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Generate impression based on findings.
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Iron deficiency anemia 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: Punctate left upper pole renal stone without evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small fat containing periumbilical hernia. Small bowel loops are unremarkable. There is a 1 x 0.9 cm polypoid lesion in the distal ileum, best seen on image number 129, series number 3. This lesion may be compatible with the polypoid lesion detected on the video capsule Endoscopy. No Other Masses Is Seen on CT Enterography. No Evidence of Bowel Obstruction.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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1 cm polypoid lesion in distal ileum which may correspond to the abnormality seen on the video capsule endoscopy.
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Generate impression based on findings.
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Female, 24 years old, history of nasopharyngeal cancer, on therapy. Postoperative changes are again seen within the nasal cavity and paranasal sinuses.Ill-defined nasopharyngeal thickening and enhancement is redemonstrated. As on prior scans, evidence of invasion of the central skull base, clivus and the left petrous apex is again seen. Enhancing tissue surrounds the left cavernous carotid and perhaps the right as well. Entrapped foci of air are seen within the enhancing tissue, smaller than before.When comparison is made to the prior CT, no definite or reliable interval changes are seen. Mild conformational differences in the appearance of the nasopharyngeal mucosa may simply be related to posttreatment edema/hyperemia and/or trapped secretions. For reference, when measurements are made in the sagittal plane in a manner similar to the prior exam, the lesion measures 22 x 19 mm (image 26 of series 80473), previously 22 x 18 mm. The degree of associated osseous erosion of the skull base is unchanged. On comparison to the prior MRI, the nasopharyngeal mucosa does appear somewhat bulkier, though this comparison is complicated by the fact that MRI much more reliably distinguishes mucosa from secretions.Elsewhere, the aerodigestive tract is unremarkable. No pathologic adenopathy is detected by size criteria. The salivary glands and thyroid are free of focal lesions. The vessels remain patent. Scarring is redemonstrated in the lung apices. Except as above, no new or concerning osseous lesions are demonstrated.Again seen are fluid levels in the maxillary sinuses. The mastoid air cells are opacified, left side more than right. The left middle ear cavity is also opacified.
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Accurate size assessment of the patient's nasopharyngeal tumor is complicated by the ill-defined margins and poor sensitivity of CT to distinguish tumor from hyperemic mucosa and secretions. Given this caveat, no definite or reliable evidence of progressive disease is seen based on comparison with the prior CT. No new lesions are detected and there is no pathologic adenopathy by size criteria.
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Generate impression based on findings.
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T2N2B right tonsil SCC, status post resection 1/19/11 and induction, followed by CRT in 2012. There are stable post-treatment findings without evidence of tumor recurrence or significant cervical lymphadenopathy. The airways are patent. The remaining salivary glands appear unchanged, with hyperemia of the left submandibular gland, that is likely treatment related. The thyroid gland is unremarkable. The major cervical vessels are intact. There are bubbly secretions within the right maxillary sinus and mild scattered opacification of the other partially imaged paranasal sinuses. There is an unchanged 10 mm diameter sclerotic focus in the right T2 transverse process, which likely represents an enostosis. There is unchanged multilevel degenerative spondylosis. The partially imaged intracranial structures are grossly unremarkable. There is unchanged mild right apical scarring.
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1. No evidence of locoregional tumor recurrence of significant cervical lymphadenopathy.2. Bubbly secretions within the right maxillary sinus may represent acute sinusitis in the appropriate clinical setting.
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Generate impression based on findings.
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Reason: questionable lymphadenopathy on CXR - CT chest with contrast to further evaluate History: none LUNGS AND PLEURA: Mild basilar interstitial opacity which appears to be chronic, possibly due to scarring. Scattered punctate micronodules are present which measure up to 2 -- 3 mm (subpleural right upper lobe image 36/105). These are nonspecific but are most likely post inflammatory. Some demonstrate calcification consistent with granulomas.MEDIASTINUM AND HILA: Hiatal hernia. Scattered small subcentimeter lymph nodes.CHEST WALL: Small axillary lymph nodes bilaterally, left greater than right.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Intra-and extrahepatic biliary ductal dilation partially visualized. Status post cholecystectomy.
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1. No significant intrathoracic lymphadenopathy. Though there are scattered nodes involving the mediastinum and hilum, all are subcentimeter and not pathologic by size criteria.2. Mild nonspecific axillary lymphadenopathy, left greater than right.3. Intra-and extrahepatic biliary ductal dilation. This is only partially visualized and cannot be fully characterized. This should be followed up with dedicated abdominal imaging such as MRCP to exclude obstruction.
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Generate impression based on findings.
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Female; 52 years old. Reason: Follicular NHL History: Evaluate extent of disease CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Reference subcarinal lymph node, best seen on image 39 of series 3, appears stable measuring 1.8 x 1.0 cm, previously 1.7 x 1.0 cm.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Reference left periaortic lymph node, best seen on image 110 of series 3, is stable in appearance measuring 0.9 x 0.6 cm, previously 0.6 x 1.0 cm. BOWEL, MESENTERY: The first reference lymph node, best seen on image 121 of series 3, has minimally increased in size now measuring 1.4 x 0.7 cm, previously 0.9 x 0.7 cm. Second reference lymph node, best seen on image 110 of series 3, appears similar measuring 1.3 x 0.7 cm, previously 1.3 x 0.8 cm.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: Reference left obturator lymph node appears stable, measuring 1.8 x 0.5 cm, previously 1.8 x 0.5 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable examination.
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Generate impression based on findings.
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Reason: T2N2B R tonsil SCC - Resection 1/19/11 at OSH; s/p induction f/b CRT in 2012. please re-eval for recurrent dz History: as above CHEST:LUNGS AND PLEURA: Scattered punctate micronodules are stable and presumably postinflammatory. Apical scarring and emphysema.MEDIASTINUM AND HILA: Scattered subcentimeter nodes are stable.CHEST WALL: Focal sclerotic lesion in left scapula is stable 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: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Small cystic lesion within the pancreatic body is unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and its branches. Scattered small subcentimeter upper abdominal lymph nodes are unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease involving lower lumbar spine.OTHER: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Left T1N2b tonsil SCC who is 2 years and 3 months out from completion of radiation therapy. Head: There is no evidence of intracranial mass or abnormal enhancement. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. Thre is a retention cyst within the right anterior ethmoid air cells. The mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Neck: There are stable post-treatment findings, including left supraglottic mucosal edema with asymmetric effacement of the left piriform sinus. Otherwise, there is no discrete mass lesion to suggest tumor recurrence. Likewise, there is no significant cervical lymphadenopathy by size criteria. The thyroid and salivary glands are unremarkable. The airways are patent. The major cervical vessels are patent. The osseous structures are unremarkable. The imaged portions of the lungs are clear.
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1. Stable post-treatment findings without evidence of locoregional tumor recurrence or residual significant lymphadenopathy.2. No evidence of intracranial metastases.
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Generate impression based on findings.
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Reason: PT with hx of HNC s/p CRT 2011. Please re-eval and compare to prior scans History: as above CHEST:LUNGS AND PLEURA: New nonspecific punctate 1-2 mm micronodule in the periphery of the right lower lobe (image 132/326 of the high-resolution series). Other scattered punctate micronodules are stable. MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Degenerative change involves the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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New very small (1-2 mm) micronodule in the right lower lobe which is most likely post inflammatory though continued follow up is recommended to exclude growth/malignancy. Other findings are stable with no definitive evidence of metastatic disease.
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Generate impression based on findings.
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Follicular lymphoma. There is no significant interval change in the cervical lymph nodes. For exam, a right level 2 lymph node measures 9 x 12 mm, previously 8 x 12 mm, a left level 2 lymph node measures 8 x 12 mm, previously 7 x 13 mm, and a left supraclavicular lymph node measures 7 x 13 mm, previously 7 x 13 mm. The Waldeyer ring structures are unremarkable. The thyroid and salivary glands are unremarkable. The major cervical vessel are patent. The osseous structures are unremarkable. There is persistent near complete opacification of the left maxillary sinus. The partially imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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No significant interval change in the cervical lymph nodes to suggest recurrent lymphoma in the neck.
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Generate impression based on findings.
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Status post craniotomy for unruptured aneurysm clipped and 2nd one coiled with rupture and subdural, post-op 12 week follow up. There are stable sequela of posterior communicating artery aneurysm clipping and right posterior communicating artery aneurysm coiling. Streak artifact obscures surrounding anatomy. There is an unchanged 4 mm wide isoattenuating extra-axial fluid collection deep to the left pterional craniotomy site. Otherwise, there is no definite evidence of acute intracranial hemorrhage. There is unchanged extensive encephalomalacia in the right MCA territory with associated ex vacuo dilatation of the right lateral ventricle and midline shift to the right, but no evidence hydrocephalus. There is an unchanged left transfrontal frontal ventricular catheter that terminates in the left lateral ventricle. The extracranial structures unchanged.
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1.There is an unchanged persistent small left frontal convexity subdural collection, without evidence of acute intracranial hemorrhage, within the limitations of streak artifact related to the treated bilateral posterior communicating aneurysms.2.Stable extensive right MCA territory encephalomalacia.
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Generate impression based on findings.
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Male, 47 years old; Reason: met melanoma, evaluate for progression. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodule or mass. No consolidation or pleuraleffusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen. The heart isnormal in size and there is no pericardial effusion. Coronary artery calcifications. CHEST WALL: Stable left axillary mass is again noted which measures 2.1 x 1.1 cm (image 38,series 3). Post surgical changes in the left axilla is unchanged.ABDOMEN:LIVER, BILIARY TRACT: Previously described multiple ill-defined hypoattenuating lesionsthroughout the liver are stable. The previously referenced largest lesion now measures 3 x 3 cm (image 101, series 3).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate hypoattenuating foci are unchanged from the prior study and likely benign.RETROPERITONEUM, LYMPH NODES: Previously noted portacaval lymph node now measures 2.0 x 1.1 cm (image 111, series 3). No retroperitoneal lymphadenopathy is seen.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: 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: Bilateral fat containing inguinal hernias are stable.
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1. Ill-defined liver metastases are stable.2. Stable left axillary mass.3. No new lesions. No other significant change.
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Generate impression based on findings.
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29 year old male. Reason: profound weight loss and back pain. Also PPD positive w normal CXR. Possible peritoneal TB. History: Weight loss ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Focal punctate calcifications in the liver suggestive of old granulomatous disease.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mildly prominent retroperitoneal lymph nodes without definite 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: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes at L4-S1. OTHER: No significant abnormality noted
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No definite evidence of peritoneal tuberculosis was found. No specific abnormality was found to explain profound weight loss. Back pain may be due in part to degenerative changes at L4 -- S1 with joint space narrowing, endplate sclerosis and spur formation.
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Generate impression based on findings.
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82 year old female. Reason: H/O Gastric DLBC Lymphoma s/p 4 cycles of R CHOP in need of restaging. Please compare to OSH images. CHEST:LUNGS AND PLEURA: Mild diffuse ground glass opacities and scattered, probably calcified, 3 mm nodules are stable. MEDIASTINUM AND HILA: Coronary artery calcifications. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Solitary gastric body mass measures 2.2 x 4.5 cm at image 90, series 3. 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: Status post posterior spinal fusion at L5-S1. Degenerative changes to the lumbosacral spine and pelvis. OTHER: No significant abnormality noted.
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Gastric body mass corresponds with the outside PET-CT abnormality, with much smaller size and extent. Gastric fundus abnormal wall thickening on prior exam is not seen.
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Generate impression based on findings.
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T1N2b right pyriform sinus cancer s/p completion of CRT in October of 2012. There are stable post-treatment findings, including mild supraglottic mucosal edema. However, there is no evidence of mass lesions or significant cervical lymphadenopathy. The airways are patent. There is an unchanged 4 mm hypoattenuating left thyroid nodule. The major salivary glands appear unchanged. The partially imaged intracranial structures are grossly unremarkable. The osseous structures are unchanged. The imaged portions of the lungs are clear.
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Stable post-treatment findings without evidence of locoregional tumor recurrence of residual significant cervical lymphadenopathy.
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Generate impression based on findings.
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Tracheal deviation on CXR; h/o testicular cancer. There is no significant tracheal deviation. The airways are patent. No mass lesions are identified. There is no significant cervical lymphadenopathy. The thyroid gland is unremarkable. The salivary glands are also unremarkable, The major cervical vessels are patent. The osseous structures are unremarkable. There imaged portions of the lungs are clear. There is mild retention cyst formation within the left maxillary sinus. The partially imaged intracranial structures are grossly unremarkable.
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No evidence of tracheal deviation, airway stenosis, mass lesions, or significant cervical lymphadenopathy.
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Generate impression based on findings.
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18 year-old male status post RPLND. Assess for abdominal process after several days of falling hemoglobin. ABDOMEN:LUNG BASES: No infiltrates or 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: Status post lymph node dissection. 1.7 x 0.9 cm left paraaortic node at image 60, series 3. Mesenteric 2 x 0.7 cm node at image 70 series 3. Right iliac 1.5 x 0.8 cm node at image 87, series 3. BOWEL, MESENTERY: Ascites and hematoma have resolved. No significant abnormality.BONES, SOFT TISSUES: Extensive fluid and air in the right lateral abdominal wall musculature has resolved. No significant abnormality.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Left internal obturator node is borderline enlarged, 1 x 1.6 cm at image 115, series 3. BOWEL, MESENTERY: Bowel itself shows no diagnostic abnormalities. Resolved hematoma and ascites. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Resolution of air and fluid collections. 2. Resolved ascites and hematoma. 3. Enlarged left paraaortic and iliac lymph nodes.
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Generate impression based on findings.
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Female 45 years old. Reason: Status of known of eneteric-cutaneous fistula seen on 11/20 CT abd/pelv? History: known enteric cutaneous fistula, on abx, assessing to see if there has been resolution, no change or worsening. ABDOMEN:LUNG BASES: No lung nodules are noted in the lung bases. No infiltrates or effusions. LIVER, BILIARY TRACT: Multiple metastatic liver lesions are larger and more numerous compared to previous study. Index lesion now measures 2 x 2.5 cm (image 25, series 4). There is a large adjacent lesion measuring 3 x 3 cm in segment 4B/5 (series 4 image 25), which has grown since the previous exam. The left-sided biliary ductal dilation persists. The gallbladder is contracted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post reversal of the right lower quadrant ileostomy. The enterocutaneous fistula was not found and may be closed. Enteric contrast in the small bowel is contained within the abdomen and no communication with the midline wound was demonstrated.BONES, SOFT TISSUES: Small fluid collection in the midline abdomen has not reaccumulated. No midline escape of enteric contrast from the bowel, as seen previously. OTHER: Open midline abdominal wound with dressing has improved since the prior exam. .PELVIS:UTERUS, ADNEXA: Right adnexal fluid collection has resolved. IUD in the endometrial cavity. Enlarged myomatous uterus. Tampon in place. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Interval increase in the size and number of liver metastases.The enterocutaneous fistula was not found and may be closed. Enteric contrast in the small bowel is contained within the abdomen and no communication with the open midline wound was demonstrated.
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Generate impression based on findings.
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Reason: 61M w endocarditis History: endocarditis LUNGS AND PLEURA: There are bilateral pleural effusions, right greater than left.Groundglass and air space opacities in both lungs are compatible with edema.7-mm nodule identified in the right middle lobe (image 45, series 4) is nonspecific.MEDIASTINUM AND HILA: Moderate to marked cardiac enlargement.Enlargement of pulmonary artery compatible pulmonary to hypertension.Right central venous catheter with its tip in the SVC.ET tube in place.No obvious hilar or mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.Start numbering Bilateral extensive groundglass and air space opacities compatible with edema/atelectasis, pleural effusions, right greater than left, and cardiomegaly all compatible with CHF.2.Nonspecific 7-mm right middle lobe nodule.
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Generate impression based on findings.
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83-year-old status post right distal ureterectomy. Right ureteral reimplant, assess for possible urinary tract recurrence or metastases ABDOMEN:LUNG BASES: Bi-basilar atelectasisLIVER, BILIARY TRACT: Multiple hypodense nonenhancing lesions in both lobes of liver most likely cysts. Calcified granuloma identified in the left lobe of liver. Hepatic vessels are patent.SPLEEN: No significant abnormality notedPANCREAS: Fatty involution of the pancreas noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of hydronephrosis. Symmetric nephrogram and contrast excretion noted. No focal lesions within the kidneys. Proximal right ureter demonstrates minimal wall thickening, best seen on delayed images, image 72, 11), this could be inflammatory or post operative in nature. There is focal dilatation of the mid to distal ureter, probably at the site of the uretero-plasty (image 83, series 4). However, no filling defects or narrowing noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: The uterus and left ovary appear unremarkable.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Generalized osteopenia noted. Compression fracture of L1 vertebral body and T8 vertebral body noted.OTHER: No significant abnormality noted
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1. Proximal right ureter demonstrates mild wall thickening, most likely inflammatory or postoperative in nature.2. Distal right ureter is focally dilated with normal insertion into the bladder most likely postoperative in nature.3. Compression fracture of L1 vertebral body and T8 vertebral body noted
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Generate impression based on findings.
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Reason: Pulmonary nodule History: None LUNGS AND PLEURA: Interval decrease in size of right lower lobe pulmonary nodule now measuring 7 x 7 mm on image 76/111 (13 x 22 mm on prior). No new pulmonary nodules. Scarring in the lingula.MEDIASTINUM AND HILA: Orphaned pacemaker leads. Postop change from heart transplant. Scattered small subcentimeter nodes are unchanged. Paratracheal air cyst. CHEST WALL: Status post sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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The reference right lower lobe pulmonary nodule has decreased in size to 7 x 7 mm. The decrease in size and history of negative PET scan are suggestive of a benign, post inflammatory nodule.
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Generate impression based on findings.
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Female, 56 years old, status post cranioplasty. Evaluate placement of cranioplasty and assess postoperative fluid collection. Post surgical alteration consistent with right pterional craniotomy is redemonstrated. The craniotomy flap is unchanged in morphology. It remains perforated by numerous linear lucencies. Also redemonstrated is a right parasellar surgical clip.Fluid surrounding both the extracranial and intracranial surfaces of the craniotomy flap is again seen with interval reduction of fluid volume. For reference, the extracranial component measures 12 mm in maximal thickness, previously 18. The intracranial component measures 6 mm in maximal thickness, previously 8. The extracranial component has become more hypodense which likely indicates evolution of blood product or absorption of proteinaceous material.Sequelae of a large right MCA distribution stroke are redemonstrated including encephalomalacia of the frontal, parietal and temporal lobes as well as the basal ganglia and insula. There is ex vacuo dilatation of the right lateral ventricle and a shift of brain structures towards the right. The ventricular system is unchanged in size and morphology. No acute intracranial hemorrhage or other acute findings are demonstrated.
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1. Stable appearance of the right pterional craniotomy flap.2. Interval reduction in the volume of fluid which surrounds both the extracranial and intracranial surfaces of the flap.
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Generate impression based on findings.
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Female 48 years old; Reason: Evaluate for nephrolithiasis, renal or bladder lesion causing hematuria. History: hematuria ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: 2.8 x 3.4 cm hypoattenuating lesion in the liver dome, likely a cyst.Patient is status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No renal stones or hydronephrosis. No renal masses detected.Prompt symmetric excretion through the ureters are noted without focal lesion in the bladder.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: 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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1.No CT evidence to suggest the patient's hematuria.
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Generate impression based on findings.
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Reason: evaluate left chest wall mass History: above LUNGS AND PLEURA: Scarring and atelectasis in the left upper lobe in the area adjacent to the left fourth rib treated mass presumably related to radiation change. Scattered punctate micronodules are unchanged and presumably postinflammatory. No new pulmonary nodules.MEDIASTINUM AND HILA: Postop change involving the thyroid.CHEST WALL: Heterogeneous sclerosis and deformity involving the left fourth rib, unchanged consistent with treated mass.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable presumed renal cysts.
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No evidence of measurable disease.
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Generate impression based on findings.
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Reason: Disease evaluation follow up. History: as abovePer prior radiology reports the patient has a history of pyriform sinus head and neck cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Coronary calcificationCHEST WALL: Degenerative change involving the thoracic spine. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hepatic hypodensities are too small to characterize but stable and presumably 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 significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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75-year-old with left-sided weakness. There is no evidence for acute infarct, hemorrhage, or midline shift. Ventricles and cisterns appear normal. Soft tissues and osseous structures are unremarkable. Limited evaluation of the orbits and paranasal sinuses demonstrate no focal abnormality.
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Unremarkable head CT.
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Generate impression based on findings.
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Reason: locally recurrent tongue HNSCC, s/p induction chemotherapy, precarinal and right hilar lymph node. Evaluate for disease response. History: recurrence in neck head cancer CHEST:LUNGS AND PLEURA: Apical scarring. No new pulmonary nodules. Scattered punctate micronodules are stable and presumably post inflammatory.MEDIASTINUM AND HILA: Continued increase in right high paratracheal lymphadenopathy contiguous with a mass in the right paratracheal area at the thoracic inlet. Please see dedicated neck CT report for further details.Reference precarinal lymph node has increased to 13 mm on image 39/155 (11 mm on prior). Reference right hilar lymph node has increased to 15 mm on image 44/155 (13 mm on prior). Other small lymph nodes have also increased in size.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Increase in intrathoracic lymphadenopathy. Increase in infiltrative high right paratracheal/thoracic inlet mass. Please see dedicated neck CT report for further details.
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Generate impression based on findings.
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Right tonsil squamous cell carcinoma in situ, T2N2b, s/p tonsil resection and right modified radical neck dissection in August of 2005 and chemoradiotherapy with cisplatin completed November of 2005. The patient now has recurrent squamous cell carcinoma in the right neck. Head: There is no evidence of intracranial mass or abnormal intracranial enhancement. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The osseous structures are unremarkable. Neck: There are post-treatment changes related to radiation therapy, right neck dissection, and partial glossectomy. There is no evidence of tumor within the oral cavity or oropharyngeal treatment bed. However, there has been interval increase in size of an ill-defined heterogenous mass centered within the right tracheoesophageal groove, measuring approximately 39 AP x 44 RL x 50 SI mm, previously approximately 30 AP x 40 RL x 45 SI mm. The mass encases the right common carotid artery, which is mildly narrowed. The mass is also indistinct from the esophagus, right tracheal wall with minimal narrowing of the lumen, and right lobe of the thyroid gland, and extends to the prevertebral space. The right internal jugular vein is also encased and narrowed by the mass. There are bilateral small air-filled laryngoceles. The right submandibular gland is surgically absent. The remaining major salivary glands appear unchanged. The paranasal sinuses and mastoid air cells are clear. There is unchanged degenerative spondylosis. There is a carious ADA 8. The imaged portions of the lung demonstrate biapical scarring and centrilobular emphysema.
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1. Interval increase in size of the recurrent tumor centered within the right tracheoesophageal groove that encases and mildly narrows the right common carotid artery. The mass is also indistinct from the esophagus, right tracheal wall, and right lobe of the thyroid gland.2. No evidence of intracranial metastases.
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Generate impression based on findings.
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56-year-old male with LVAD with pain, tenderness, and abdominal distention. Evaluate for hematoma of the left abdomen, and the left testicle. CHEST:LUNGS AND PLEURA: Bibasilar scarring/atelectasis.MEDIASTINUM AND HILA: Left chest wall generator and biventricular ICD leads as well as LVAD are in expected location. Severe coronary arterial calcifications. CHEST WALL: Status post median sternotomy.ABDOMEN: Absence of IV contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Left adrenal calcification may represent prior infection or prior hemorrhage. KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: No gross abnormalities noted.BONES, SOFT TISSUES: Heterogeneously hyperdense collection within the left rectus abdominis sheath measuring up to 18.9 x 5.3 cm, previously 16.4 x 4.3 cm (image 111; series 80256) compatible with the stated history of hematoma. OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Small bilateral fat-containing inguinal hernias.OTHER: Minimal fat stranding adjacent to the left testicle is nonspecific.
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1. Interval increase in size of the left rectus abdominis sheath hematoma. LVAD in appropriate position. 2. Gallstones without evidence of acute cholecystitis.
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Generate impression based on findings.
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Female; 49 years old. Reason: RA, uncontrolled DM, sarcoid, with N/bilious emesis and RUQ/R flank pain. Eval for nephrolithiasis, acalculous cholecystitis (hx of CCK0, SBO). History: N/V, RUQ flank/abdominal pain Lack of IV contrast administration limits evaluation.CHEST:LUNGS AND PLEURA: Bilateral lung base bronchiectasis and scarring appear similar to prior.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Right upper quadrant surgical clips, likely from cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable 4-mm nonobstructive stone in the left lower pole. No evidence of hydronephrosis. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Bilateral C7 cervical ribs noted.PELVIS:UTERUS, ADNEXA: Multiple tiny pelvic calcifications likely representing uterine fibroids are stable.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable left lower pole nonobstructive renal calculus. No evidence of cholecystitis.
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Generate impression based on findings.
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Reason: evaluate ILD History: cough sob fibrosis LUNGS AND PLEURA: Diffuse predominantly subpleural and basilar interstitial disease with reticular opacities, traction bronchiectasis and mild honeycombing, consistent with UIP.No significant air trapping on expiration scan.MEDIASTINUM AND HILA: Moderate mediastinal and hilar lymphadenopathy.Severe coronary artery calcification, particularly in the LAD branch.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Right lobe hepatic cyst.
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Diffuse interstitial disease, compatible with UIP, unchanged since the previous scan.
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Generate impression based on findings.
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71-year-old female. Metastatic lung cancer status post chemotherapy. Compare to previous. CHEST:LUNGS AND PLEURA: Post-surgical changes of left lower lobectomy with scattered basilar consolidation, pleural nodularity and loculated pleural fluid, similar to prior exam. Left lung peripheral scarring and chronic interstitial opacities, not significantly changed.Right upper lobe 3 mm micronodule (series 5, image 30) and 6 mm right middle lobe nodule (series 5, image 65) are unchanged in size but increased in density. Additional scattered calcified and noncalcified micronodules are not significantly changed. Small endobronchial nodule at the takeoff of the right lower lobe bronchus is stable over several exams (image 51/116). MEDIASTINUM AND HILA: Index pretracheal lymph node measures 6 mm, unchanged (series 3, image 31). Some lymph nodes are calcified. Normal heart size without significant pericardial effusion. CHEST WALL: Again seen is a left 5th rib fracture. Interval development of fractures of the left 6th and right 5th as well as 6th ribs. Callus formation and indistinctness of fracture line suggests that these are subacute. No associated soft tissue mass to indicate that these are metastatic pathologic fractures.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered subcentimeter hypodensities in the right hepatic lobe are unchanged, likely cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild calcified atherosclerotic calcification of the abdominal aorta. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the lumbar spine.OTHER: No significant abnormality noted.
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1. Two small subcentimeter right lung nodules, while not significantly changed in size, are increased in density. No significant interval change in size or appearance of remainder of pulmonary nodules. Nonspecific left sided pleural thickening is unchanged. Continued follow up is recommended. No new pulmonary metastases are seen.2. Interval development of left 6th and right 5th as well as 6th rib fractures, which appear subacute. No associated soft tissue mass to suggest that these are metastatic, correlate for trauma.
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Generate impression based on findings.
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58 year old male with a history of liposarcoma. Evaluate for lung metastatic disease. CHEST:LUNGS AND PLEURA: Micro-nodules in the right middle lobe. No infiltrates or effusions. Right diaphragmatic thickening and calcification at the hepatic dome may be old scar. MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensity in the interpolar region of the left kidney is too small to characterize, but likely represents a simple cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: 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: No significant abnormality notedBOWEL, MESENTERY: Hiatal hernia. BONES, SOFT TISSUES: Note is made of encapsulated fluid collection along the anterior aspect of the right femoral neck which is incompletely visualized on this examination. While these findings may represent post surgical changes secondary to the resection of a previously described large right thigh mass, superimposed infection cannot be excluded. OTHER: No significant abnormality noted
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1. No measurable metastatic disease. Thickened right hemidiaphragm most consistent with old scarring. 2. Encapsulated fluid collection within the soft tissues along the anterior right thigh. While these findings may represent post surgical changes/hematoma, secondary to the resection of a previously described large right thigh mass, superimposed infection and/or residual disease cannot be excluded.
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Generate impression based on findings.
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60-year-old male with PTCL-NOS status post 6 cycles of CHOEP in need of end of treatment scans. CHEST:LUNGS AND PLEURA: There is minimal left apical scarring/atelectasis. There is bilateral dependent atelectasis. No suspicious pulmonary nodules or masses are identified. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Right chest port tip terminates at the junction of the SVC and right atrium.ABDOMEN:LIVER, BILIARY TRACT: Note is made of a subcentimeter hypodensity in segment 5 of the right lobe of the liver as well as within the dome of the liver, which are incompletely characterized, but may represent simple cysts or hemangiomas.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Note is made of vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Mild concentric wall thickening of the bladder may reflect chronic outlet obstruction.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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No evidence of lymphadenopathy. No measurable disease.
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Generate impression based on findings.
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Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Redemonstration of a right lower lobe calcified granuloma. MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Stable minimal residual thymic tissue.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No interval change without evidence of metastatic disease.
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Generate impression based on findings.
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Reason: hx H\T\N ca, s/p CRT, evaluate dx and compare measurements to previous scans History: as above CHEST:LUNGS AND PLEURA: Scattered punctate calcified and noncalcified micronodules are unchanged and presumably benign.Previously noted patchy groundglass opacities have nearly completely resolved and were likely secondary to aspirate.MEDIASTINUM AND HILA: Coronary calcification.CHEST WALL: Degenerative change involving thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Presumed splenule posterior to spleen is 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.G-tube tip in stomach.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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T4aN2c R BOT SCC who completed radiation therapy approximately 1.5 years ago. There was an in-field recurrence in Oct 2012 as well as lesions in the posterior pharyngeal wall, piriform sinuses, and cervical esophagus. Panendoscopy on 11/9/12 showed no recurrent tumor on examination and benign findings on pathology in the right BOT. There stable post-treatment findings with asymmetric volume loss and distortion of the right tongue base, without evidence of recurrent tumor. There is no significant cervical lymphadenopathy. The airways are patent. The salivary glands appear unchanged with diffuse fatty replacement. The thyroid gland. There is at least moderate stenosis of the proximal right internal carotid artery secondary to atherosclerotic plaque. There is unchanged degenerative spondylosis. The partially imaged intracranial structures are unremarkable.
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1. No evidence of locoregional tumor recurrence of significant cervical lymphadenopathy.2. At least moderate stenosis of the proximal right internal carotid artery secondary to atherosclerotic plaque. This can be further evaluated via dedicated vascular imaging.
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Generate impression based on findings.
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Male; 47 years old. Reason: hx of ALL s/p allo HSCT and hx of GVHD now with intermittent daily abdominal cramping, constipation and GERD notable GI symptoms History: hx of abdominal cramping/pain Lack of intravenous contrast limits evaluation.CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Incidental note is made of a doubled renal vein with one vein retroaortic.RETROPERITONEUM, LYMPH NODES: Stable subcentimeter retroperitoneal lymph nodes.BOWEL, MESENTERY: Previously identified epiploic appendagitis it is no longer visualized. No evidence of obstruction, pneumatosis, or pneumoperitoneum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate is mildly enlarged and heterogeneous.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Within the limitations of a non-enhanced study, no radiologic evidence to account for the patient's symptoms.
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Generate impression based on findings.
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Reason: increasing DOE and cough, history of NSIP, assess for aspiration History: cough LUNGS AND PLEURA: Patchy ground glass and interstitial opacities at the bases, right greater than left, are not significantly changed. No new opacities are identified. There is patchy very mild air trapping.Small area of scarring with bronchiectasis in the periphery of the lingula (image 30/83) is unchanged. Otherwise no significant bronchiectasis or honeycombing.MEDIASTINUM AND HILA: Cardiomegaly. ICD device with leads in right atrial appendage and right ventricular apex. Coronary calcification. Coronary stents.CHEST WALL: Left chest wall ICD generator. Small subcentimeter axillary lymph nodes unchanged. Mild degenerative change involving thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Stable parenchymal and interstitial opacities suggestive of NSIP. No new opacities to suggest aspiration.
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Generate impression based on findings.
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Communicating hydrocephalus. There has been interval decrease in size of the ventricular system, in which the lateral and third ventricles are now nearly collapsed. There is an unchanged right transparietal ventricular shunt catheter that terminates in the frontal horn of the left lateral ventricle. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The brain parenchyma appears unchanged. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unchanged, including diffuse skull thickening related to chronic shunting.
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Interval decrease in size of the ventricular system with ventricular shunt in position, in which the lateral and third ventricles are now nearly collapsed. This may indicate over-shunting in the appropriate clinical setting versus resolution of prior hydrocephalus.
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Generate impression based on findings.
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Reason: Please describe and identify LUQ abdominal mass History: abdominal mass Lack of intravenous contrast limits evaluation of solid organs.ABDOMEN: LUNG BASES: Bilateral scarring/atelectasis of bilateral lung bases.LIVER, BILIARY TRACT: A hypodense subcentimeter lesion in hepatic segment 8 is too small to further characterize but likely represents a simple cyst, unchanged. Another small subcentimeter hypodense lesion in hepatic segment 5 likely represents a benign hepatic cyst, unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Small scattered periaortic lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes along the anterior abdominal wall are again seen, appearing similar to the prior study. There is soft tissue fat stranding and edema of the subcutaneous tissue overlying the anterior abdominal wall. Interval removal of the previously described surgical drain. The previously described large, thin loculated fluid collection with an enhancing rim draping over the anterior abdominal wall is not appreciated on today's examination. There is a small focus of soft tissue density in the soft tissues overlying the anterior aspect of the left hemiabdomen measuring 1.9 by 1.0 cm (58; series 3). These findings may represent phlegmon versus early abscess formation. No drainable fluid collection is identified.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Right adnexal cystic lesion is poorly characterized on CT examination, measuring 4.6 x 3.6 cm (102; series 3).BLADDER: The bladder is markedly distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic foci in the right sacral ala and left iliac bone, unchanged. Chronic appearing, marked anterior spondylolisthesis of the L5 vertebral body with a pars interarticularis defect.OTHER: No significant abnormality noted
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1. Findings suggestive of phlegmon formation versus early abscess along the left anterior hemiabdomen. No drainable collection is identified. Near complete interval resolution of the previously described loculated fluid collection along the anterior abdominal wall. 2. Right adnexal cystic lesion is incompletely characterized on CT examination. Further evaluation with ultrasound examination could be considered if clinically indicated.
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Generate impression based on findings.
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Fever CHEST:LUNGS AND PLEURA: Right upper left upper, left lingular, right lower and left lower lobe airspace opacities, likely subsegmental atelectases. The possibility of no effusions superimposed pneumonia cannot be excluded.MEDIASTINUM AND HILA: Postsurgical clips are noted in the mediastinum. No evidence of pericardial effusion. No evidence of enlarged lymph nodes.CHEST WALL: Some postsurgical changes of the sternum are noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Not clearly visualized.KIDNEYS, URETERS: Horseshoe kidneys with no evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: Central line terminates at retrohepatic IVC.BOWEL, MESENTERY: No significant abnormality noted. A gastrostomy tube is in place.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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Multifocal air space opacities either atelectasis or pneumonia.Horseshoe kidneys.
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Generate impression based on findings.
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Newly diagnosed Hodgkin lymphoma, in need of initial staging. There is extensive left cervical lymphadenopathy. For example, a left parotid lymph node measures 18 x 18 mm, a left level 5 lymph node measures 30 x 41 mm, and a left supraclavicular lymph node measures 26 x 47 mm. A left level 2 B lymph node demonstrate central necrosis, which the other lymph nodes appear solid. Thre is compression of the left internal jugular vein. The other major cervical vessels are otherwise intact. The Waldeyer structures are not enlarged. The thyroid gland and salivary glands are unremarkable. There is a right mesiodens. There is a torus mandibularis. There is prominence of the lateral ventricles. The patient is intubated and the airways are otherwise patent.
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1. Extensive left cervical lymphadenopathy, compatible with Hodgkin lymphoma.2. Prominence of the lateral ventricles, which can be further evaluated via dedicated brain imaging.
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Generate impression based on findings.
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Evaluate for PE PULMONARY ARTERIES: Pulmonary arteries branch normally with no evidence of thrombosis.LUNGS AND PLEURA: A 18 mm right lung pleural-based nodule. Left lung base airspace opacity consistent with a lung nodule or subsegmental atelectasis is noted as well. No effusions or pneumothorax.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.
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Right and left lower lobes air space opacities either of infectious origin or atelectasis. No evidence of PE.
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Generate impression based on findings.
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Syncope and collapse. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses are clear. There is mild opacification of the mastoid air cells. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage, mass, or cerebral edema.
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Generate impression based on findings.
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Reason: h/o HNC/ACC and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Stable scattered nonspecific micronodules.Mild basilar scarring.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Focal left thyroid calcification.No hilar or mediastinal lymphadenopathy.Cardiac size is normal.Small pericardial effusion stable.CHEST WALL: Bilateral breast implants with redemonstration of intracapsular rupture on the right and mixed densities on the left. Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable right hepatic lobe hypodensity, most likely a cyst.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No specific evidence of metastatic disease. Stable small pericardial effusion.
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Generate impression based on findings.
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41 year old male patient with tenderness to palpation. Evaluate for fracture. Mild joint space narrowing and acetabular osteophytes, consistent with mild osteoarthritis in the bilateral hips. No evidence of fracture or dislocation.Mild degenerative changes in the sacroiliac joints and the symphysis pubis.Mild multilevel degenerative changes in the visualized lumbosacral spine.Colonic diverticulosis without evidence of diverticulitis.
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No evidence of fracture or dislocation.
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Generate impression based on findings.
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50 year-old female with history of celiac disease and abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is minimal increase in the fold frequency pattern of the ileal segments. No other abnormality is noted in the small bowel segments.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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Minimally increased number of folds involving the ileum. This may be compatible with patient's known history of celiac disease.
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Generate impression based on findings.
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25 year old female with Crohn's disease with multiple fluid collections requiring drainage and pleural effusions. Reason: LLQ fluid collection, please evaluate - with PO and IV contrast History: fevers, chills. ABDOMEN:LUNG BASES: Moderate left pleural effusion is stable. Persistent left base consolidation/atelectasis. Right lung unremarkable.LIVER, BILIARY TRACT: Hepatomegaly. The liver measures 20 cm craniocaudally. SPLEEN: Stable multi-loculated perisplenic fluid collection.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left pelvic kidney unchanged. Right kidney unremarkable.RETROPERITONEUM, LYMPH NODES: Multiple enlarged upper retroperitoneal lymph nodes.BOWEL, MESENTERY: Right lower quadrant ileostomy is unchanged.The right lower quadrant fluid collection has resolved and the percutaneous catheter was removed.The complex, multiloculated fluid collection along the left pericolic gutter has resolved. The left lower quadrant portion of this collection has resolved. A percutaneous drain is present within the inferior portion of the fluid collection site. Multiple enlarged mesenteric lymph nodes have decreased in size. Postsurgical changes status post subtotal colectomy.BONES, SOFT TISSUES: Surgical staples are present in the anterior abdominal wall were removed. 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: Stable multiple peripheral enhancing fluid collections are seen in the pelvis surrounding the adnexa; while some of these may represent hydrosalpinx, superimposed small abscesses are also suspected. This is not significantly changed since prior exam.Postsurgical changes status post subtotal colectomy.BONES, SOFT TISSUES: Surgical staples in the anterior abdominal wall were removed.OTHER: No significant abnormality noted.
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1.Stable left moderate pleural effusion.2.Interval resolution of right lower quadrant abscess, with percutaneous drain removed.3.Superior portion of the complex, multiloculated left upper quadrant and left pericolic gutter abscess has resolved. A percutaneous drain is present in the inferior, left lower quadrant aspect of this region.4.Multiple peripherally enhancing fluid collections in the pelvis are not significantly changed; some of these have tubular morphology which may represent hydrosalpinx although a superimposed small abscesses also suspected.5.Stable small loculated fluid collections at the superior pole of the spleen. Hepatomegaly. Pelvic kidney. Left pleural effusion.
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Generate impression based on findings.
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41 years old Male. Reason: r/o fx History: midline ttp CERVICAL SPINE: Alignment is anatomic. Vertebral body heights and disk spaces are maintained. No acute fractures are identified. Central canal is within normal limits. No abnormal soft tissue masses are identified.There is stranding and irregularity along the soft tissues of the posterior neck at midline. No evidence of adjacent skin thickening or draining sinus tract is evident.THORACIC SPINE: Alignment is anatomic. Vertebral body heights and disk spaces are maintained. No acute fractures are identified. Central canal is within normal limits.Paraseptal emphysema/bullous disease is present.LUMBAR SPINE: There is normal lumbar lordosis. The spine alignment is anatomic. Vertebral body heights are maintained. The paraspinal soft tissues are unremarkable. Limited views of the intra-abdominal viscera is unremarkable.Degenerative changes are specified by the intervertebral level as follows: T12/L1 through L3/4: no neuroforaminal narrowing or spinal stenosis. L4/L5: Disk bulge with apparent disk extrusion directed inferiorly. Facet hypertrophy results in the left greater than right neural foraminal stenosis.L5/S1: Mild diffuse disk bulge. Mild facet hypertrophy results in mild bilateral neural foraminal stenosis.
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1. No acute osseous abnormality.2. Soft tissue stranding and irregularity along the posterior neck, may indicate ligamentous injury. MRI may be beneficial for further characterization if clinically warranted. 3. Degenerative changes including disk bulge and probable extrusion at L4 -- 5 and disk bulge at L5 -- S1.
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Generate impression based on findings.
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Suicide attempt following ingestion of Draino-O. s/p gastric pull-up. Recurrent aspiration pneumonia and dysphagia. The patient is status post left neck surgery. There are air bubbles present along the soft tissues of the left neck extending to the subcutaneous tissues and into the anterior aspect of the superior mediastinum. There is infiltration of the fat planes anterior to the left carotid space and the left larynx. These are consistent with the history of gastric pull-up.The epiglottis is partially absent.There are fractures along body of the hyoid bone associated with deformity of the left thyroid cartilage and dislocation of the left arytenoid cartilage.There is calcium deposition in the left half of the prevertebral space at the C1-C2 vertebral level. This likely represents dystrophic calcification. A weblike defect is also present at the level of the soft palate with narrowing of the nasopharygeal passage.The left clavicle head is deformed and separated from the sternum.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses are clear. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices demonstrate som right sided interstitial thickening.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 degenerative changes present worse at C5-6 where there are endplate and uncovertebral osteophytes.
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1.The patient is status post left neck and mediastinal surgery. There are bubbles present in the left neck associated with infiltration of the fat planes. No obvious ring enhancing lesion to suggest abscess. The possibility of superinfection cannot be excluded. Please correlate with clinical findings.2.There is a comminuted fracture of the body of the hyoid bone associated with thyroid deformity and left arytenoid dislocation. It is associated with distortion of the floor of the mouth. I suspect that these injuries may be old. Please correlate with clinical history.3.Absence of the epiglottis. Please correlate with clinical history.4.Deformity of the left clavicle with dislocation at the left sternoclavicular joint is probably related to prior traumatic injury.5.A weblike defect at the level of the soft palate narrows the nasopharyngeal passage. Please correlate with clinical findings.6.Please refer to Chest CT of 12/8/13 for further comments.7.Findings were discussed with Maureen Crawley at the time of this dication.
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Generate impression based on findings.
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Clinical question: Evaluate for hemorrhage. Signs and symptoms: Altered mental status. Nonenhanced head CT: There is no detectable intracranial acute abnormalities in particular no evidence of hemorrhage.There is mild prominence of cortical sulci for patient's stated age of 44. Correlate with history and risk factors.Unremarkable cerebral cortex, ventricular system, CSF and spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells.
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No acute intracranial findings.
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Generate impression based on findings.
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Clinical question: 102 year old female with AMS and pleural effusion. Signs and symptoms: Asked above. Nonenhanced head CT:No detectable acute intracranial process.CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Minimal subcortical and periventricular low-attenuation white matter likely secondary to age indeterminate small vessel ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system and the CSF spaces otherwise.Unremarkable orbits.Extensive opacification and bony thickening of the chamber of the sphenoid sinus and unremarkable other visualized paranasal sinuses.
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No acute intracranial process.
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Generate impression based on findings.
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Clinical question : Evaluate for mass. Signs and symptoms: Headache and HIV. Enhanced head CT:No detectable abnormal parenchymal or leptomeningeal enhancement.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Partially visualized paranasal sinuses demonstrate diffuse chronic sinusitis and mild bilateral mastoid air cell opacification. There is also partial opacification of left middle ear cavity.
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1.Unremarkable exam and without evidence of abnormal parenchymal/leptomeningeal enhancement.2.Mild chronic sinusitis and partial opacification of bilateral mastoid air cells and left middle ear cavity.
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Generate impression based on findings.
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Clinical question: Please assess for edema or signs of new stroke, patient had CVA on outside hospital last week. Signs and symptoms: Headache and visual hallucination. Nonenhanced head CT:Examination demonstrate small bilateral occipital subacute nonhemorrhagic strokes with subtle associated effacement of adjacent cortical sulci. Stroke in the right occipital lobe measures approximately 20 times 20-mm and 12 times 14-mm in the left occipital lobe.There is also a tiny focus of low-attenuation highly suspected though an additional focus of a stroke is noted along the superior aspect of left cerebellar (axial image 10). This focus measures approximately 7 mm in size.There is also diffuse subcortical and periventricular low attenuation white matter consistent with age indeterminate small vessel ischemic strokes. No evidence of intracranial hemorrhage, normal size of ventricular system and with maintained midline.Moderate bilateral vertebral and cavernous carotid vascular calcification is noted.Calvarium demonstrate extensive patchy areas of sclerotic and lytic changes of calvarium consistent with Paget's disease.Unremarkable orbits, partially visualized paranasal sinuses and mastoid air cells.
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1.Small bilateral occipital and a tiny left superior cerebellar subacute nonhemorrhagic ischemic strokes as detailed.2.Advanced age indeterminate small vessel ischemic strokes is noted.3.Extensive findings of calvarium consistent with Paget's disease.
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Generate impression based on findings.
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Clinical question: History of breast cancer, headache, hypertension; rule out metastases. Signs and symptoms: As mentioned above. Unenhanced head CT:No detectable acute intracranial process CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Lack of intravenous contrast reduces the sensitivity of the exam for detection of smaller metastatic lesions or leptomeningeal process.Within this limitation there is no findings to suggest presence of metastatic disease on this non-infused study.There is a focus of low-attenuation consistent with encephalomalacia in the left occipital lobe and along the medial aspect of left temporal lobe consistent with a chronic left posterior cerebral artery territory stroke stable since prior exam from 2000.Calvarium and soft tissues of the scalp are unremarkable.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.
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1.No acute intracranial process.2.No detectable metastatic disease on this non-infused exam. Please see above comments.3.Chronic left PCA territory ischemic stroke similar to prior exam from 2012.
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Generate impression based on findings.
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Clinical question: Evaluate for intracranial injury. Signs and symptoms: Evaluate for intracranial injury. Nonenhanced head CT:No detectable at U. posttraumatic intracranial, calvarial or soft tissues of the scalp the findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable orbits.Unremarkable all visualized paranasal sinuses and mastoid air cells.
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Negative nonenhanced head CT.
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Generate impression based on findings.
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Clinical question: Status post craniotomy. Signs and symptoms: Status post craniotomy. Unenhanced head CT:Examination demonstrates extensive postoperative changes of left anterior frontal craniectomy as well as left orbit and in including enucleation and surgery at the level of the floor of the left anterior cranial fossa.There is a large soft tissue flap placement as well as prosthetic device at the site of craniectomy. Expected residual air overlapping the left frontal lobe is noted. Residual air is also noted in the epidural space overlapping the left frontal lobe as well. There is a subtle flattening of the left frontal lobe as result of postop changes. No detectable intracranial hemorrhage.There is extensive periventricular and subcortical low attenuation white matter consistent with age indeterminate small vessel ischemic strokes.There is expected postoperative changes of extensive opacification of bilateral paranasal sinuses.
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1.Expected extensive postoperative changes of left anterior frontal craniectomy and postop changes of left orbit including enucleation and surgery at the level of the floor of the anterior cranial fossa as detailed above.2.There is subtle mass effect on the left frontal lobe secondary to postop changes.3.Minimal expected postoperative pneumocephalus and without images of intracranial hemorrhage. 4.Moderate to advanced age indeterminate small vessel ischemic strokes are noted.
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Generate impression based on findings.
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75-year-old female with left-sided weakness. Evaluate for stenosis. NONCONTRAST CT HEADThe ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. Atherosclerotic calcification is noted within the distal right common carotid artery. . There is normal contrast opacification through anterior circulation (bilateral petrous/cavernous/supraclinoid internal carotid arteries, anterior and middle cerebral arteries).A short segment defect is seen in the proximal right posterior cerebral artery P1 segment concerning for thrombotic occlusion. The right PComm is not visualized. The remainder of the posterior circulation (vertebral-basilar, posterior-inferior cerebellar, anterior-inferior cerebellar, superior cerebellar, and left posterior cerebral arteries), and distal intracranial vasculature are patent. Tortuous bilateral vertebral arteries superior to the foramen magnum. No evidence of aneurysm, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage.
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1.No acute intracranial hemorrhage or other brain parenchymal abnormalities. However CT is insensitive for the detection of acute ischemia. A brain MRI has become available since this CT exam. Refer to the brain MRI for further details.2.Proximal short segment defect spanning 4 mm in the the right P1 segment of the right posterior cerebral artery with reconstitution via collaterals. 3.The remainder of the intracranial and neck vasculature are patent.
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Generate impression based on findings.
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Female 51 years old; Reason: 51 year old female with sarcoidosis and low-grade NHL. Compare to prior exam. History: none CHEST:LUNGS AND PLEURA: Status post right lower lobe wedge resection. Volume loss in the upper lobes. Findings compatible with known history of sarcoidosis including nodular septal beading. Interval development of a small wedge-shaped opacity in the left lower lobe, which is likely atelectasis. Surgical clips in the right apex.MEDIASTINUM AND HILA: Atherosclerotic calcifications of the thoracic aorta and coronary arteries.CHEST WALL: Left axillary lymph node measuring 2.5 x 2 .0 cm, previously 2.4 x 1.8 cm (image 36, series 3). Enlarged subpectoral lymph node on the left is stable.Multinodular thyroid.ABDOMEN:LIVER, BILIARY TRACT: No focal lesion detected.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodense lesions in both kidneys, too small to characterize but statistically likely benign.RETROPERITONEUM, LYMPH NODES: No pathologically enlarged retroperitoneal lymph nodes. Moderate atherosclerotic calcification of the abdominal aorta.BOWEL, MESENTERY: Peripherally calcified round nodule with fat within mesentery, adjacent to surgical clips is stable. This is likely a treated node. Mild small bowel dilatation with small bowel feces sign without discrete transition point. No evidence of pneumoperitoneum or pneumatosis intestinalis.BONES, SOFT TISSUES: Interval development of a wedge compression deformity in the T9 vertebral body with approximately 50% loss of height. No retropulsion of the osseous structures is identified, however MRI should be considered to further characterize central stenosis.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: Interval development of a wedge compression deformity in the T9 vertebral body with approximately 50% loss of height. No retropulsion of the osseous structures is identified, however MRI should be considered to further characterize whether canal stenosis is present as CT cannot detect soft tissue components.Sternal fracture is also noted, which is new since previous exam (series 80277 image 51).OTHER: No significant abnormality noted.
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1.Enlarged left axillary and left subpectoral lymph nodes are stable.2.Mild small bowel dilatation without identification of a discrete transition point which is also stable.3.Interval development of a wedge compression deformity in T9 , MRI advised to characterize impingement or cord compression. In conjunction with the sternal fracture, traumatic etiology is though more likely.
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Generate impression based on findings.
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102 year old female. Status post thoracentesis. History of pleural effusion. LUNGS AND PLEURA: Large left hydropneumothorax with dependent layering hyperdensity consistent with blood. This causes marked compressive atelectasis and consolidation of the left lung, mostly the lower lobe, limiting evaluation for underlying pathology such as neoplasia and infection. There are also patchy ground-glass opacities in the left upper lobe. 5 mm nodule in the right upper lobe (series 5, image 16).MEDIASTINUM AND HILA: Moderate atherosclerotic calcification of the thoracic aorta and coronary arteries. Mild rightwards mediastinal shift caused by the hydropneumothorax. Several small herniations of epicardial or mediastinal fat in the left hemithorax.CHEST WALL: Degenerative disk disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Scattered subcentimeter hypoattenuating foci in the liver are incompletely characterized. Splenic calcified granulomata. 8-mm hyperdense focus arising from interpolar region of left kidney, incompletely characterized.
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1. Large left hydropneumothorax with small amount of dependent hemorrhage. This causes severe compressive atelectasis and consolidation of the left lung, limiting evaluation of lung pathology. Repeat CT upon reexpansion of the left lung with IV contrast if possible is recommended to exclude underlying infectious or neoplastic etiologies.2. 5-mm right upper lobe nodule.
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Generate impression based on findings.
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61 year-old female with right lower quadrant abdominal pain. Evaluate for intra-abdominal pathology. ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: Non-enhancing subcapsular hypoattenuating lesion in the right posterior liver measuring 1.2 x 2.9 cm likely represents a benign hepatic cyst. No evidence of suspicious lesion. No evidence of cholelithiasis or cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Non-enhancing soft tissue dense lesion in the midpole of the left kidney measuring 1.6 x 2.2 cm best seen on image 58 of series 3 appears similar to prior. Follow up is recommended. Cortical thinning noted bilaterally.RETROPERITONEUM, LYMPH NODES: Severe, diffuse atherosclerosis of the abdominal aorta without evidence of aneurysmal dilatation. Benign-appearing left paraaortic lymphadenopathy.BOWEL, MESENTERY: The appendix is not visualized, but no inflammatory changes are seen in the right lower quadrant to suggest acute appendicitis. The bowel is normal in caliber. No evidence of obstruction. No pneumoperitoneum, pneumatosis, or portal venous air is seen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Extensive coronary artery calcifications.PELVIS:UTERUS, ADNEXA: Uterine fibroids again noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No evidence of acute appendicitis.2.Indeterminant left kidney mass as described above. Consider a non-contrast enhanced CT for further evaluation. Follow up is recommended.3.Extensive calcifications of the abdominal aorta and coronary arteries.
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Generate impression based on findings.
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29-year-old female status post Whipple and small bowel resection for neuroendocrine tumor. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Note is made of a 2.0 x 1.6 cm hypervascular lesion in segment 8 of the liver, suspicious for metastatic disease (17; series 9). Note is made of diffuse fatty infiltration of the liver. Note is made of hepatomegaly. Status post cholecystectomy.SPLEEN: Status post splenectomy.PANCREAS: Note is made of postsurgical changes consistent with the stated history of pancreatectomy. No demonstrable pancreatic tissue is identified. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Note is made of numerous prominent mesenteric lymph nodes of uncertain etiology. BOWEL, MESENTERY: Postoperative changes consistent with partial gastrectomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Bilateral subcentimeter adnexal cystic lesions are likely physiologic.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Hypervascular lesion in segment 8 of the liver is suspicious for metastatic disease in the setting of a known primary neuroendocrine tumor.
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Generate impression based on findings.
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penile cancer and planning lymph node dissection for staging. Evaluate lymph nodes prior to dissection. Evaluate general abdomen for other lymphadenopathy. ABDOMEN:LUNG BASES: Small bilateral pleural effusions and right basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic changes in the aorta, with a small infrarenal aortic aneurysm measuring 3.0-cm.. No upper abdominal lymphadenopathy or other retroperitoneal masses are abnormality seen.BOWEL, MESENTERY: Stomach, small bowel, and colon show no diagnostic abnormalities. No free mesenteric fluid. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No change is seen in the left obturator slightly enlarged lymph node measuring 2.0 x 0.9 cm (series 3, image 126) compared with prior reference measurement of 2.4 x 1.1 cm.. The other visualized prior referenced right external iliac lymph node measures 0.6-cm (series 3, image 119 ), unchanged from previous examination. A similar small right femoral lymph node is seen (series 3, image 135) subcentimeter in size, unchanged. The scattered bilateral subcentimeter small inguinal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Ill-defined haziness in the left groin is seen just anterior to these left femoral artery -- most likely relating to prior. Procedure. No discrete fluid collection is seen. This does not have an appearance typical of metastases and appears more postprocedural or inflammatory. Diffuse bony degenerative changes are seen without focal abnormality to suggest metastases.OTHER: No significant abnormality noted
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1. Small bilateral pleural effusions. 2. Mostly small subcentimeter scattered lymph nodes identified nonspecific in appearance in the pelvis with one slightly larger lymph node in the left obturator chain, all not changed significantly.
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Generate impression based on findings.
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34-year-old female with chest pain, tachycardia, shortness of breath, lower extremity pain and swelling. Rule out PE. Exam is limited by respiratory motion artifact and patient's body habitus. PULMONARY ARTERIES: No evidence of pulmonary embolus.LUNGS AND PLEURA: Moderate diffuse bilateral groundglass pattern with nodular opacities demonstrate interval worsening from the prior exam. A small amount of air trapping is again seen and grossly unchanged.MEDIASTINUM AND HILA: Aortopulmonary window, subcarinal, right paratracheal, and bilateral hilar lymphadenopathy is unchanged.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. The liver and spleen are partially imaged though appear mildly enlarged, consistent with previous mention of mild hepatosplenomegaly.Status post cholecystectomy.
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1.No evidence of pulmonary embolus, as clinically questioned.2.Interval increase in diffuse groundglass opacities with stable lymphadenopathy, compatible with the progressive pulmonary sarcoidosis.3.Mild hepatosplenomegaly.
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Generate impression based on findings.
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Tachycardia, SOB. Evaluate for PE. PULMONARY ARTERIES: Technically adequate examination for evaluating pulmonary embolism. No pulmonary emboli identified.LUNGS AND PLEURA: Right middle lobe intrapulmonary abscess with decreased fluid within it. There is a decrease in the amount of consolidated lung surrounding this abscess. Bilateral multifocal patchy ground-glass opacities that are upper lobe predominant are also decreased.Moderate bilateral pleural effusions, similar to prior exam, with bibasilar dependent atelectasis.MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy, possibly reactive. Some of the lymph nodes are calcified related to prior granulomatous disease. Small pericardial effusion, unchanged.CHEST WALL: Anasarca.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No evidence of pulmonary embolism.2. Right middle lobe intrapulmonary abscess with decreased internal fluid. There is decrease in consolidation surrounding the abscess as well as upper lobe predominant multifocal groundglass opacities.
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Generate impression based on findings.
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Reason: restaging scans s/p 4 cycles of systemic immunotherapy History: hx of head and neck cancer CHEST:LUNGS AND PLEURA: Previously described noncalcified nodule within the right upper lobe (image 47) has increased in size. Using similar measurement technique, it measures 7 mm, as compared to 5 mm. The right middle lobe nodular opacity inferior to large calcification is demonstrated progressive growth. This currently measures 12 x 16 mm (series 5 image 76), as compared to 7 x 10 mm compared to September.The previously described PET avid left upper lobe sub pleural nodule is stable, measuring 9 x 6 mm (image 31, series 7). Clusters of centrilobular nodules in the lung bases are again identified, suggestive of aspiration. A wedge-shaped, pleural-based opacity within the posterior lateral basal segment right lower lobe has become more dense at the pleural surface (series 5 image 76).Severe centrilobular emphysema is againseen. Additional scattered micronodules and calcified granulomas are unchanged. No new pleural effusion.MEDIASTINUM AND HILA: Cardiac size is normal without pericardial effusion. Coronary artery calcifications. There is no mediastinal or hilar lymphadenopathy. Small cardiophrenic lymph node left lateral to the super hepatic IVC unchanged (image 87, series 3).CHEST WALL: Right port unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: A cleft in the liver is again identified.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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Progressive increase size of right upper and middle lobe nodules suspicious for metastases. Additional pulmonary nodules are stable. No interval mediastinal or hilar lymphadenopathy.
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Generate impression based on findings.
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Reason: chest pain, tachycardia, r/o PE History: chest pain, tachycardia, r/o PE PULMONARY ARTERIES: There is no evidence of a pulmonary embolus.LUNGS AND PLEURA: Multifocal areas of groundglass opacities are noted in the upper lobes bilaterally as well as left lower lobe.Moderate size right pleural effusion with underlying atelectasis.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Cardiac size is normal with a small pericardial effusion.CHEST WALL: Trabecular thickening and increased density within all the vertebrae, compatible with renal osteodystrophy. Focus of nonspecific sclerosis in the T12 vertebrae.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy.Focal wedge-shaped areas of of hypodensity throughout the right lobe of the liver has a noted on recent CT the abdomen and may represent areas of infection or infarction.Large hypodense mass within the body of the pancreas with enlargement of the pancreatic tail compatible with pancreatitis and pseudocyst formation.
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1.No evidence of a pulmonary embolus.2.Multifocal mixed groundglass and solid opacities compatible with an atypical infection including fungal etiologies.3.Multiple wedge-shaped hypodensities within the liver, suggestive of infarction or infection.4.5-cm, hypodense mass within the pancreas, compatible with a pancreatic pseudocyst.
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Generate impression based on findings.
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61-year-old female with pain, nausea. Within the limits of a non-IV contrast enhanced examination limiting evaluation of solid parenchymal organs and vascular structures, following observations can be made:ABDOMEN:LUNG BASES: Cardiomegaly and ICD with expected appearances.LIVER, BILIARY TRACT: Lobulated near water density lesion in posterior right lobe liver (series 4, image 33) which is unchanged since prior chest CT examination of 2009 and represents a benign cyst. Scattered other small subcentimeter hypodensities in the liver that are too small to characterize without IV contrast. Gallbladder is with normal distention and no gallbladder wall thickening and no pericholecystic fluid. No evidence of intrahepatic or hepatic biliary duct dilatation is seen to suggest obstruction. SPLEEN: No significant abnormality noteddPANCREAS: No significant abnormality noteddADRENAL GLANDS: No significant abnormality noteddKIDNEYS, URETERS: Normal appearing left kidney. Right kidney shows some scattered cortical scarring without other focal abnormality. Lack of IV contrast limits ability to detect parenchymal masses. No perirenal fluid collections are seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted..BOWEL, MESENTERY: Residual barium from fluoroscopy study is present in the cecum and in the sigmoid colon creating extensive streak artifact and limiting evaluation in those areas. The bowel, otherwise, shows no diagnostic abnormalities with no evidence of obstruction. Extensive streak artifact in the right colon prohibits evaluation of the appendix, although no inflammatory findings are seen. Sigmoid colon and rectum and the associated regions cannot be evaluated due to streak artifact.BONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality noteddPELVIS:UTERUS, ADNEXA: No significant abnormality noteddBLADDER: No significant abnormality noteddLYMPH NODES: No significant abnormality noteddBOWEL, MESENTERY: Residual barium from fluoroscopy study is present in the cecum and in the sigmoid colon creating extensive streak artifact and limiting evaluation in those areas. The bowel, otherwise, shows no diagnostic abnormalities with no evidence of obstruction. Extensive streak artifact in the right colon prohibits evaluation of the appendix, although no inflammatory findings are seen. Sigmoid colon and rectum and the associated regions cannot be evaluated due to streak artifact.BONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality notedd
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1. No abdomen/pelvic findings to account for patient's symptomatology. 2. Residual barium in cecum and sigmoid colon substantially limits ability to evaluate those regions.
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Generate impression based on findings.
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26 year old female with RUQ pain. Evaluate for cholelithiasis/cholecystitis. Absence of intravenous contrast enhancement limits evaluation of the solid parenchymal organs and vascular structures, but within these limitations the following observations can be made:ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: The gallbladder is minimally distended. No evidence of cholelithiasis, gallbladder wall thickening or pericholecystic fluid. No intrahepatic ductal dilatation. No evidence of suspicious hepatic lesion.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Tiny non obstructing left midpole calyceal calculus. No evidence of hydronephrosis or perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is well visualized with no evidence of acute appendicitis. The bowel is normal in caliber. No evidence of obstruction, pneumoperitoneum, pneumatosis or portal venous air.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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Within the limitations of a noncontrast enhanced study, no radiographic evidence to account for the patient's pain. No diagnostic abnormalities are identified.
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Generate impression based on findings.
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Clinical question: Persistent left-sided sinusitis. Signs and symptoms: Nasal congestion and discharge. Medtronic fusion sinus CT:Frontal sinuses are well pneumatized and without evidence of disease.Sphenoid sinus is well pneumatized and unremarkable.Ethmoid sinuses are well pneumatized and without evidence of sinusitis. There is a small osteoma measuring 6.6 times 3-mm in the right posterior ethmoid and a smaller osteoma of approximately 2.6 mm size is along the lateral aspect of the left anterior ethmoid air cells.Maxillary sinuses are well pneumatized and went bilateral ostiomeatal units.Nasal cavity demonstrate mild nasal septum deviation to the right without evidence of a bony septal spur and unremarkable otherwise.Bilateral mastoid air cells and middle ear cavities remain well pneumatized and unremarkable.Images through the orbits are unremarkable.
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1.No evidence of acute or chronic sinus disease.2.Two small osteomas in the right posterior ethmoid and left anterior ethmoid air cells as detailed.3.Mild nasal septum deviation to the right without bony septal spur and unremarkable images through the nasal passage otherwise.
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Generate impression based on findings.
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48 year old female with abdominal pain. Evaluate for Crohn's flare. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Unchanged subcentimeter hypodense foci in the liver, which are too small to fully characterize, but likely representing benign cysts.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: Postsurgical changes of a right hemicolectomy with ileocolic anastomosis in the left hemiabdomen. No loculated fluid collections or pneumoperitoneum. There is wall thickening of a 18 m length of the distal ileum immediately proximal to the side to side ileocolonic anastomotic site with associated hyperenhancing mucosa and increased vascularity, consistent with active disease. No new intrabdominal fluid collections or free intraperitoneal air are identified. There is no evidence of fistula formation. BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted. No pneumoperitoneum.BONES, SOFT TISSUES: Perirectal curvilinear multiloculated fluid collection measuring 1.5 x 1 .4 cm, previously 1.9 x 1.1 cm (series 3, image 130) at the 11 o'clock position. This appears to originate above the levator ani muscle and extending to the external sphincter.
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1. Persistent 1.5 cm abscess anterior to the rectum, likely secondary to proctocolitis of inflammatory bowel disease. There are also findings consistent with active inflammatory bowel disease affecting the distal ileum at the level of the ileocolonic anastomotic site. 2. No evidence of bowel obstruction.
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Generate impression based on findings.
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Clinical question: Status post fall with increasing headaches. Signs and symptoms: As above. Unenhanced head CT:There is no evidence of acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.There is evidence of anatomical variation of cavum vergae and with normal size of supratentorial ventricular system.Unremarkable cerebral cortex, cortical sulci, CSF spaces and gray -- white matter to initiation. Review of prior brain MRI (11 -- 1 -- 13) from Ingalls Memorial Hospital Harvey Illinois demonstrated mild chronic ischemic strokes which cannot be identified on this head CT.Unremarkable calvarium and soft tissues of the scalp.Unremarkable images through the orbits.All visualized paranasal sinuses and bilateral mastoid air cells and middle ear cavities remain well pneumatized.
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Negative nonenhanced head CT and stable since prior head CT from 9 -- 11 -- 13.
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Generate impression based on findings.
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55-year-old male with dyspnea on mild exertion. Evaluate for PE. PULMONARY ARTERIES: No significant abnormality noted.LUNGS AND PLEURA: No areas of consolidation, pleural effusion, or pneumothorax. Mild bilateral apical paraseptal emphysema.MEDIASTINUM AND HILA: While this is exam is not optimized for evaluation of the coronaries, coronary artery disease is noted with intimal plaque in the proximal LAD demonstrating calcified and noncalcified components. Small hiatal hernia is noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Punctate right hepatic lobe calcification consistent with prior granulomatous disease.
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No evidence of pulmonary embolism, as clinically questioned.
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Generate impression based on findings.
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71-year-old man with recurrent tonsillar/base of tongue cancer status post 4 cycles of systemic immunotherapy. CT brain:VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age. Unchanged focal hypodensity within the right basal ganglia likely represents a prominent perivascular space.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage.FLUID:No fluid collections. No evidence of hemorrhage.BONE:Chronic right orbital floor blowout fracture without entrapment.Visualized bony structures are normal.CT NECK:SOFT TISSUES:Soft tissue thickening and enhancement at the left aspect of the base of the tongue and tonsillar pillar appears more necrotic but similar in size on the axial images when compared to the prior examination. However on sagittal images, where evaluation is limited by streak artifact, the lesion now measures 2.3 x 7.5 cm where it previously measured 2.7 x 1.1 cm. LYMPH NODES:Stable appearing necrotic right level 2/3 lymph nodes are again present with reference node measuring approximately 0.8 x 1.0 cm (series 6 image 26). Similar to the prior, there is ill-defined enhancement within the right sternocleidomastoid muscle. No pathologic adenopathy is detected in the left neck.NASOPHARYNX, OROPHARYNX, LARYNX:Evidence of treatment related change is present including mucosal hyperemia, infiltration of the fascial planes and a thin retropharyngeal effusion.GLANDS:Small hypoattenuating thyroid nodules, unchanged. The parotid, submandibular are unremarkable. BONES:There are multilevel degenerative changes of the cervical spine including straightening of the normal cervical lordosis, minimal anterolisthesis of C4 on C5, loss of disk height at C4-5 C5-6 and C6-7 and associated endplate and degenerative changes. There are no suspicious lesions.OTHER:There are extensive emphysematous changes within bilateral lung apices. There are small bilateral pleural based nodules, similar to a prior chest from March 13, 2013. There is mild atherosclerotic calcification of the great vessels.
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No evidence of intracranial metastases.More necrotic and slightly decreased in size (on sagittal images) focus of soft tissue thickening and enhancement of the left aspect of the base of the tongue and tonsillar pillar. Stable appearing postoperative changes, necrotic right level 2/3 node, ill-defined enhancement in the right sternocleidomastoid.
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Generate impression based on findings.
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Clinical question: Evaluate for bleeding. Signs and symptoms: Status post TSH. Nonenhanced head CT:Examination demonstrates expected postoperative changes of transphenoidal hypophysectomy. Minimal postoperative air within the sella is noted. There is also opacification of the sphenoid sinus with fatty tissue consistent with packing. There is also air fluid levels within bilateral maxillary sinuses.Bilateral mastoid air cells and middle ear cavities remain well pneumatized.There is no detectable intracranial hemorrhage or pneumocephalus. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.
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1.Expected postoperative changes of transphenoidal hypophysectomy and including minimal post op air within the sella, fatty density packing material in the sphenoid sinus and fluid levels in bilateral maxillary sinuses.2.No acute intracranial process and unremarkable head CT otherwise.
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Generate impression based on findings.
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Clinical question: Sinus surgery for ligation of sphenopalatine artery. Signs and symptoms: And excessive nasal epistaxis and Medtronic fusion sinus CT:All paranasal sinuses are well pneumatized and without evidence of acute or chronic sinus disease.Bilateral ostiomeatal units of maxillary sinuses and bilateral sphenoethmoidal recesses of the sphenoid sinus remain patent.There is normal anatomical variation of pneumatization of the crista galli.Images through the nasal passage demonstrate mild nasal septum deviation to the left and with mucosal contact with the left inferior turbinate and unremarkable otherwise. Bilateral mastoid air cells and middle ear cavities remain well pneumatized.No convincing evidence of any soft tissue abnormality in the region of the exam.Unremarkable images through the orbits.
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Unremarkable nonenhanced Medtronic fusion CT of paranasal sinuses.
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Generate impression based on findings.
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83-year-old female with a history of chronic abdominal wound. Rule out enterocutaneous fistula. ABDOMEN:LUNG BASES: Reference 5-mm left lower lobe nodule is unchanged (4/14). The reference subcentimeter right lower lobe nodule is obscured by pulmonary opacity. Note is made of bilateral pleural effusions with underlying atelectasis/consolidation. There is a 6-mm nodule in the right lower lobe. Additional micronodules are again seen, appearing similar to the prior study. Marked coronary calcifications.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Small splenules.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left lower pole cyst is unchanged. Right lower pole cyst is mildly increased measuring 2.5 cm, previously 2.3 cm, incompletely characterized on a noncontrast examination. Punctate right renal parenchymal calcification. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Small scattered retroperitoneal lymph nodes. Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Numerous surgical clips adjacent to the stomach fundus producing extensive streak artifact is unchanged. Duodenal diverticula. Laxity of the ventral wall with focal areas of herniation. No evidence of obstruction or strangulation. Gastrojejunostomy tube with tip in the jejunum and retention balloon in the stomach. A soft tissue density in the abdominal wall adjacent to the catheter is again seen. No focal fluid collections adjacent to the catheter. Open wound in the anterior abdominal wall at the site of prior abscess measures 5.1 x 1 .4 cm, previously 6.9 x 1.9 cm (3/58) with debris and foci of air. High density within the wound may be packing material and does not appear to come from bowel. There is however a curvilinear focus with oral contrast density which appears to communicate with the inferior margin of the aforementioned abdominal wound and is suspicious for enterocutaneous fistula formation (image 75 series 3). BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumbar spine. OTHER: No significant abnormality notedPELVIS: UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Scattered enlarged pelvic nodes. A left external iliac node measures 1.9 x 1 .4 cm, previously 2.0 x 1.4 cm (3/123).BOWEL, MESENTERY: Diverticulosis.BONES, SOFT TISSUES: Left hip prosthesis.OTHER: No significant abnormality noted
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1.Persistent open wound along the anterior abdominal wall with associated debris and foci of air. If the patient has gauze packing with iodophorm, this could explain the high density material within the site. There are, however, additional findings which are suspicious for enterocutaneous fistula formation along the inferior margin of the abdominal wound, as described above. 2.Gastrojejunostomy tube with tip in the jejunum. Soft tissue density adjacent to the catheter may be related to scarring. No focal fluid collections adjacent to the catheter site.3.Bilateral pleural effusions with underlying atelectasis/consolidation.
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Generate impression based on findings.
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Female 60 years old; Reason: assess for metastatic endometrial cancer History: bleeding CHEST:LUNGS AND PLEURA: Scattered nonspecific lung nodules, with the largest measuring 4-mm nodule in the right lower lobe. Smaller 3-mm pleural-based nodules are seen in the right and left lower lobe. No pleural disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. 7-mm hypodensity is seen in the hepatic dome, within segment 7 , too small to reliably characterize. Cholelithiasis is noted without cholecystitis.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: Mild to moderate degenerative changes in the spineOTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Hypoattenuating endometrial lesion measuring soft tissue density is noted, likely compatible with previous diagnosis of endometrial carcinoma.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild to moderate degenerative changes in the spineOTHER: No significant abnormality noted.
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1.Few nodules in the lungs, largest in the right lower lobe. Continued follow-up is advised.2.No evident metastatic disease detected in the abdomen/pelvis.3.Lesion in the endometrial canal compatible with carcinoma.
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Generate impression based on findings.
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70 year-old male with hematuria. ABDOMEN:LUNG BASES: No significant abnormality noted. LIVER, BILIARY TRACT: Liver parenchyma appears normal. No evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intra-or extrahepatic ductal dilatation. No evidence of suspicious liver lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 8 mm non-obstructing left inferior pole calyceal calculus has slightly increased in size. No evidence of hydronephrosis or perinephric fluid collections. No suspicious masses noted. The ureters were nearly completely opacified with the exception of a small distal segment of the left ureter and are unremarkable.RETROPERITONEUM, LYMPH NODES: Minimal aortic and iliac calcifications. No evidence of lymphadenopathy.BOWEL, MESENTERY: The bowel is normal in caliber. No evidence of obstruction, pneumatosis, pneumoperitoneum or portal venous air. The appendix is well visualized and unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small fat-containing umbilical hernia.PELVIS:PROSTATE, SEMINAL VESICLES: Minimal prostatic calcifications.BLADDER: The bladder is well distended without evidence of suspicious mass. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Minimal sigmoid diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Bilateral mesenteric fat containing inguinal hernias.
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8 mm left inferior pole non-obstructing calyceal calculus. Kidneys, ureters, and bladder are otherwise unremarkable.
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Generate impression based on findings.
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59-year-old male with a history of rectal cancer follow up examination. CHEST:LUNGS AND PLEURA: Unchanged calcified left lower lobe presumed granuloma. Scarlike opacity in the left lung base, unchanged.MEDIASTINUM AND HILA: Small mediastinal lymph nodes without significant lymphadenopathy, unchanged. Unchanged atherosclerotic calcification of the aortic arch.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Note is made of prominent porta hepatis and gastrohepatic lymph nodes, appearing similar to prior study.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: Status post resection of the descending colon. The previously described soft tissue density in the presacral space (series#3, image 186) is estimated at 47 x 23 mm, previously 46 x 26 mm, unchanged. This likely represents postsurgical/posttreatment changes. Loculated fluid collection in the left paracolic gutter is also unchanged, which may represent a lymphocele.BONES, SOFT TISSUES: Presumed postsurgical changes to the anterior abdominal wall, stable.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: The previously described small pelvic lymph nodes appear similar to the prior examination. The reference lymph node (image 173; series 3) measures 6 x 5 mm, previously 7 x 5 mm, unchangedBOWEL, MESENTERY: Status post resection of the descending colon. The previously described soft tissue density in the presacral space (series#3, image 186) is estimated at 47 x 23 mm, previously 46 x 26 mm, unchanged. This likely represents postsurgical/posttreatment changes. Loculated fluid collection in the left paracolic gutter is also unchanged.BONES, SOFT TISSUES: Presumed postsurgical changes to the anterior abdominal wall, stable.
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No substantial interval change in reference measurements compared to the prior examination.
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Generate impression based on findings.
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Male 55 years old; Reason: 55yoM w/ pancreatic cancer please evaluate for progression. History: Pancreatic cancer. CHEST:LUNGS AND PLEURA: Stable appearance of the pulmonary nodules. For reference, left upper lobe pulmonary nodule measures 6 x 4 cm (series 10221, image 33), stable in size. Stable nodularity along the left major fissure.MEDIASTINUM AND HILA: Prominent mediastinal lymph nodes, some of which are calcified. Index right paratracheal lymph node measures 8 mm, previously 9 mm (series 3, image 26). Heart size is normal without pericardial effusion. Left hilar lymphadenopathy is increased in size from previous exam. Currently, the reference nodule measures 1.3 cm, previously 0.6 cm. Stable calcified hilar lymphadenopathy.CHEST WALL: Right chest Port-A-Cath tip terminates at the superior cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Hepatic metastases are not well visualized on this examination. For instance, left hepatic lobe lesion previously measuring 7 x 5 mm is not well visualized and may be due to timing of contrast and noise from the scan. No evident new metastatic lesions detected.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic tail mass is not clearly discernible, however inflammatory reaction around the pancreatic tail remains. No measurable mass is seen, which may be due to phase of contrast.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval development of numerous nodes along the omentum, with large conglomerate nodal mass adjacent to the hepatic flexure measuring 5.2 x 3.8 cm (series 3 image 114) compatible with peritoneal carcinomatosis.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. Interval development of extensive peritoneal carcinomatosis.2 interval increase in size of the left hilar lymphadenopathy. 3.Pancreatic mass is not well visualized, however appears stable since previous exam.4. Hepatic metastases are not well-visualized, although no new hepatic metastatic lesions are detected.5.Stable pulmonary nodules and mediastinal adenopathy.
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Generate impression based on findings.
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76-year-old male with a history of metastatic prostate carcinoma. Evaluation of disease after 9 cycles of investigational therapy. CHEST:LUNGS AND PLEURA: Stable micronodules. No new or suspicious pulmonary nodules or masses. MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable left lobe low attenuation foci which are too small to characterize but likely represent simple cysts. Stable cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Again seen are enlarged retroperitoneal lymph nodes. Reference left para-aortic lymph node best seen on image 126 of series 3 measures 2.9 x 1 .7 cm, previously 2.4 x 1.5 cm. Vascular calcifications of the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: There are marked coronary artery calcifications.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Reference right external lymph node best seen on image 163 of series 3 measuring 1.8 x 1 .2 cm, previously 1.6 x 1.2 cm. Stable reference right external iliac lymph node best seen on image 182 of series 3 measures 0.6 cm, previously 0.6 cm in diameter.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Left total hip arthroplasty device in place without evidence of hardware complication. Note is made of a posterior spinal fixation device affixing the level of L4/L5 with transpedicular screws in place without evidence of hardware complication. Degenerative changes affect the lower lumbar spine. OTHER: No significant abnormality noted
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1. Slight interval increase in size of abdominopelvic lymphadenopathy, consistent with the stated history of metastatic prostate cancer, with reference measurements above.2. Gallstones without evidence of acute cholecystitis.
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Generate impression based on findings.
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37-year-old male with a history of pancreas mass in MEN-1 syndrome status post parathyroidectomy. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology without suspicious hepatic lesions. Hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is normal in morphology. There is a focal hyperenhancing lesion in the pancreatic tail, measuring 9 mm, previously 8 mm on image 36, series 11. Similarly, there is a second hyperenhancing lesion involving the pancreatic body, along its superior aspect measuring 1.6 cm, previously 1.4-cm and is at the level of the gastrohepatic ligament (26; series 11). There is a focus of peripheral calcification which appears slightly more prominent as well as interval development of foci of central necrosis. There is an additional hyperenhancing focus in the head of the pancreas, which also appears unchanged when compared to the prior study, and also likely represents a pancreatic islet cell tumor (image 33; series 11). No pancreatic ductal dilatation.ADRENAL GLANDS: Adrenal glands are normal in morphologyKIDNEYS, URETERS: Punctate bilateral, nonobstructive nephrolithiasis. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a moderate-sized hiatal hernia.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Multiple persistent hyperenhancing lesions in the pancreas: in the tail and body, which remain suspicious for islet cell neoplasms.
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Generate impression based on findings.
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54 year old male. Shortness of breath with history of pulmonary hypertension and recent molded exposure. Evaluate for groundglass or other abnormality. LUNGS AND PLEURA: Diffuse mosaic attenuation of both lungs. This may be seen with hypersensitivity pneumonitis possibly with small airways disease. MEDIASTINUM AND HILA: Multiple small and mildly enlarged mediastinal and right hilar lymph nodes. Main pulmonary artery diameter is 3.3 cm (series 4, image 41) suggestive of pulmonary artery hypertension. CHEST WALL: Mild degenerative arthritic changes of thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Diffuse mosaic attenuation suggestive of hypersensitivity pneumonitis. 2. Findings consistent with pulmonary artery hypertension.
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Generate impression based on findings.
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Female, 3 years old, status post fall, continuing lethargy. Evaluate for hemorrhage. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. Partial opacification of the sphenoid and maxillary sinuses is again seen, similar to prior. The right middle ear cavity and mastoid air cells are also opacified similar to prior. The adenoids are very prominent.The bones of the calvarium and skull base are intact.
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1. No acute intracranial abnormality or other specific findings to account for the patient's lethargy.2. Paranasal sinus opacification and marked prominence of the adenoids. Correlation with URI symptoms is suggested.
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Generate impression based on findings.
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62-year-old male. Fever. History of mycobacterium infection status post stem cell transplant. History of myelodysplastic syndrome. Evaluate for pneumonia. LUNGS AND PLEURA: Increased tree-in-bud opacities and nodular opacities in both lungs, most pronounced in the lung bases. Left basilar consolidation with adjacent small pleural effusion also increased.MEDIASTINUM AND HILA: Multiple enlarged supraclavicular mediastinal, and hilar lymph nodes, not significantly changed. Right jugular catheter tip in the SVC. Reference pretracheal lymph node is stable at 17 mm in short axis (series 3, image 33). Stable subcarinal nodes.CHEST WALL: Left thoracotomy, thoracic laminectomies, corpectomy, and placement of posterior stabilization rods and screws for previous known spinal chondrosarcoma.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. IVC filter.
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1. Increased bilateral tree in bud and nodular opacities consistent with recurrent/increasing MAI infection. Graft versus host disease is in the differential diagnosis.2. Stable mediastinal, hilar, and supraclavicular lymphadenopathy.
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Generate impression based on findings.
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Reason: AML, need for pre-chemotherapy CT of chest and sinus History: none LUNGS AND PLEURA: Scattered ill-defined nodules primarily clustered in the right middle lobe are present. Mild dependent atelectasis posteriorly.MEDIASTINUM AND HILA: Right PICC extends to the SVC/RA junction level.Mild coronary calcifications are present.There is no significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Clustered nodules in the right middle lobe; the differential diagnosis includes atypical infection or leukemic deposits given the patient's markedly elevated white blood count.
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Generate impression based on findings.
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Reason: T2N1 oral tongue SCC on FHX completed 6 cycles adjuvant FHX 6/10/11 History: as above CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Residual thymic tissue or anterior mediastinal lymph nodes are upper normal size, unchanged.No significant mediastinal or hilar disease. CHEST WALL: Mild degenerative abnormalities affect the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastases or other significant abnormality.
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Generate impression based on findings.
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Male 66 years old; Reason: Pancreas Cancer: Restaging History: none CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes are noted, not enlarged by CT criteria and unchanged. Interval resolution of thrombus around the tip of the Port-A-Cath.CHEST WALL: Right-sided Port-A-Cath.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted PANCREAS: Primary tumor: Interval decrease in the size of pancreatic tumor which currently measures 3.5 x 2.3 cm previously 4.3 x 3.2 cm (series 3 image 95)Pancreatic duct: 0.4 cm, unchanged Stable celiac artery encasement is noted greater than hundred and 80 degrees, although decrease in soft tissue attenuation. The GDA remains contiguous with tumor. The splenic vein remains occluded and reconstitutes distal to the mass.The tumor abuts less than 180 degrees of the SMV-PV confluence, however it narrows the confluence. The tumor also appears to encase the 1st jejunal branch.Extensive inflammation to a pancreatic fat is noted.Portal venous system and IVC are patent.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Perigastric varices secondary to splenic vein occlusion.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. Interval decrease in size of pancreatic mass with unchanged vascular invasion.
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Generate impression based on findings.
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52 year-old male with left facial swelling. The orbits are unremarkable except for chronic blowout fracture of the right lamina papyracea. The mastoid air cells are clear. There are left maxillary sinus retention cyst and left maxillary, sphenoid and ethmoid mucosal thickening. Limited view of the intracranial structure is unremarkable. There are small nodes in the bilateral parotid glands. The parotid glands appear symmetric in size and density. There is no mass lesion or inflammatory or infectious change. The submandibular and thyroid glands are unremarkable. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. No lymphadenopathy or mass is noted. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable except for postsurgical change of anterior fusion of C5 and C6. Limited view of the chest is unremarkable.
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1. Unremarkable contrast enhanced CT soft tissue neck.2. Paranasal sinus inflammatory disease.
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Generate impression based on findings.
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Female, 44 years old, history of tongue squamous cell carcinoma on FHX completed 6 cycles of adjuvant FHX 6/10/11. No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Mucosal thickening within the right maxillary sinus is unchanged.Deformity of the oral tongue is again seen compatible with prior surgery. The left submandibular gland has been resected. There is evidence of scarring and prior surgery through the fascial planes in the left neck. Within this posttreatment background, no evidence of recurrent tumor is seen.Asymmetric effacement of the left piriform sinus is a stable finding. The aerodigestive tract is otherwise unremarkable. No pathologic adenopathy is detected by size criteria. A small focal hypodensity in the left thyroid lobe is unchanged. The left parotid gland is atrophic. The right sided salivary glands are unremarkable. The cervical vessels remain patent. No concerning osseous lesions are detected. A posterior disk-osteophyte complex is present at the C5-6 level likely causing mild spinal canal stenosis.
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1. Post treatment changes in the neck with no evidence of recurrent disease or pathologic adenopathy.2. No evidence of intracranial metastatic disease.
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Generate impression based on findings.
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79-year-old male with history of metastatic prostate cancer. CHEST:LUNG BASES: 5-mm nodule in the left upper lobe best seen on image 38 of series 10261 is nonspecific, but unchanged. Bilateral punctate calcifications are non-specific but may represent prior granulomatous disease.MEDIASTINUM AND HILA: Reference posterior periaortic mediastinal lymph node, best seen on image 49 of series 3, is stable in size and appearance measuring 1.8 x 1.7 cm, previously 1.8 x 2.0 cm. Additional calcified mediastinal lymph nodes may represent prior granulomatous disease.CHEST WALL: No significant abnormality noted.OTHER: Coronary artery calcifications.ABDOMEN:LIVER, BILIARY TRACT: Liver parenchyma appears normal. Small fluid dense subcapsular lesion located in the right lobe is unchanged and likely represents a benign hepatic cyst. Cholelithiasis without evidence of cholecystitis. No intra-or extrahepatic ductal dilatation. No evidence of suspicious liver lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodule, best seen on image 97 of series 3, is unchanged measuring 1.6 x 1.2 cm, previously 1.3 x 1.1 cm, and represents a benign adenoma.KIDNEYS, URETERS: Bilateral hypodense lesions are unchanged and likely represent benign renal cysts. Right mid pole slightly hyperdense lesion, best seen on image 99 of series 3 is stable measuring 2.0 x 1.8 cm, previously 1.8 x 1.7 cm. No evidence of hydronephrosis, nephrolithiasis, or perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: Reference left para-aortic lymph node best seen on image 113 of series 3 measures 2.2 x 1.6 cm, previously 2.2 x 2.2 cm. Lymph node adjacent to the aortic bifurcation best seen on image 133 of series 3 is stable measuring 1.6 x 1.2 cm, previously 1.7 x 1.2 cm. Retrocrural lymph nodes are unchanged since 2012 but new from 2007 and likely represent metastatic disease.BOWEL, MESENTERY: No significant abnormality noted. The bowel is normal in caliber. No evidence of obstruction, pneumatosis, pneumoperitoneum or portal venous air. The appendix is well visualized.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Reference external iliac lymph node best seen on image 167 of series 3 has minimally decreased in size now measuring 1.3 x 1.0 cm, previously 1.6 x 1.0 cm. Non-reference right external iliac lymph node best seen on image 38 of series 8028 measures 2.5 x 1.7 cm, previously 2.5 x 1.5 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Bilateral mesenteric fat containing inguinal hernias.
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Minimal changes in lymphadenopathy as described above.
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Generate impression based on findings.
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Malignant neoplasm of thyroid glandSecondary malignant neoplasm of lung(197.0)Diagnosis Edits: Clinical question: metastatic thyroid with mets to hilar and lung, on therapy, eval for dz, compare to previous with measurements CT neck:The patient is status post thyroidectomy. There is infiltration of the fat planes of the right lower neck surrounding the carotid space which remains stable since prior exams. The right jugular vein is absentWithin 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.The airway appears patent.The parotid and the submandibular glands appear intact. The submandibular glands are atrophic and the parotid glands are fatty replaced right more than left. There is redemonstration of a 9 x 10 mm nodule in the left parotid gland.The visualized lung apices demonstrate multiple nodules scattered in both lung fields which were also identified on prior examsThe carotid and vertebral vasculature visualized on this exam appears intact. Atherosclerotic calcifications are present at the carotid bifurcations. The right jugular vein is absentThe cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are degenerative changes in the cervical spine worse at C5-6 where there are endplate and uncovertebral osteophytes with neural frontal encroachment and narrowing of the spinal canalCT head:There is redemonstration of a partially calcified lesion located in the inferior aspect of the left paracentral lobular measuring 7 x 9 mm sagittal dimensions which was larger on the 12/9/12 examThe CSF spaces are appropriate for the patient's stated age with no midline shift. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The right eyeball lens is thin.
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1.There is no evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy2.a left paracentral lobule lesion remains a stable and partially calcified and still is smaller than its original size3.left parotid gland nodule is stable4.multiple lung nodules are compatible with metastatic disease5.degenerative changes are present in the cervical spine worse at C5-6 which are stable.
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Generate impression based on findings.
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66-year-old female. Lung cancer follow-up. On oral chemotherapy. CHEST:LUNGS AND PLEURA: Small right pleural effusion and pleural thickening, not significantly changed. Adjacent atelectasis/mass is obscured by effusion and limits accurate measurement. Focal atelectasis and calcification of the right base, unchanged. There has been interval removal of the Pleurx catheter. Left lung is unremarkable.MEDIASTINUM AND HILA: Stable supraclavicular and mediastinal lymph nodes. Reference right supraclavicular lymph node measures 4 mm in short axis (series 3, image 15). Reference prevascular lymph node measures 8 mm in short axis (series 3, image 36), unchanged.Moderate coronary artery calcifications.CHEST WALL: Benign appearing sclerotic focus in the right seventh rib is unchanged.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypoattenuating lesion in the right hepatic lobe measures 2.2 x 3.4 cm (series 3, image 88), incompletely characterized but unchanged.SPLEEN: Partially calcified splenic artery pseudoaneurysm at the hilum, unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild calcified atherosclerotic disease of the abdominal aorta and branch vessels.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine.OTHER: No significant abnormality noted.
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1. Interval removal of right pleurex catheter. No significant change in right pleural fluid and pleural thickening. Adjacent atelectasis/mass is obscured by the effusion and limits accurate measurement.2. Right hepatic lobe lesion is unchanged.3. Stable mediastinal lymph nodes.4. No new sites of disease identified.
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83-year-old male with history of bladder and prostate cancer status post cystoprostatectomy, bilateral pelvic lymph node dissection, and ileal conduit. Evaluate for recurrent or metastatic disease. CHEST:LUNGS AND PLEURA: Bilateral pulmonary micronodules, unchanged.MEDIASTINUM AND HILA: Enlarged, multinodular thyroid with mediastinal extension of the left thyroid lobe, unchanged.Reference precarinal lymph node measures 1.0 x 0 .7 cm, previously 1.1 x 0 .8 cm (series 6; image 38). Redemonstration of calcified lymph nodes in the hila and subcarinal regions compatible with prior granulomatous disease.Normal cardiac size with coronary artery calcifications in the left anterior descending artery. No pericardial effusion.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensity in the right lobe of the liver is too small to characterize, but likely represents a simple cyst. Calcified granuloma in the liver.SPLEEN: Calcified granulomata in the spleen.PANCREAS: No significant abnormality notedADRENAL GLANDS: Nodular thickening of the left adrenal gland, unchanged.KIDNEYS, URETERS: Patient is status post ureteroileostomy and ileal conduit construction. Mild to moderate left-sided hydronephrosis and hydroureter unchanged. No filling defects are identified within the collecting system on delayed contrast enhanced sequences. Hypoattenuating subcentimeter right renal superior pole lesion is too small to characterize, but likely represents a simple cyst, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Chronic deformity of the left femoral neck and head, likely represents prior remote trauma. Multilevel degenerative changes of the thoracolumbar spine. Sclerotic foci in the iliac wings bilaterally, unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Sigmoid diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable examination with unchanged mild to moderate left-sided hydroureteronephrosis status post ileal conduit creation.
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Generate impression based on findings.
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45-year-old. Left upper lobe mass. Known lung cancer. Compared to CT from 5/2013. LUNGS AND PLEURA: Spiculated left upper lobe nodule measures 2.7 x 2 .5 cm (series 6, image 37), previously 2.1 x 2.8 cm (series 4, image 41 on prior study). Mild upper lobe predominant centrilobular emphysema.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy, some lymph nodes are larger while others are smaller. For example, a 2 cm node anterior to the left main pulmonary artery branch (series 4, image 34) previously measured 2.5 cm. Left paratracheal node measures 1.4 cm (series 4, image 30), previously was 9 mm. Right chest wall Port-A-Cath tip terminates in the SVC.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple hyperdense liver lesions concerning for metastasis are hard to visualize given lack of IV contrast and also makes comparison difficult (prior exam was contrast enhanced). Cholecystectomy clips. Left renal cysts.
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1. Increased size of left upper lobe spiculated nodule consistent with patient's known primary lung malignancy.2. Mediastinal lymphadenopathy, some nodes are larger while others are smaller.3. Multiple liver lesions concerning for metastases, poorly visualized on this noncontrast exam. Recommend IV contrast enhanced study of abdomen if no contraindications exist for future exams.
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Reason: Monitoring for disease response to chemotherapy - 71 yo M w squamous cell carcinoma of lung with liver mets History: NSCLC CHEST:LUNGS AND PLEURA: Pulmonary fibrosis in a UIP pattern not typically changed compared to the prior exam.Left upper lobe mass (image 37, series 5) measures 4.6 cm x 3.1 cm, previously, measuring 4.2 cm by 3.4 cm.New small left pleural effusion.MEDIASTINUM AND HILA: Above-noted left upper lobe mass again demonstrates extension of the mediastinum on the left.Interval increase in several of the enlarged mediastinal lymph nodes in the right lower paratracheal and subcarinal regions.Mild cardiac enlargement without evidence of a pericardial effusion.Marked coronary and aortic calcifications.CHEST WALL: Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Increasing size of reference right hepatic metastasis (image 76, series 4) now measuring 21 mm, previously, measuring 18 mm.Stable hepatic cysts.Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Aorto- liac bypass graft.
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1.Stable minimal increase in size of the left upper lobe mass.2.Interval increase in size of enlarged mediastinal lymph nodes.3.Interval increase in reference hepatic metastasis.4.No new sites of disease identified.5.Underlying pulmonary fibrosis, stable.
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Generate impression based on findings.
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43 year-old female with history of left parotid cancer. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. Postsurgical changes of the left parotidectomy are noted. There is no evidence of recurrent mass, or enlarged lymph nodes. There is atrophy of the left submandibular gland. The overall imaging appearance is unchanged.The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The right parotid, right submandibular, and thyroid glands are unremarkable. No lymphadenopathy or mass is noted. The carotid arteries and jugular veins are patent. The right vertebral artery is hypoplastic. The osseous structures are unremarkable. There is degenerative disease of the cervical spine, with disk-osteophyte complexes at the C5-C6 and C6-C7 levels.Limited view of the chest is unremarkable.
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No evidence of recurrent tumor or lymphadenopathy in the neck.
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Generate impression based on findings.
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Male; 52 years old. Reason: metastatic prostate cancer, Evaluation of disease after 6 months of investigational therapy. ABDOMEN:LUNG BASES: No acute infiltrates or 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: L5 vertebral segment is sacralized on the left. OTHER: Multiple sclerotic osseous foci are consistent with metastases. PELVIS:PROSTATE, SEMINAL VESICLES: Atrophic 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. Diffuse sclerotic bony metastases in the pelvis. Capsular calcification of the left gluteus medius seen best on coronal image 44.OTHER: No significant abnormality noted
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Multi-focal osseous metastases. No other significant abnormality.
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Generate impression based on findings.
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64-year-old female with history of lung cancer, status post resection. CHEST:LUNGS AND PLEURA: Again seen is a right upper lobe groundglass nodule measuring 9 mm in diameter (image 126, series #4), smaller from prior exam (utilizing image 114, series #5). Previously commented upon right lower lobe groundglass nodule demonstrates focal bronchiolar wall thickening suggesting an inflammatory etiology.A solid right middle lobe pulmonary nodule measures 6 mm (image 54, series #5), unchanged, consistent with lymph node versus granuloma. Redemonstrated moderate diffuse centrilobular emphysema. Unchanged postsurgical scarring at the left base, consistent with prior left lower lobectomy.MEDIASTINUM AND HILA: Significant coronary artery and mild thoracic aorta atherosclerotic calcification. No mediastinal or hilar adenopathy.CHEST WALL: Small scattered bilateral 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: Bilateral subcentimeter hypodensities are too small to further characterize..PANCREAS: No significant abnormality noted..RETROPERITONEUM, LYMPH NODES: Small scattered 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. Right upper lobe groundglass nodule slightly decreased in size from prior exam. Recommend follow-up examination in one year.2. Stable right middle lobe nodule, likely benign.3. Previously noted possibly groundglass nodule more likely represents focal bronchiolar wall thickening of inflammatory etiology.
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