower quadrant, nonspecific. No drainable fluid collections, free air, or abscess noted.
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Generate impression based on findings.
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Female 34 years old; Reason: h/o RLQ pain and possible stone, UPT neg History: see above 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: Minimal bibasilar atelectasis.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: A 1 x 0.8 cm stone noted at the proximal right ureter/UPJ is seen. Mild to moderate hydronephrosis. The right kidney is markedly enlarged with extensive perinephric inflammatory changes. No drainable fluid collection or perinephric fluid collections identified.There is an atrophic left kidney. Punctate stone in the left upper pole without evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fluid in the endometrial canal is likely physiologic.BLADDER: Foley catheter is coiled up in the bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.1 cm stone in the right UPJ with enlarged kidney and marked inflammatory change and edema to the perinephric fat mild-to-moderate hydronephrosis.
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Generate impression based on findings.
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Female 35 years old; Reason: bacteremia, h/o VP shunt, eval for collection History: bacteremia Within the limits of a non-IV contrast enhanced examination which limits evaluation of solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted in liver parenchyma, although lack of IV contrast markedly limits evaluation. Patient status post cholecystectomy. No intrahepatic or extrahepatic biliary duct dilatation is seen.SPLEEN: 5.9 x 5.7 cm well-defined near water density lesion in the spleen likely representing benign cysts, unchanged when compared with prior chest CT examination. No other abnormalities.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilaterally small kidneys, without focal mass identified -- lack of IV contrast markedly limits ability to evaluate the kidneys. No perinephric fluid collections. RETROPERITONEUM, LYMPH NODES: Inferior vena cava filter in position just past the confluence of the iliac veins. No adenopathy, masses, or other fluid collection seen.BOWEL, MESENTERY: Orally administered contrast reveals normal stomach with rapid progression of contrast through normal-appearing small bowel to the normal appearing colon..Interval removal of the CSF shunt catheter. Diverticulosis without diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No fluid collections identified.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted in the bowel. Diverticulosis without diverticulitis seen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Vascular stent in the pelvis, but appears to be in the right external venous stent, but without contrast administration exact determination whether this is arterial or venous is difficult. Patency cannot be ascertained without IV contrast. No abnormal fluid collections about the pelvis are seen.
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1. interval removal of the CSF shunt catheter without drainable fluid collection or acute intra-abdominal pathology detected.
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Generate impression based on findings.
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Status post endoscopy. Asses for bronchiectasis LUNGS AND PLEURA: Bibasilar, likely chronic atelectasis. No effusions or pneumothorax.MEDIASTINUM AND HILA: Right upper extremity PICC and right IJ venous access tips are at the SVC/right atrium.CHEST WALL: Neurostimulator and spinal rods as well as skeletal deformities are again noted.UPPER ABDOMEN: Upper abdomen
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Bibasilar, likely chronic atelectases with no effusions or pneumothorax.
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Generate impression based on findings.
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History of renal cell carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Interval increase in the size of the right rib metastases. The lesion now measures 5.3 x 2.4 cm on image number 72, series number 8. Previously, it was measuring 3.9 x 2.2 cm on image number 10, series number two.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis, unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Interval resection of the right kidney. Small amount of fluid is present in the right nephrectomy bed. Simple renal cysts, unchanged.RETROPERITONEUM, LYMPH NODES: Enlarged right testicular vein, unchanged in caliber, however, in the right inguinal region, right testicular vein demonstrates central hypodensity with rim enhancement, compatible with necrosis. There are some collateral vasculature in the right retroperitoneal region.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval increase in the size of the right rib metastatic lesion.Interval resection of the right kidney.Dilated right testicular vein with possible thrombus and associated collateral vessels in the right retroperitoneum.Left renal hypodense lesions, unchanged.Small amount of fluid in the right nephrectomy bed.Cholelithiasis.
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Generate impression based on findings.
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78-year-old male with altered mental status. History of normal pressure hydrocephalus status post ventriculoperitoneal shunt placement and remote history subdural hemorrhage. Redemonstrated is a right frontal approach shunt catheter terminating near the pre-pontine cistern, unchanged in position.As before, there has been slight decrease in size of the ventricles. Previously demonstrated bilateral chronic subdural hematomas overlying prominent subarachnoid spaces have increased in size, demonstrating a density greater than that of CSF suggesting interval rehemorrhage, however without hyperdensity to suggest acute hemorrhage. On the left this measures up to 9 mm (previously 7 mm) and on the right up to 8 mm (previously 6 mm).No parenchyma hemorrhage. As before, the brain parenchyma is notable for mild periventricular and deep white matter hypodensity, unchanged from prior study and consistent with chronic small vessel ischemic disease. No new hypodensity or mass lesion. No mass-effect, midline shift, or basal cistern effacement. Mild intracranial vascular calcification.Persistent partial opacification of left sphenoid sinus is again noted, and there is also left maxillary mucosal thickening. The remaining paranasal sinuses and mastoid air cells are otherwise clear. Orbital contents are unremarkable as visualized.
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1.Redemonstrated is a right frontal approach shunt catheter terminating near the pre-pontine cistern, unchanged in position. As before, there has been slight decrease in size of the ventricles. 2.Previously demonstrated bilateral chronic subdural hematomas overlying prominent subarachnoid spaces have increased in size, demonstrating a density greater than that of CSF suggesting interval rehemorrhage, however without hyperdensity to suggest acute hemorrhage. On the left this measures up to 9 mm (previously 7 mm) and on the right up to 8 mm (previously 6 mm).
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Generate impression based on findings.
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67-year-old male with altered mental status. Evaluate subdural hematoma. CT HEAD:High density subdural material consistent with acute hemorrhage is visualized along the right and left frontotemporal subdural regions, the falx, and the tentorium. The blood is thickest at the right frontotemporal region where it measures 2.1 cm (series 80252, image 20) consistent with acute subdural hematoma. Subdural blood along the left frontal parietal region measures 5 mm in thickness at its widest dimension. The ventricles are nonenlarged. However there is slight asymmetry to the right lateral ventricle secondary to mass effect from the peripherally located subdural hematoma on the right side. There is also 3 mm of leftward midline shift again from the mass effect but no herniation. No evidence of intraventricular involvement of hemorrhage. The osseous structures are unremarkable. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. CERVICAL SPINE:Alignment is lordotic. Multilevel degenerative changes are noted along the cervical spine. No acute fractures or dislocations are visualized. There is preservation of vertebral body heights. Mild loss of posterior disk space height most notable at C3-4, C4-5 and C6-7 with small disk osteophyte complexes at a few levels. The C4-5 level contains the worst disk osteophyte complex which causes mild central canal stenosis. There is uncovertebral hypertrophy throughout. There is facet hypertrophy predominantly on the right and worse at the right C2-C3 level. No significant neuroforaminal stenosis at any cervical level. The basion-dental and atlantodental intervals are normal. No prevertebral soft tissue swelling. Endotracheal tube is noted in the airway and terminates below the field of view. The visualized paraspinal contents are unremarkable.
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1.Large bilateral right greater than left subdural hematoma measuring 20 mm in diameter with right-sided mass effect and leftward midline shift by 3 mm.2.Multilevel degenerative changes in the cervical spine without fracture or dislocation.
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Generate impression based on findings.
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SOB, fever. Evaluate for cavitary lesion/abscess. LUNGS AND PLEURA: 6.5 x 3.7 cm cavitary predominately air-filled lesion (series 5, image 24) in the right upper lobe with a small amount of dependent fluid. There is surrounding ground-glass opacity as well as more nodular appearing areas of consolidation at its inferior aspect. This may represent an abscess with surrounding inflammatory changes; however, a cavitating malignancy cannot be excluded.Small right pleural effusions with mild basilar dependent atelectasis.MEDIASTINUM AND HILA: 6 mm hypodense lesion in left thyroid lobe nonspecific, correlate with ultrasound as clinically warranted (series 4, image 4).Central filling defects in the distal right main pulmonary artery, bilateral lobar and segmental pulmonary arteries consistent with acute pulmonary embolism. Markedly patulous esophagus filled with fluid and debris up to the thoracic inlet. Severe calcified atherosclerotic disease of the thoracic aorta with eccentric mural thrombus and multiple penetrating atherosclerotic ulcers. Fusiform aneurysmal dilatation of descending thoracic aorta up to 4.9 cm (series 80324, image 38). Severe calcification of the coronary arteries. Cardiomegaly without a significant pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesions in upper pole of left kidney are partially visualized, likely cysts. Surgical clips are noted at the esophagogastric junction.
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1. Large cavitary lesion in the right upper pole lobe with surrounding ground-glass opacities and nodular areas of consolidation. This could represent an abscess/infection; however a cavitating malignancy cannot be excluded and follow-up is recommended.2. Findings consistent with acute pulmonary embolism in central and lobar pulmonary arteries.3. Dilated patulous esophagus filled with debris up to the thoracic inlet.4. Calcified atherosclerotic aneurysm of the descending thoracic aorta with eccentric mural thrombus and multiple penetrating ulcers.Findings communicated by radiology resident on call to Dr. Frazer on 12/15/2013 8:09 PM.
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Generate impression based on findings.
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81-year-old female patient with pain after fall with negative radiograph. Evaluate for fracture. Left hip with medial joint space narrowing, acetabular osteophytes and small subchondral cysts, consistent with moderate osteoarthritis. No evidence of fracture or dislocation.Degenerative changes of the pubic symphysis.Calcified fibroid uterus.
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No evidence of left hip fracture or dislocation.
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Generate impression based on findings.
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Other specified visual disturbancesOther specified visual disturbances. evaluate for orbital fx, hematoma, cellultiis There is right periorbital soft tissue swelling present in the thickening of the right lacrimal gland. Although there is preseptal involvement there is minimal extraconal involvement adjacent to the right lateral rectus muscle and no intraconal involvementA couple air bubbles are present within the right periorbital soft tissues at the level of the inferior orbital rim.The orbits are intact with no abnormal mass lesions in either orbit. There is no abnormal enhancement of the optic nerves. The visualized eyeballs are intact lacrimal glands are unremarkable. Extraocular muscles are intact. The suprasellar cistern is unremarkable.The cavernous sinuses appear symmetricVisualized portions of the mastoid air cells and middle ears are clear. The visualized portions of the paranasal sinuses demonstrate mucosal thickening in the maxillary sinuses. The visualized intracranial structures are within normal limits.
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1.Right periorbital soft tissue swelling is almost exclusively preseptal and periorbital without any intraconal extension.2.A couple of air bubbles within the subcutaneous tissues adjacent to the right infraorbital rim. Please correlate with clinical symptoms, clinical findings and history for the origin of these air bubbles which could be traumatic or infectious.3.No evidence for acute orbital fracture.
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Generate impression based on findings.
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Female 63 years old; Reason: To reassess for locally advanced pancreatic cancer History: Pancreatic cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Unchanged hepatic steatosis limiting evaluation for parenchymal masses. Within this limitation, there are at least two nodules which may represent metastases given the patient's history. Thre previously referenced lesion is stable in size in the right lobe. Few other lesions are noted throughout the liver (right and left lobe) and are all stable, although difficult to reliably measure given the fatty infiltration.Focal fatty sparing along the ligamentum teres. CBD stent with expected pneumobilia.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic tumor in the head measures 5.0 x 3.9cm, previously 5.7 x 4.1 cm, stable or equivocally decreased in size compared to prior. Continued encasement of the portal vein as described previously. The mass also abuts the duodenum, with no fat plane visualized between the two, and invasion is not completely excluded.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is no evidence of bowel dilatation to suggest obstruction. Persistent mesenteric haziness from tumor is stable.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid in the uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate amount of fecal material throughout the colon. No definite evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Pancreatic carcinoma with encasement of the portal vein and SMV. Loss of fat plane between the duodenum and tumor is also noted. Possible stable liver metastasis although limited evaluation due to underlying steatosis.
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Generate impression based on findings.
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Male; 50 years old. Reason: evaluate for abdominal mass History: Intractable vomiting ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small benign-appearing cyst at the midpole of the right kidney. This is a Bosniak I classification. The remainder of the kidneys and ureters are unremarkable. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No evidence of lymphadenopathy.BOWEL, MESENTERY: Moderate amount of retained solid food products within the stomach. Small foci of retained oral contrast also present. Retained food contents in the stomach may indicate a gastric emptying abnormality. The appendix was visualized and unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Infrarenal IVC filter present in the expected location.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No evidence of abdominal mass.2.Moderate amount of retained food contents in the stomach may indicate a gastric emptying abnormality.
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Generate impression based on findings.
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Left neck swelling. There is left level 1, 2, 4, and 5 lymphadenopathy, the largest of which is a level 2B lymph node that contains areas of hypoattenuation and measures 14 x 20 mm. There is diffuse prominence of the adenoids, although this can be within normal limits for age. There is no significant airway narrowing or discrete mass lesion. No fluid collections to suggest abscess are identified. The major salivary glands are unremarkable. There is a possible small right C7 rudimentary rib. The osseous structures are otherwise unremarkable. The partially imaged intracranial structures and orbits are grossly unremarkable. There is partially imaged bilaterally tympanomastoid opacification. The imaged paranasal sinuses are clear. The imaged portions of the lungs are clear.
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Left cervical lymphadenopathy. Differential considerations include cervical lymphadenitis or reactive lymphadenopathy and less likely a neoplastic process. Partially imaged bilaterally tympanomastoid opacification may represent otomastoiditis or may be due to Eustachian tube obstruction related to nasopharyngeal swelling. No evidence of abscess.
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Generate impression based on findings.
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27-year-old female. Pleurisy, chest pain. Evaluate for PE. PULMONARY ARTERIES: Technically adequate examination for evaluate for pulmonary embolism. No pulmonary emboli were identified.LUNGS AND PLEURA: No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. No significant pericardial effusion.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 acute pulmonary emboli or specific findings to account for patient's symptoms.
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Generate impression based on findings.
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63 year-old female status post bowel resection. Reason: on-going abd pain and tenderness; loose stools, eval for intrabdominal collection, obstruction, inflammation ABDOMEN:LUNG BASES: Large bilateral pleural effusions and bilateral lower lobe consolidation/atelectasis have decreased since the prior exam, leaving a moderate residual. LIVER, BILIARY TRACT: CholelithiasisSPLEEN: No significant abnormality notedPANCREAS: Focal hypoattenuating foci in the pancreatic head and uncinate process along course of pancreatic duct are incompletely characterized but may represent cystic pancreatic neoplasm such as IPMN, unchanged since 2004.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: IVC filter in place. Severe atherosclerotic calcifications affect the aorta and its branches.BOWEL, MESENTERY: Postsurgical changes in the right lower quadrant.Multiple dilated loops of small bowel have resolved. No bowel obstruction.Several foci of free intraperitoneal air related to recent surgery have resolved.BONES, SOFT TISSUES: Diffuse anasarca has resolved. Postsurgical changes with open midline abdominal wound. Superficial midline drain. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy. BLADDER: Foley catheter has been removed.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Multiple dilated loops of small bowel with transition point distal to anastomosis site in right lower quadrant have resolved. Moderate right free fluid present in the abdomen and pelvis has resolved.BONES, SOFT TISSUES: Diffuse anasarca has resolved. Enhancing soft tissue lesion located within subcutaneous fat of lateral proximal thigh measures approximately 3 x 5 cm (series 3, image 167).OTHER: No significant abnormality noted
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1.Moderate grade distal small bowel obstruction has resolved. Moderate amount of free fluid in the abdomen and pelvis has resolved. Improved bilateral pleural effusions since prior exam. 2.Postsurgical changes in the right lower quadrant with open midline abdominal wound.3.Highly vascular soft tissue mass in the lateral proximal left thigh. Stable IPMN in pancreas.
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Generate impression based on findings.
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Reason: h/o thyroid cancer with mets to lung and liver check for prog History: none CHEST:LUNGS AND PLEURA: Widespread pulmonary metastases with reference measurements as follows.Soft tissue mass at the left apex medially measures 2.9 x 2.5 cm, previously 2.8 x 2.4 cm (image 14; series 5).Right middle lobe pulmonary nodule measures 1.4 x 1.4 cm, previously 1.3 x 1.1 cm (image 52; series 5).Right lower lobe pulmonary nodule measures 0.8 x 0.8 cm, previously 0.8 x 0.7 cm (image 76; series 5).Post op changes with volumes loss.MEDIASTINUM AND HILA: Postop change involving the neck status post thyroidectomy. Small supraclavicular lymph nodes are present. Please see dedicated neck CT report for further details.CHEST WALL: Post operative changes from thyroidectomy. Sclerotic focus within the sternum, unchanged. Surgical clips in the left breast. Presumed T12 hemangioma unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Reference hypodense lesion in right hepatic lobe is unchanged in size measuring 14 x 9 mm on image 125/151.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Nonspecific subcentimeter hypodensity involving the left kidney too small to characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Continued slight increase in size of pulmonary metastases. Hepatic lesion is unchanged.
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Generate impression based on findings.
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52-year-old male. History of HNC and CRT. Compared to previous measurements. CHEST:LUNGS AND PLEURA: Nonspecific ground glass nodular opacity in the right upper lobe with adjacent mild retraction of the major fissure. There is a ground glass nodule in the left lower lobe. These are both new from prior exam and most likely postinflammatory. Interval resolution of previously seen cluster of right upper lobe nodules, which likely represented aspirate. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: Stable benign-appearing lucency in the manubrium. Degenerative disk disease of the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered punctate hepatic hypodensities are not significantly changed and too small to characterize, likely benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disk disease of the thoracolumbar spine.OTHER: No significant abnormality noted.
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1. No definite evidence of metastatic disease.2. Interval resolution of previously seen clustered nodular opacities in the posterior segment of the right upper lobe, which were most likely due to aspirate.3. Two new nodular ground glass opacities in the right upper and left lower lobes, most likely postinflammatory.
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Generate impression based on findings.
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Male 64 years old; Reason: 64 year old male with metastatic carcinoid. Staging. History: abdominal pain, nausea CHEST:LUNGS AND PLEURA: Large mass in the left upper lobe with partial collapse is noted. Small calcifications are seen within this mass suggesting metastatic spread of carcinoid tumor. Definite measurements are difficult given lack adjacent lung, however necrotic central area measures 7 x 8.8 cm (series 7 image 26).Centrilobular emphysema and scattered ground glass pulmonary nodules are notedMEDIASTINUM AND HILA: Borderline mediastinal adenopathy with a reference subcarinal node measuring 1.6 cm in short axis.CHEST WALL: No significant abnormality notedOTHER: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Large hepatic metastasis occupying nearly the entire right lobe measuring 15.2 x 15.6 cm (series 6 image 56). Few other satellite lesions throughout the liver are noted. The portal veins are patent although the right branch is attenuated within the tumor. The hepatic arteries are patent however the right branch is also attenuated within the lesion.Flash filling hemangioma in the left lateral lobe. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: 2-cm adenoma in the right adrenal gland noted.KIDNEYS, URETERS: Numerous low attenuating lesions in the kidneys bilaterally, which likely represent cysts. Some, however are too small to reliably characterize. No hydronephrosis or perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: Borderline adenopathy with a gastrohepatic node measuring 1.1 cm. atherosclerotic disease of aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate with central calcificationsBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Large lung mass in the left upper lobe with partial collapse of left upper lobe, likely metastatic disease or primary Carcinoid tumor.2.Large hepatic metastatic mass occupying the majority of the right lobe with few satellite lesions throughout the liver.
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Generate impression based on findings.
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67 year old female. Reason: concern for intraperitoneal bleed History: drop in H/H Lack of intravenous contrast limits evaluation of solid organs. ABDOMEN:LUNG BASES: Slight interval increase in the size of the right pleural effusion with underlying atelectasis/consolidation.LIVER, BILIARY TRACT: Cirrhotic morphology without worrisome mass, given the limitations of a noncontrast examination. Previously described arterially enhancing segment 4A and 4B lesions are not visualized on this noncontrast examination.Prominent common bile duct without distal obstructing lesionSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Expected portacaval and porta hepatis adenopathy. BOWEL, MESENTERY: Slight interval increase in moderate amount of ascites. Extensive peri-splenic and omental varices. Normal contrast reaches the distal small bowel. No dilated loops of bowel suggest obstruction. There is no evidence of free intraperitoneal air. Note is made of right-sided diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Cirrhotic liver. Slight interval increase in ascites and right sided pleural effusion. No evidence of intraperitoneal hemorrhage, as clinically questioned.
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Generate impression based on findings.
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85 year old male. Reason: Increasing abdominal distension and nausea; concern for obstruction. History: distension/nausea ABDOMEN:LUNG BASES: Old healed right posterior rib fracture. Calcified mitral valve anulus. Left posterior base pleural thickening. Bibasilar paraseptal emphysema. No acute infiltrates. Small bilateral pleural effusions.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: Old healed T11-T12 vertebral body fusion. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Large prostate. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis.OTHER: No significant abnormality noted
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No bowel obstruction. Emphysema. Gaseous distention of bowel suggests mild ileus.
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Generate impression based on findings.
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28 year old female. Reason: evaluate gastric bypass, intrabdominal pathology History: LLQ, LUQ abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: 1 cm hepatic hypodensity in the right lobe (image 32, series 3) may be a cyst or hemangioma.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: Gastric bypass with the expected postoperative changes.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Gastric bypass with expected postoperative changes. No obstruction. No free air. No acute abnormalities were identified that explain the patient's pain.
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Generate impression based on findings.
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78 year old female. Reason: eval for diverticulitis History: abd pain, vomiting ABDOMEN:LUNG BASES: No acute infiltrates or effusions. Coronary artery calcifications.LIVER, BILIARY TRACT: Stable 3-cm peripherally and centrally calcified mass at the inferior margin of the right hepatic lobe appears benign. A second densely calcified subcentimeter mass is present at the dorsal margin of the right hepatic lobe on image 38 series 3. No hepatic parenchymal lesions.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. No obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Fat-containing umbilical hernia.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Foley catheter in a decompressed urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No specific evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes of the lumbosacral spine and pelvis.OTHER: No significant abnormality noted
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No diverticulitis. No acute intra-abdominal abnormality to explain the patient's pain.
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Generate impression based on findings.
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68-year-old male, hx heart transplant with aspergillus. Reason: eval for pneumonia vs effusion vs abdominal abscess from prior lymphocele. History: septic shock CHEST:LUNGS AND PLEURA: No infiltrates or effusions. Mild basilar atelectasis/scarring.MEDIASTINUM AND HILA: Retrosternal space is now filled with soft tissue density and there are several small gas bubbles that suggest abscess formation. New 2 x 4 cm retrosternal fluid collection at image 30 of series 3. Postoperative changes of orthotopic heart transplant.CHEST WALL: Sternal fixation hardware is unchanged. Short metallic structure arises off the proximal subclavian, unchanged. There is a second structure which appears to be a vascular conduit with the terminal portion in the left subclavian artery and the proximal portion buried in the left subpectoral fat. Left jugular venous catheter is in the expected position. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small sliding-type hiatal hernia. BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: Severe atherosclerosis of the abdominal aorta. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: New L2 vertebral segment superior end plate invagination since the 6/26/2013 examination. OTHER: No significant abnormality noted
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New retrosternal fluid collection and gas bubbles suggest abscess formation. Resolution of right upper lobe pneumonia. New L2 superior end plate invagination.
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Generate impression based on findings.
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61-year-old male. Sarcoma. Evaluate for response. LUNGS AND PLEURA: Without intravenous contrast, the accuracy of measurements of the right hemithorax mass, accompanying atelectasis, and the pleural effusion are limited. Post-surgical changes of right upper lobectomy. Moderate right pleural effusion, decreased from prior exam.Large mass in the right upper chest has decreased in size, measuring 9.1 x 6.7 cm (series 80384, image 47) with corresponding prior measurements of 9.7 x 8.7. It is again noted to abut the hilum and mediastinum with loss of multiple fat planes suggesting invasion.Right medial lower chest mass measures 8.2 x 4.9 cm (series 4, image 45), previously 7.7 x 5.3 cm.Large mass in the right anterior lower chest measures 11.4 x 9.2 cm (series 4, image 62), previously 11 x 9.2 cm.MEDIASTINUM AND HILA: Port tip is at the RA/SVC junction.CHEST WALL: Right chest wall port. No focal osseous lesion identified.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Left adrenal ade3noma.
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1. Interval decreased size of right upper chest mass and moderate pleural effusion. Remaining masses in the right hemithorax are not significantly changed.2. Lack of intravenous contrast limits accurate measurement of the right hemithorax mass, accompanying atelectasis, and pleural effusion. For future exams, IV contrast enhanced studies are recommended unless clinically contraindicated.
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Generate impression based on findings.
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Squamous cell carcinoma of the oral tongue now 2 years since completion of radiation therapy. Extensive streak artifact from dental amalgam obscures much of the oral cavity. Furthermore, the exam is limited by the lack of intravenous contrast. Within this limitation, there are stable post-treatment findings with no definite evidence of recurrent tumor. There is no significant cervical lymphadenopathy. The remaining salivary glands and thyroid gland are unremarkable. There is unchanged multilevel degenerative spondylosis. There are unchanged hyperdense foci within the right maxillary sinus, which may represent sinoliths. The imaged intracranial structures are grossly unremarkable. The imaged portions of the lungs are clear.
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No evidence of locoregional tumor recurrence or significant cervical lymphadenopathy, although the exam is limited by artifact from dental amalgam and lack of intravenous contrast.
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Generate impression based on findings.
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Reason: Pt with hx of tongue cancer; s/p RT in 2011. Please re-eval for recurrence History: as above CHESTLUNGS AND PLEURA: Minimal basilar scarring and atelectasis. Scattered punctate micronodules are unchanged.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Coronary calcification. Trace pericardial effusion unchanged.CHEST WALL: Healed rib fractures. Degenerative change involving thoracic spine.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Calcified splenic artery aneurysm is unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Large amount of stool retained in the colon and desiccated small bowel contents are similar in appearance to previous study and suggestive of chronic constipation.BONES, SOFT TISSUES: No significant abnormality noted.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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Non-Hodgkin's lymphoma, new onset abdominal pain and lymph nodes on outside CT 5/2013 CHEST:LUNGS AND PLEURA: Stable, scattered punctate micronodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hypodense lesions in the right lobe and left lobe of liver are unchanged, most likely representing cysts. Hepatic vessels are patent. No new lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild interval increase in right upper pole renal cyst. No new lesions noted.RETROPERITONEUM, LYMPH NODES: Numerous enlarged mesenteric lymph nodes are mostly unchanged from prior study. Haziness in the root of the mesentery is also unchanged suggestive of treated lymphoma. Reference mesenteric lymph node measures 1.2 x 1.6 cm (image 128, three).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. Stable liver cysts.2. Mesenteric lymphadenopathy is unchanged from prior study.3. Mild interval increase in right renal cyst.
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Generate impression based on findings.
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Reason: uncontrolled asthma History: sob cough LUNGS AND PLEURA: Mild-to-moderate diffuse bronchial wall thickening but no evidence of bronchiectasis or parenchymal opacity.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Mild degenerative involving the thoracic spine. There is a solitary nonspecific sclerotic focus in T9 (sagittal image 66/113) which is incompletely characterized on CT though given the patient's age and lack of known malignancy is most likely a benign bone island. If clinically warranted this could be further evaluated with MR.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Mild-to-moderate diffuse bronchial wall thickening but no evidence of bronchiectasis or parenchymal opacity. While the findings are nonspecific they are consistent with the history of asthma.2. Incidental lesion in T9 vertebral body as described above.
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Generate impression based on findings.
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48-year-old female. Sarcoidosis. Evaluate for hilar lymphadenopathy. LUNGS AND PLEURA: Motion artifact in the lung bases decreases evaluation of fine detail. Small bilateral pleural effusions, new from prior exam, with mild nonspecific basilar atelectasis possibly representing element of aspiration. Debris is seen in the upper trachea. Ground-glass opacities in the posterior aspect of the left upper lobe, likely aspirate. No specific changes of sarcoidosis are identified in the lungs. MEDIASTINUM AND HILA: Multiple mildly prominent mediastinal lymph nodes are not significantly changed. Reference precarinal lymph node measures 1 cm in short axis and right hilar lymph node measures 1.2 cm, unchanged (series 3, images 41 and 44). Left sided central line tip terminates in the SVC.CHEST WALL: No significant abnormality noted..UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Unchanged two small hypodense lesions in the right hepatic lobe, too small to characterize but likely cysts. Multiple small retroperitoneal lymph nodes are noted in the visualized upper abdomen, similar to prior exam..
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1. No specific chest findings of sarcoidosis.2. Slightly prominent mediastinal lymph nodes, similar to prior exam.3. New small bilateral pleural effusions of unclear etiology.4. Debris in trachea with ground-glass opacity in the posterior aspect of the left upper lobe and basilar atelectasis, possibly secondary to aspiration.
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Generate impression based on findings.
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Reason: pt with lung ca s/p chemo and Rt History: doing well now needs evaluation compare to previous scans CHEST:LUNGS AND PLEURA: Continued decrease in left upper lobe mass now measuring 5.3 x 4.6 cm on image 40/157 (5.9 x 5.3 cm on prior).New trace left pleural effusion and new nonspecific groundglass and interstitial opacity involving the superior segment of the left lower lobe (image 53/118) is presumably related to radiation pneumonitis though continued follow up is recommended.Scattered punctate nodules, bilaterally, are unchanged. Emphysema. No new pulmonary nodules.MEDIASTINUM AND HILA: Trace pericardial fluid. Stable thyroid nodules. Coronary calcification. Scattered small lymph nodes are unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Status post splenectomy.ADRENAL GLANDS: Nonspecific but very mild nodular thickening left adrenal gland is unchanged.KIDNEYS, URETERS: Stable small presumed cysts.PANCREAS: Status post distal pancreatectomy.RETROPERITONEUM, LYMPH NODES: Small nodule in left upper quadrant is unchanged at 14 mm (image 114/157). BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Ventral hernia. Post op change.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Interval decrease in left upper lobe mass. New small left pleural effusion and new opacity in superior segment of the left lower lobe most likely related to radiation pneumonitis, though continued CT follow up is recommended. 2. Other findings stable.
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Generate impression based on findings.
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61-year-old male with metastatic renal cell cancer -- evaluate for progression of disease Lack of intravenous contrast limits evaluation of solid organs.CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules are again seen, appearing similar to the prior study. Reference left lower lobe nodule (series 6, image 81) measures 1.4 x 1 .0 cm, previously 1.4 x 1 .0 cm. Similarly, the nodularity along the left major fissure also appears similar to the prior study. Note is made of a calcified granuloma in the left lung base.MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy with reference measurements as noted below:Subcarinal lymph node (series 4; image 51): 5.6 x 4 .4 cm, previously 5.7 x 4 .5 cm.Right hilar lymph node (series 4; image 48): 3.5 x 3 .1 cm, previously 3.3 x 3.2 cm.Left hilar lymph node (series 4; image 61) 4.5 x 3 .4 cm, previously 4.6 x 3 .6 cm.CHEST WALL: Right posterior rib lytic osseous lesion with soft tissue mass appears unchanged. No new bony lesions are seen.Left anterior chest wall Port-A-Cath is unchanged with tip of the catheter in the superior vena cava.ABDOMEN: Within the limits of a non-IV contrast enhanced examination which limits ability to visualize solid organ parenchyma and vascular structures, the following observations can be made:LIVER, BILIARY TRACT: Lack of IV contrast makes it difficult to accurately delineate the margins of space occupying lesions in the liver. The prior noted reference lesion (series 4; image 113) measures 5.9 x 4 .1 cm, previously 5.9 x 4 .2 cm. There is a large right lobe aggregate confluent mass lesion (series 4; image 98) that measures approximately 10.5 x 8 .9 cm, previously 10.2 by 8.9-cm.Gallbladder and biliary tree appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal mass measures 4.1 x 2 .4 cm, previously 4.0 x 2.7 cm (series 4; image 118), not significantly changed.KIDNEYS, URETERS: Left nephrectomy with multiple soft tissue masses in the left nephrectomy bed. The index lesion in the left nephrectomy bed (series 4; image 107) measures 4.1 x 3.4 cm, previously 4.5 x 3.5 cm. Right kidney appears normal, however, lack of IV contrast limits ability to evaluate solid parenchyma.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy is again seen throughout the left periaortic region, appearing similar to the prior study. Reference conglomerate of retroperitoneal nodes (series 4; image 126) now measures 4.8 x 4 .0 cm, previously 4.9 x 3.8 cm.BOWEL, MESENTERY: Left lateral abdominal wall hernia containing small bowel, and colon without evidence of complication unchanged.BONES, SOFT TISSUES: Lytic lesions involving the lumbar spine are unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis, without evidence of diverticulitis.BONES, SOFT TISSUES: Lytic lesions involving the lumbar spine and right iliac bone are unchanged.OTHER: No significant abnormality noted
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1. Persistent bilateral pulmonary nodules. 2. No significant interval change in mediastinal lymphadenopathy. 3. Stable appearance to musculoskeletal metastases in the chest, abdomen, and pelvis. 4. No significant interval change in retroperitoneal lymphadenopathy and mass in left nephrectomy bed.
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Generate impression based on findings.
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Reason: RUL nodule, r/o sarcoid History: SOB LUNGS AND PLEURA: Diffuse moderate to severe bronchial wall thickening with areas of mucus plugging and areas with very mild bronchiectasis.The opacity noted on radiograph correlates with a mixed groundglass and solid area of opacity in the superior segment of the right lower lobe (images 138 -- 140 5/328 of the high-resolution series)..MEDIASTINUM AND HILA: Left acute artery arises directly from aortic arch, normal variant. Scattered small subcentimeter nodes. Small hiatal hernia.CHEST WALL: Degenerative change involving thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Diffuse moderate to severe bronchial wall thickening with areas of mucus plugging and areas with very mild bronchiectasis. While these findings are nonspecific they are most likely due to asthma or bronchitis. The imaging findings are not typical of sarcoidosis.2. The opacity noted on radiograph correlates with a mixed groundglass and solid area of opacity in the superior segment of the right lower lobe which is nonspecific but most slightly due to aspirate or infection. It may be related to an area of atelectasis from the associated mucus plugging. While this is less likely to represent malignancy, follow up with CT is recommended in 3 to 6 months to confirm resolution.
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Generate impression based on findings.
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Left sided preauricular lymphadenopathy and bilateral floor of mouth masses, possible osteomas, noted on clinical exam. Head: The exam is limited by lack of intravenous contrast. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. There is minimal left maxillary sinus opacification. The mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Neck: The exam is limited by lack of intravenous contrast. There is bilateral prominent torus mandibularis. There is also mild torus maxillaris internal and externus. There are multiple dental caries with associated periodontal lucencies. There is no significant cervical lymphadenopathy. The parotid glands are unremarkable, including a superficial lymph node with fatty hilum in the left parotid gland that measures up to 6 mm. There is no evidence of preauricular mass lesions. There are partially imaged irregularly-marginated fluid collections in the bilateral upper back subcutaneous tissues, overlying the trapezius muscles. There is a possible sinus track that extends to the overlying skin on the right. There is multilevel degenerative spondylosis. The airways are patent. There is mild pulmonary emphysema.
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1. No evidence of intracranial hemorrhage, mass, or cerebral edema.2. Torus mandibularis. Mild torus maxillaris internal and externus is also present. 3. No evidence of significant cervical lymphadenopathy or left preauricular mass, although the exam is limited by lack of intravenous contrast. Otherwise, a benign 6 mm left superficial left parotid lymph node is identified.4. Bilateral partially imaged fluid collections the bilateral upper back subcutaneous tissues, overlying the trapezius muscles. These may be post-traumatic or infectious in nature. Further interrogation via a dedicated chest CT or ultrasound can be performed.
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Generate impression based on findings.
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Female; 56 years old. Reason: eval for progression History: metastatic RCC, on 6 months of pazopanib1346 CHEST:LUNGS AND PLEURA: Again noted are multiple pulmonary nodules. The reference right middle lobe nodule now measures 0.8 x 0.7 cm, previously measuring 0.8 x 0.7 cm (best seen on image 47 of series 4). Non-reference spiculated nodule in the right horizontal fissure, best seen on image 41 of series 4, has increased in size measuring 1.0 x 0.9 cm, previously measuring 0.8 x 0.9 cm. A second non-reference nodule in the right lower lobe , best seen on image 57 of series 4, has increased in size measuring 1.1 x 0.7 cm, previously 0.8 x 0.7 m.MEDIASTINUM AND HILA: Reference right paratracheal lymph node best seen on image 28 of series 3 has decreased in size now measuring 1.3 x 1.1 cm, previously 1.6 x 0.9 cm. Additional new mediastinal lymph nodes are identified. The first, adjacent to the main pulmonary artery, best seen on image 33 of series 3 measures 1.5 x 0.8 cm and has a necrotic morphology. A second node, best seen on image 40 of series 3 measures 1.9 x 1.1 cm also has a necrotic appearance. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The right renal mass abutting the right renal vein best seen on image 105 of series 3 has minimally decreased in size now measuring 5.6 x 5.6 cm previously 5.6 x 6.0 cm. The mass is also more regular in appearance with less fat stranding and inflammation in the perirenal space. Interval decrease of renal distention and edema. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: Interval decrease in size of retroperitoneal lymph nodes.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.New left-sided mediastinal lymphadenopathy.2.Non-reference pulmonary nodules have increased in size when compared to prior. Reference nodule is stable.3.Right renal mass has minimally decreased in size.
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Generate impression based on findings.
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Reason: pre-chemotherapy baseline scan. Also, patient found to have RML infiltrate in OSH CT scan History: none LUNGS AND PLEURA: Faint linear opacity in the right middle lobe likely due to scarring or atelectasis. No evidence of pneumonia. Punctate left lower lobe micronodule on image 70/115, is nonspecific but presumably post inflammatory.MEDIASTINUM AND HILA: Residual thymic tissue. Scattered small mediastinal lymph nodes.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Splenomegaly.
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Faint linear opacity in the right middle lobe likely due to scarring or atelectasis. No evidence of pneumonia.
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Generate impression based on findings.
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17 year-old female with history of AML in remission, now with improving fever and neutropenia. Status post broad-spectrum antibiotics. CHEST:LUNGS AND PLEURA: Several scattered pulmonary nodules are again seen, some of which have disappeared or decreased in size. A new right upper lobe pulmonary nodule is seen (series 4 image 38). Previously seen left lower lobe groundglass opacities have decreased.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Bilateral central venous catheters have their tips in the SVC/right atrium junction.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Lack of enteric contrast limits evaluation of the bowel. The appendix is visualized, within normal limits.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Scattered subcentimeter pulmonary nodules are again seen, many of which have decreased in size or resolved. There is one new right upper lobe pulmonary nodule. The left lower lobe groundglass opacities are no longer visible.
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Generate impression based on findings.
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68-year-old male with head and neck cancer (tonsil). CT Head: The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, midline shift, intra- or extra-axial fluid collection, or acute hemorrhage. No abnormal contrast enhancement is identified within the brain. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. CT Neck:Extensive postoperative changes are again seen. There is fatty atrophy of the right side of the tongue. Nodularity in the left paramedian base of the tongue is not significantly changed, just cranial to the anterior hyoid bone. Stable thickening of both aryepiglottic folds, right greater than left. In the region of the right upper neck, numerous soft tissue surgical clips and multiple heterogeneously enhancing right neck masses are again identified with central necrotic regions. These lesions likely represent conglomerate necrotic lymph nodes. Stable necrotic component of the right parapharyngeal space nodal conglomerate mass measures 4.7 x 2.3 cm (series 7 image 25), previously 4.3 x 2.5 cm. Mass effect on the adjacent oropharyngeal airway appears mildly increased, possibly secondary to swelling and treatment-related changes.Right level 2 necrotic nodal conglomerate mass measures 5.0 x 4.0 cm (series 7 image 39), unchanged.Right level 1a necrotic lymph node measures 1.9 x 1.2 cm (series 7 image 39), previously 1.4 x 1.3 cm and slightly increased in size. Fat planes between the right common/internal carotid arteries and the right neck masses again appear obscured, suspicious for tumor invasion. The right internal jugular vein is effaced secondary to tumoral mass effect. These vascular findings are not significantly changed after accounting for bolus timing differences. The left salivary glands and thyroid gland are unremarkable. Multilevel degenerative changes of the cervical spine are again seen. Sclerotic T1 vertebral body lesion is unchanged and likely benign. Irregularity at the posterior aspect of the hyoid bone is again noted and may represent osseous extension of disease. No evidence of new osseous metastatic disease. Partially visualized right central venous catheter. The visualized lung apices are unremarkable; please see dedicated chest CT from today's date for further evaluation.
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1.Bulky right parapharyngeal necrotic mass has not significantly changed in size from the prior examination, but mass effect on the oropharyngeal airway appears to have increased. This may be secondary to swelling and post-treatment changes. 2.Reference necrotic right neck lymph nodes are not significantly changed in size or appearance, and no new sites of disease are identified. 3.Stable involvement of the right carotid artery and internal jugular vein after accounting for technique differences as described above. 4.No evidence of intracranial metastatic disease.
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Generate impression based on findings.
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69 year-old female with right retroperitoneal mass. Evaluate for interval change. Lack of intravenous contrast limits evaluation of solid organs. Lack of enteric contrast limits evaluation of bowel.ABDOMEN:LUNGS BASES: A 5-mm nodule in the left lower lobe (4; image 3). Calcified left lower lobe granuloma is unchanged. Minimal bilateral basilar atelectasis.LIVER, BILIARY TRACT: Unchanged left hepatic lobe simple cyst. Gallbladder surgically absent with cholecystectomy clips in the gallbladder fossa.SPLEEN: Multiple calcified splenic granulomas are noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Unchanged previously described left adrenal adenoma.KIDNEYS, URETERS: Unchanged right angiomyolipoma. Enlarged right kidney. A left simple cyst and bilateral subcentimeter hypodensities, too small to characterize, are unchanged. Unchanged right lower pole nonobstructing renal calculi.RETROPERITONEUM, LYMPH NODES: Interval placement of a right-sided percutaneous pigtail drain. There is near complete interval resolution of the previously described right retroperitoneal reference lesion now measuring 2.9 x 2 .1 cm, previously 11.2 x 6.8 cm (75; series 3). The previously described anterior displacement of the right kidney appears decreased when compared to the prior study. Reference left para-aortic lymph node measures 1.4 x 1 .0 cm, previously 1.1 x 0.9 cm (image 61, series #3). Scattered small retroperitoneal lymph nodes are unchanged.Moderate atherosclerotic calcification of the abdominal aorta and its branches, unchanged. The previously described ulcerated plaques are not visualized on this noncontrast examination.BOWEL, MESENTERY: Left lower quadrant ostomy. Scattered small mesenteric lymph nodes. The ascending and transverse colon are dilated and filled with oral contrast and stool.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The ascending and transverse colon are dilated and filled with oral contrast and stool.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Redemonstrated left-sided lymphocele, grossly unchanged.
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1.Significant interval decrease in size of the previously described right retroperitoneal complex cystic mass.2.Dilated ascending and transverse colon, which appeared filled with oral contrast and stool. These findings may represent the sequela of constipation. 3.Left lower lobe 5 mm pulmonary nodule.
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Generate impression based on findings.
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Reason: pt with recurrent tonsil ca, s/p CRT, tonsillectomy and ND, eval for dz, compare to previous with measurements History: as above CHEST:LUNGS AND PLEURA: Centrilobular nodules and tree in bud opacities, most pronounced in the right lower lobe, persist but are marginally improved. Associated bronchiectasis and debris within the subsegmental bronchi of the right lower lobe. Findings are most consistent with the known history of chronic aspiration. Aspirated debris is seen in the central airways though not to the same degree as on prior. Bibasilar atelectasis/consolidation. No pleural effusions or pneumothorax. Left upper lobe ground glass opacity, (image 43; series 5) is unchanged but of uncertain significance; continued follow up is recommended. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Reference right paratracheal lymph node is stable 8 mm on image 22/145. Port tip at RA/SVC junction.CHEST WALL: Right chest wall port. Small sclerotic focus in T1 is unchanged and presumably benign.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Stable adrenal thickening.KIDNEYS, URETERS: Stable presumed left renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastrostomy tube tip in stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Chronic aspiration but no evidence of metastases.
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Generate impression based on findings.
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Female 37 years old; Reason: new amsses or change in masses History: neurodendocrine tumors with node and liver masses CHEST:LUNGS AND PLEURA: Scattered pulmonary micro-nodules are stable, for example 3-mm nodule in superior segment left lower lobe is stable in size.MEDIASTINUM AND HILA: Right thyroid surgical clips are again noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Reference liver dome lesion (series 3 image 83) measures approximately 5. x 3.7 cm, previously 5.5 x 3.7 cm.Reference segment 7 liver lesion (series 3 image 87) measures approximately 4.0 x 2 .8 cm, previously 4.1 x 2.9 cm.Stable hypoattenuating focus in segment 6 (series 3 image 105) is stable.Hepatic vessels are patent. Dystrophic parenchymal calcifications are unchanged. Changes of cholecystectomy. SPLEEN: No significant abnormality noted.PANCREAS: Partial pancreatectomy with atrophy of the body and tail.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small nonobstructing calculus in the right kidney upper pole, unchanged. Accessory right renal artery and partially duplicated right collecting system. Previously described left renal pelvis calculus is no longer visualized.RETROPERITONEUM, LYMPH NODES: Again seen is peripancreatic lymphadenopathy (or pancreatic tail), with left peripancreatic avidly enhancing reference lymph node (series 3 image 106) measuring approximately 1.2 x 1.0 cm previously 1.1 x 1.1 cm.BOWEL, MESENTERY: Postsurgical changes of omentectomy.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 change in the reference lesions. The reference enhancing mesenteric lesions are unchanged.
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Generate impression based on findings.
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History of renal cell carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Interval increase in the size of the right rib metastases. The lesion now measures 5.3 x 2.4 cm on image number 72, series number 8. Previously, it was measuring 3.9 x 2.2 cm on image number 10, series number two.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis, unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Interval resection of the right kidney. Small amount of fluid is present in the right nephrectomy bed. Simple renal cysts, unchanged.RETROPERITONEUM, LYMPH NODES: Enlarged right testicular vein, unchanged in caliber, however, in the right inguinal region, right testicular vein demonstrates central hypodensity with rim enhancement, compatible with necrosis. There are some collateral vasculature in the right retroperitoneal region.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval increase in the size of the right rib metastatic lesion.Interval resection of the right kidney.Dilated right testicular vein with possible thrombus and associated collateral vessels in the right retroperitoneum.Left renal hypodense lesions, unchanged.Small amount of fluid in the right nephrectomy bed.Cholelithiasis.
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Generate impression based on findings.
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Seven month old evaluate ventricular size. Intraventricular catheter is identified with its tip at the foramina of Monro. There is extensive severe, stable ventriculomegaly of the lateral and third ventricles. Fourth ventricle is normal.The small amount of extra-axial CSF density along the right parietal lobe has decreased even further in size. Once again identified are multifocal areas of encephalomalacia within the right frontal lobe, right basal ganglia, right parietotemporal occipital lobes, and right frontotemporal lobes.There is no evidence of gross intracranial hemorrhage. No midline shift. The paranasal sinuses and mastoids are unchanged.The orbits are unremarkable.
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Intraventricular catheter at the foramina of Monroe without significant change in ventriculomegaly of the lateral and third ventricles.
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Generate impression based on findings.
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Evaluate for progression of subdural hematoma. There is no significant interval change in the bilateral hypodense holoconvexity subdural fluid collections, measuring up to 9 mm on the right and 8 mm on the left, although these have increased in size since June 2012. There is an unchanged right transfrontal ventricular shunt cathter that terminates in the prepontine cistern. There is no significant interval change in size or configuration of the ventricles and basal cisterns, although the degree of ventriculomegaly has decreased since June 2012. There is no midline shift or herniation. There is unchanged mild nonspecific cerebral white matter hypoattenuation. The imaged mastoid air cells are unremarkable. There is near complete opacification of the left sphenoid sinus with associated sclerosis and thickening of the sinus walls, suggestive of a chronic sinusitis. The skull and extracranial soft tissues are unchanged.
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1. No significant interval change in the bilateral hypodense holoconvexity subdural fluid collections, measuring up to 9 mm on the right and 8 mm on the left, although these have increased in size since June 2012. 2. No significant interval change in size or configuration of the ventricles and basal cisterns, although the degree of ventriculomegaly has decreased since June 2012 and may account for the concomitant increase in size of the subdural collections (Monro-Kelly doctrine).
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Generate impression based on findings.
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49-year-old female with history of metastatic breast cancer with known pulmonary metastases. Evaluate response to treatment. CHEST:LUNGS AND PLEURA: Right apical scarring/atelectasis, unchanged. Right medial pulmonary mass measures 3.5 x 2 .8 cm, previously 2.9 x 2.4 cm (image 41; series 6). Multiple additional small bilateral pulmonary nodules are identified, suspicious for metastatic disease, also appearing minimally increased in size when compared to the prior study. No new pulmonary nodules or masses are identified.MEDIASTINUM AND HILA: Port catheter extends to the SVC. No mediastinal lymphadenopathy.CHEST WALL: Left chest wall port. Posttreatment change of the right axilla with soft tissue infiltration and fluid noted. Status post right mastectomy.ABDOMEN:LIVER, BILIARY TRACT: One small medial right hepatic hypoattenuating lesion likely represents a cyst, appearing similar to the prior study. No intra or extrahepatic biliary ductal dilatation.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: No significant abnormality noted
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1. Persistent multiple pulmonary lesions consistent with metastatic disease, some of which appear increased in size.2. Post treatment change of the right axilla and chest wall.
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Generate impression based on findings.
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24 year old female. Reason: recurrent head and neck cancer on therapy. Evaluate for progressive disease with measurements. Recurrent squamous cell carcinoma of the nasopharynx status post surgery, chemotherapy and radiation. ABDOMEN: LUNG BASES: New bilateral diffuse pulmonary nodules may be due to pulmonary metastases. Expansile lesion of right posterior ninth rib appears slightly larger compatible with metastatic disease measures 1.8 x 3 cm at image 7 of series 5. Large nodules adjacent to the rib mass measure 1.8 x 2.1 cm and 1.9 x 2.6 cm in the posterior costophrenic sulcus at image 9 of series 4. Numerous additional nodules bilaterally. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted. Splenule posterior to spleen at image 28, series 5. 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 limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Expansile lesion of right posterior ninth rib is highly suggestive of metastatic disease. Focal calcification in the anterior abdominal wall at image 33 of series 5 appears benign. OTHER: No significant abnormality noted.
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Enlarging expansile lesion of right posterior ninth rib highly suggestive of metastatic disease. New bilateral pulmonary nodules are suggestive of pulmonary metastases.
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Generate impression based on findings.
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50 year old female. Reason: ovarian cancer s/p 6 cycles of Taxol/Carboplatin eval disease process post treatment. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted. Left thyroid cyst. 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: Left upper pole nonobstructing renal calculus. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Status post omentectomy. Numerous retroperitoneal and pelvic surgical clips, probably due to prior lymph node dissection procedure. PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Numerous borderline pelvic lymph nodes bilaterally. For reference, there is a right and 12 x 19-mm lymph node at image 179 of series 3. At the same image there is a left sided obturator node which measures 1.3 x 1.6 cm. These nodes were not definitely seen on the 6/24/2013 pre-op examination where there was a very large pelvic mass that has since been removed. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Right buttock calcification, probably granuloma.
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Borderline enlarged pelvic lymph nodes bilaterally. Post-op hysterectomy and omentectomy changes.No other significant interval change since 6/24/2013.
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Generate impression based on findings.
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70-year-old male with a history of bladder cancer. Status post radical cystectomy. Please evaluate for metastatic disease with delayed imaging. ABDOMEN:LUNGS BASES: Right lower lobe pulmonary micronodule, appearing similar to the prior study. There is bibasilar atelectasis/scarring. No new pulmonary nodules or masses are identified.LIVER, BILIARY TRACT: Dense right hepatic lobe calcifications are unchanged, most likely granulomas, unchanged. No new focal hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral renal hypoattenuating lesions, some of which are too small to characterize, and the others are most likely cysts and unchanged. The distal left ureter is not opacified on delayed sequences. Given this limitation, no filling defects or mass lesions are identified within the collecting system bilaterally.RETROPERITONEUM, LYMPH NODES: Dense atherosclerotic calcification of the abdominal aorta and its branches. Aneurysmal dilatation of the abdominal aorta, measuring 2.9 cm, previously 2.8 cm in maximum diameter (image 50 coronal series) not significantly changed. Thickening of the distal esophagus is nonspecific, but can be seen in esophagitis, appearing similar to the prior study.BOWEL, MESENTERY: Right abdominal ostomy with ileal conduit. Surgical drain terminating in the right lower quadrant. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: AbsentBLADDER: Cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Right abdominal ostomy with ileal conduit. Previously described right lower quadrant fluid collection has resolved. Interval removal of right-sided percutaneous drain.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Changes status post cystectomy and ileal conduit.2.Interval resolution of the previously described abdominal fluid collection.3.No evidence of residual or recurrent disease.
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Generate impression based on findings.
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Reason: pt with esophageal ca s/p weekly chemo for 12 weeks History: now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Bilateral nodular airspace opacities with variable cavitation.Reference left upper lobe lesion is larger at 19 x 12 mm on image 37/100 (17 x 11 mm on prior). Reference left lower lobe lesion measures 23 x 9 mm on image 51/100 though.The left lower lobe paracardiac and right middle lobe peripheral opacity have also increased in size (images 64 and 55/100 respectively). Other opacities are stable.MEDIASTINUM AND HILA: Coronary calcification. Venous catheter tip in SVC.Nonspecific stable mild wall thickening of the upper esophagus at the site of the initial lesion, unchanged.CHEST WALL: Right chest wall port. Degenerative change involving the spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Continued increase in size of left upper lobe reference nodule. Two other nodular opacities (right middle lobe and left lower lobe adjacent to heart) have also shown definitive increase in size. Left lower lobe reference nodule stable in size though is now more solid. No new sites of disease.
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Generate impression based on findings.
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76-year-old male with a history of renal cell carcinoma. Status post right-sided partial nephrectomy in June of 2013. Evaluate for renal recurrence. ABDOMEN:LUNG BASES: There is bibasilar dependent atelectasis/scarring. Note is made of scattered pulmonary micronodules some of which appear calcified suggestive of prior granulomatous disease. Note is made of multiple calcified mediastinal and hilar lymph nodes. Note is made of a small fat-containing right Bochdalek hernia.LIVER, BILIARY TRACT: There is minimal tubal subcentimeter hypodensities in the liver, which are too small to characterize, but likely represent simple cysts, appearing similar to the prior study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: None is made of postsurgical changes consistent with the stated history of right-sided partial nephrectomy. Note is made of multiple subcentimeter hypodensities in the left kidney, which are too small to characterize, but likely represent simple cysts, appearing similar to prior study. Note is made of multiple simple cysts within the right kidney, appearing similar to the prior study.RETROPERITONEUM, LYMPH NODES: Prominent retroperitoneal and mesenteric lymph nodes, appearing similar to the prior study.BOWEL, MESENTERY: There is a small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Prominent retroperitoneal and mesenteric lymph nodes, appearing similar to the prior study.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Postsurgical changes with no definitive evidence of residual or recurrent disease. No significant interval change in prominent retroperitoneal and mesenteric lymph nodes.
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Generate impression based on findings.
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Reason: History of metastatic breast cancer on treatment, evaluate for response and extent of disease. History: History of metastatic breast cancer on treatment, evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: Stable bilateral pleural effusions. Left sided pleural thickening and enhancement with some areas of loculation, unchanged. Radiation fibrosis involving the anterior left upper lobe, not significant changed. Punctate right apex micronodules (image 13/77) not significantly changed in size and now has calcification. Other punctate micronodules also unchanged. Right middle lobe atelectasis unchanged. Calcified granuloma on the right is also unchanged. No new pulmonary nodules.MEDIASTINUM AND HILA: Scattered small subcentimeter lymph nodes are unchanged. The reference high right paratracheal lymph node measures 6 mm on image 22/125, unchanged.CHEST WALL: Stable hyperdense nodule in right chest wall measuring 8 mm on image 42/125. Right subcutaneous lymphadenopathy is unchanged. Extensive postop change involving the left anterior chest with punctate areas of nodular enhancement, not significantly changed.Reference left anterior left chest wall soft tissue mass is stable a 12 x 9 mm image 42/125. Previously noted fluid tracking in a rib interspace on the left (image 69/125) appears to be related to a prior chest tube site.Heterogeneous sclerosis involving the sternum is unchanged. Punctate sclerosis in T6 vertebral body is unchanged. The right sixth rib lesion is unchanged. Please see dedicated bone scan report for further details.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: The previously noted presumed to/filling hemangioma is not visualized on current study due to phase of contrast enhancement. Heterogeneous liver enhancement pattern is unchanged and of uncertain significance.SPLEEN: Calcified granulomas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable presumed right renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable CT with reference measurements as above. No new sites of disease.
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