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Generate impression based on findings.
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Male, 63 years old, history of metastatic basal cell to the neck status post surgery. Evaluate for recurrence. Evidence of interval left neck dissection is seen. A cystic mass formerly present within the left submandibular space has been resected along with the left submandibular gland. The surgical bed shows scarring and mild infiltration but no evidence of recurrent tumor.Elsewhere in the neck, no pathologic adenopathy is detected by size criteria. The aerodigestive mucosa is within normal limits. The remaining salivary glands and thyroid are free of focal lesions. Cervical vessels remain patent. No concerning osseous lesions are detected.
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Since the prior examination, a cystic left submandibular space mass has been resected. No evidence of recurrent disease or pathologic adenopathy is detected.
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Generate impression based on findings.
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63-year-old male status post cystectomy for bladder cancer in 2005, evaluate for disease ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Scattered calcifications compatible with prior granulomatous disease. Diffuse fatty infiltration of the liver. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No pelvicaliceal dilatation. On delayed imaging both ureters opacify normally. Small AML and additional hypodensity too small to characterized in the upper pole of the right kidney are unchanged.RETROPERITONEUM, LYMPH NODES: Calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Scattered, unchanged mildly prominent mesenteric lymph nodes. Diverticulosis without evidence for diverticulitis.BONES, SOFT TISSUES: Mild degenerative disease of the thoracolumbar spine. Small fat containing umbilical hernia. PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: The neobladder is unchanged.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Bilateral inguinal hernia repairs and unchanged. Prominent mesenteric lymph nodes adjacent to the surgical bed, appearing similar to the prior study.BONES, SOFT TISSUES: Mild degenerative disease of the thoracolumbar spine. Coarse trabeculations and sclerosis of the right hip, the differential for which includes Paget's disease.
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Status post cystoprostatectomy with no evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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Reason: palate cancer History: r/o chest mets LUNGS AND PLEURA: No suspicious pulmonary nodules. No pleural effusion.MEDIASTINUM AND HILA: There is a small prevascular lymph node between the right brachiocephalic vein and the innominate artery (series 3 image 28) measuring 9 mm. In metastatic disease measure approximate 6 mm on the prior scout size CT. No additional mediastinal or hilar lymphadenopathy is appreciated.The heart size is normal. No pericardial effusion.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Lucency at the inferior field of view in the region of the porta hepatis favors gas within a loop of duodenum.
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One small prevascular lymph node measures 9 mm. No mediastinal or hilar lymphadenopathy.No suspicious pulmonary nodules.
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Generate impression based on findings.
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63-year-old male with ampullary adenocarcinoma status post Whipple, restaging following chemotherapy. Reason: HIGH RISK DUODENAL CANCER. EVALUATE FOR RECURRENCE. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. Nodular scarlike opacity in the right lower lobe with is unchanged. Additional peripheral scarlike opacities are unchanged.MEDIASTINUM AND HILA: Small scattered mediastinal nodes are unchanged. No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: Right chest port with tip terminating in the right atrium.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly measuring 20 cm in craniocaudal dimension. No intrahepatic or extrahepatic biliary ductal dilatation. 6 x 7 cm hypodensity in the hepatic dome is much larger since the prior exam. Postsurgical changes of Whipple surgery with cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: Postsurgical changes of Whipple procedure. Pancreatic ductal dilatation has increased since the prior exam measuring up to 10 mm in diameter.ADRENAL GLANDS: Bilateral adrenal adenomas are unchanged.KIDNEYS, URETERS: Right renal cyst is mildly increased in size.RETROPERITONEUM, LYMPH NODES: Mild retroperitoneal lymphadenopathy is unchanged with a reference aortocaval node measuring 1.6 cm (series 3, image 117).BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Small ventral hernia at the incision site with a subcutaneous focus of air. Mild degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS: PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality noted.LYMPH NODES: Pelvic lymphadenopathy is not significantly changed with a reference right obturator node measuring 3.4 x 1.2 cm (series 3, image 188).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.The hepatic dome metastasis is much larger since the prior exam.2.Pelvic and retroperitoneal lymphadenopathy is unchanged.
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Generate impression based on findings.
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Reason: pt with stage IV melanoma History: melanoma Lack of intravenous contrast limits evaluation of vascular structures and solid parenchymal organs. Within these limitations, the following observations can be made:CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, some of which are calcified and clustered as seen in the left lower lobe unchanged. There are scattered small ground-glass opacities, unchanged and likely post inflammatory or postinfectious. No pleural effusions. Azygos lobe is again noted, a normal variant.MEDIASTINUM AND HILA: No significant lymphadenopathy. Heart size is normal. No pericardial effusion.CHEST WALL: Note is made of multiple small right axillary lymph nodes, unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scoliosis with degenerative changes of the thoracolumbar spine. No suspicious osseous lesions.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Prominent left inguinal lymph node, appearing similar to the prior study, measuring 12 mm in the short axis (3: image 196).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evidence of metastatic disease on this limited non IV contrast enhanced exam. 2.Stable calcified nodules at the left lung base and additional scattered ground-glass opacities are likely post-inflammatory or post-infectious.
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Generate impression based on findings.
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Male, 56 years old, hard palate cancer status post surgery and radiation. Evaluate for recurrence. Since the prior examination, surgical alteration is demonstrated including partial left maxillectomy to include the hard palate, left maxillary alveolar ridge and a portion of the left maxillary sinus wall. Resection was carried back to include the pterygoid plates. Presumably the soft palate was resected as well and repaired with soft tissue flaps. The left inferior turbinate has been incorporated into repair of the palatal defect.Given this extremely altered background, and the fact that this is the first postoperative study, sensitivity for residual or recurrent disease is reduced. Note is made of a small collection of fluid and air situated where the superior surface of the oral tongue contacts the soft palate flap (see image 46 of series 80484). The palatal mucosa surrounding this collection is mildly enhancing. Elsewhere, there is low density peripheral soft tissue thickening within the left maxillary sinus. This thickening blends posteriorly and superiorly with similar appearing tissue at the level of the left pterygopalatine fossa. On the preoperative examination, the pterygopalatine fossa and the palatine foramina were enlarged concerning for tumor infiltration.The oral tongue and floor of mouth are otherwise unremarkable. The supraglottic larynx, glottis and subglottic airway are also within normal limits.No pathologic adenopathy is detected in the neck by size criteria. The salivary glands and thyroid are free of focal lesions. Cervical vessels remain patent. No concerning osseous lesions are detected.
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Extensive post surgical change is demonstrated consistent with partial left maxillectomy and flap repair. This is the first postoperative study and will therefore serve as a new baseline.Given the limitations mentioned above, no definite residual or progressive disease is visualized. There is a small air and fluid collection situated between the oral tongue and the reconstructed soft palate with mild enhancement of the involved palatal tissue. This is nonspecific in the postoperative setting and may simply represent trapped secretions with tissue hyperemia. Continued follow-up will be required to ensure stability or resolution. Infiltration in the region of the left pterygopalatine fossa could also be postoperative, though this area was abnormal on the preoperative study and therefore infiltrating disease is suspected.No definite discrete mass lesions are seen in the operative bed, and there is no evidence of pathologic adenopathy by size criteria.
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Generate impression based on findings.
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59-year-old female with history of thoracic dissection. CHEST:LUNGS AND PLEURA: No nodules, masses or airspace disease. No pleural disease.MEDIASTINUM AND HILA: CT Angiogram shows postsurgical changes with ascending graft aorta. No evidence of abnormal contrast enhancement in the perigraft space to suggest leak. The prior noted changes in the mediastinal fat have predominately cleared suggesting evolving hematoma. The descending thoracic aorta stent graft is unchanged in position as it extends to the suprarenal abdominal aorta. There has been, however, interval dissection of the contrast between the distal stent and the left lateral wall of the graft typical of a type Ib endo- leak.No abnormal masses or adenopathy. 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: CT Aortogram shows minimal filling of the prior noted abdominal aorta dissecton with filling now limited to the prior described ulcer at the origin of the right renal artery and not extending diffusely along the posterior lateral aspect of the aorta as shown on prior examination. The aorta bifurcates normally into the bilateral common iliac arteries and normal bifurcation thereafter to the internal/external iliac arteries bilaterally. No adenopathy or retroperitoneal masses.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: Enhancing masses in the uterus, unchanged, most consistent with fibroid uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Near complete resolution of prior noted fluid collections adjacent to the bilateral femoral arteries. No other significant abnormality seen.OTHER: No significant abnormality noted.
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1. Ascending aortic graft without findings suspicious for continued anastomotic leak. 2. Descending aorta stent with distal dissection of contrast in a type Ib endo- leak, new since March, 2013. 3. Decreased flow in prior visualized infrarenal aortic dissection with contrast now only visualized at the penetrating ulcer at origin of the right renal artery.
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Generate impression based on findings.
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Reason: h/o metastatic skin cancer History: r/o lung mets LUNGS AND PLEURA: Subsegmental atelectasis involving the lingula and left lower lobe.No suspicious pulmonary nodules. No pleural effusion.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion.No supraclavicular, mediastinal or hilar lymphadenopathy.CHEST WALL: Multilevel degenerative changes of the thoracic for tubal bodies.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Reason: h/o parotid cancer History: r/o mets LUNGS AND PLEURA: Calcified granuloma lateral basal segment left lower lobe. No suspicious pulmonary nodules. No pleural effusion.MEDIASTINUM AND HILA: Retroesophageal right subclavian artery, normal variant. Stable nodularity in the anterior mediastinum dating back to 3/2011. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Mild enlargement of the central left ovarian vein of uncertain significance.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Reason: metastatic thyroid ca with mets to lung and hilar, on therapy, eval for dz, compare to previous with measurements History: as above CHEST:LUNGS AND PLEURA: No significant change in innumerable bilateral pulmonary metastases. Reference left upper lobe nodule measures 12 x 11 mm, previously measured 12 x 11 mm (series 4, image 25).Reference left upper lobe nodule measures 12 x 9 mm, previously measured 12 x 9 mm (series 4, image 28).No new nodules identified. No pleural effusion.MEDIASTINUM AND HILA:Soft tissue thickening along right brachiocephalic artery appears similar. No mediastinal lymphadenopathy. Right hilar adenopathy notsignificantly changed. Moderate to severe coronary artery calcifications. Heart size normal. No pericardial effusion. Mild-to-moderate coronary artery disease.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.Mesenteric calcification with associated soft tissue extensions/scarring unchangedcompared to 6/2013.BONES, SOFT TISSUES: Bone island in L1 vertebral body. Lucent lesions in L1, L3, and L4 vertebral bodies also unchanged and most compatible with hemangiomas. No new or suspicious bone lesions.OTHER: No significant abnormality noted.
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Stable lung and hilar metastatic disease.
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Generate impression based on findings.
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Reason: r/o PE History: sob with tachycardia PULMONARY ARTERIES: No pulmonary embolus to the subsegmental level.LUNGS AND PLEURA: Multi-focal patchy regions of groundglass are fairly uniform in distribution from the apices to the basis, extending into the posterior costophrenic sulci. It is predominantly peripheral in distribution. There is associated traction bronchiectasis and bronchiolectasis primarily involving the right middle lobe. To a lesser degree, bronchiolectasis noted in the posterior costophrenic sulci. The constellation of findings, long patulous esophagus, raising question of a possible mixed connective tissue disorder. Another consideration includes fibrosing NSIP. It is atypical for UIP.No pleural effusion.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.No mediastinal or hilar lymphadenopathy.Mildly patulous esophagus.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia.
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No evidence of pulmonary embolus to the subsegmental level.Predominantly peripheral groundglass was localized regions of bronchiectasis and bronchiolectasis extending from the apices to the bases. This, along with a patulous esophagus, raises the question of a mixed connective tissue disorder. Another consideration includes fibrosing NSIP.
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Generate impression based on findings.
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69 year old male. Reason: Colon cancer on chemotherapy holiday. CHEST:LUNGS AND PLEURA: Stable emphysema.Stable micronodules. Reference right middle lobe nodule best seen on image 63 of series 4, measures 0.4 cm in diameter.MEDIASTINUM AND HILA: Stable right thyroid nodule. Stable reference AP window lymph node, best seen on image 43 of series 3, measuring 2 x 0.9 cm.CHEST WALL: Right sided venous access device is in the expected position. ABDOMEN:LIVER, BILIARY TRACT: Status post partial hepatectomy. Stable segment 4b low-attenuation focus as seen on image 104 of series 3 measures 1.1 x 0.7 cm.SPLEEN: No significant abnormality notedPANCREAS: Slight interval decrease in size of pancreatic body lesion best seen on image 108, series 3, now measuring 2.9 x 1.8 cm. Upstream pancreatic ductal dilatation, unchanged.ADRENAL GLANDS: Stable left adrenal nodularity.KIDNEYS, URETERS: Stable bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Stable retroperitoneal enlarged lymph nodes. Reference left periaortic lymph node is seen on image 113 of series 3 measures 1.2 x 1.7 cm. Reference aortocaval lymph node best seen on image 127, series 3, measures 1.4 x 0.9 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable examination.
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Generate impression based on findings.
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Female 91 years old. Reason: T3 N1 Colon Cancer History: Colon Cancer follow up. CHEST:LUNGS AND PLEURA: Stable micronodules.MEDIASTINUM AND HILA: Stable mediastinal lymph nodes. Aortopulmonary lymph node is stable measuring 1.3 x 2.8 cm image number 41, series number 4. Coronary artery calcifications.CHEST WALL: Degenerative changes in the glenohumeral joints bilaterally. Probable joint effusions. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent. Gallbladder contains large calcified gallstones. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small probable renal cortical cysts.RETROPERITONEUM, LYMPH NODES: Reference portacaval lymph node measures 1.5 x 0.7 cm (image 97/series 3).BOWEL, MESENTERY: The small bowel is normal in caliber and course. There is a ventral abdominal hernia left of midline that contains portion of transverse colon, omentum and mesentery. The neck of the hernia measures approximately 4-cm. No bowel obstruction.BONES, SOFT TISSUES: Ventral abdominal hernia with a neck measuring 4-cm the uterus changes of the lumbar spine with a levoconvex scoliosis.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: Bilateral hip prostheses. Metal streak artifact obscures adjacent details in the pelvis.Extension of the urinary bladder, and rectum below the level of the symphysis pubis with a cystocele and rectocele from pelvic prolapse. This is due to atrophy of the puborectalis muscle and the pelvic musculature.OTHER: No significant abnormality noted.
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1.Anterior abdominal wall hernia containing portion of transverse colon without obstruction2.Pelvic prolapse with a cystocele and rectocele.3.Cholelithiasis. Stable examination. No measurable metastatic disease.
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Generate impression based on findings.
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60 year old with history of renal cell carcinoma status post nephrectomy. Evaluate for recurrence. Reason: restaging scans s/p 2.5 years post op; please assess for metastatic disease. CHEST:LUNGS AND PLEURA: Right middle lobe nodule is not significantly changed and measures 2.1 x 1 .7 cm (image 63; series 3) most consistent with a benign hamartoma. No focal pulmonary opacities. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: The heart is normal in size. No pericardial effusion. Scattered non-pathologically enlarged mediastinal lymph nodes. No new nodules identified. CHEST WALL: Multiple axillary lymph nodes bilaterally are not significantly changed and not pathologically enlarged. No destructive osseous lesions are identified. Small hypodensities in the thyroid bilaterally are unchanged and most likely benign nodules. Bilateral gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: The liver has normal morphology. No discrete hepatic lesions are identified. The biliary tract is unremarkable.SPLEEN: Small splenule.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right kidney is surgically absent. No enhancing mass lesion in the resection bed to indicate a local recurrence. Multiple hypodensities in the left kidney are not significantly changed and are consistent with benign renal cysts. No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy is identified. Vascular calcifications of the aorta and its branches. BOWEL, MESENTERY: Small hiatal hernia.BONES, SOFT TISSUES: Subcutaneous nodule in the soft tissues along the anterior right hemiabdomen, unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Prominent inguinal lymph nodes, unchanged.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Small sclerotic focus in the right iliac bone is unchanged and most likely a bone island. Degenerative changes affect the hips, right greater than left.OTHER: No significant abnormality noted
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Stable postoperative changes without evidence of local recurrence or metastatic disease.
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Generate impression based on findings.
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58-year-old male with metastatic renal cancer, assess for progression. Reason: met RCC, evaluate for progression on everolimus. CHEST:LUNGS AND PLEURA: Scattered micronodules, not significantly changed. Chronic left basilar interstitial opacities, scarring and volume loss. Trace left pleural effusion is unchanged. MEDIASTINUM AND HILA: No enlarged mediastinal or hilar lymph nodes.CHEST WALL: Expansile left posterior rib metastases and multiple predominantly lytic thoracic vertebral lesions appear similar. ABDOMEN:LIVER, BILIARY TRACT: Innumerable fluid attenuation hepatic lesions are unchanged. Cholelithiasis. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal nodule consistent with metastasis, measures 1.4 cm x 1.1 cm (series 3 image 88) stable.KIDNEYS, URETERS: Postoperative changes of left nephrectomy.RETROPERITONEUM, LYMPH NODES: Stable postoperative changesBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: The expansile destructive lytic lesion centered in the L1 vertebral body with involvement of the posterior elements and paraspinal soft tissue/left psoas muscle, with similar CT appearance. Spinal canal involvement with spinal canal narrowing, not well evaluated by CT. Stable reference measurement of 5.9 cm x 4.5 cm (series 3 image 101). OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No enlarged pelvic lymph nodesBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Lytic lesions involving the osseous pelvis and the sacrum not significantly changed. Right sacral reference measurement of 5 cm x 3 cm (series 3 image 166). Left iliac crest reference measurement of 4.9 cm x 2.8 cm.OTHER: No significant abnormality noted
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Stable examination. No new lesions.
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Generate impression based on findings.
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77 year-old female with abdominal pain, left lower quadrant. Rule-out diverticulitis. Within the limits of a non-IV contrast enhanced examination which limits ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Granulomatous calcifications in liver -- no other significant abnormalities. Gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia. Stomach, small bowel, and colon otherwise show no diagnostic abnormalities. The sigmoid colon does not show significant diverticular changes and no evidence specifically of diverticulitis without any pericolonic inflammatory changes seen. Appendix is well visualized and normal.Small amount of free fluid is seen in the dependent pelvis of uncertain significance.BONES, SOFT TISSUES: Diffuse degenerative changes throughout the lumbar spine. Lytic lesion seen in L3 vertebral body, consistent with myeloma. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small hiatal hernia. Stomach, small bowel, and colon otherwise show no diagnostic abnormalities. The sigmoid colon does not show significant diverticular changes and no evidence specifically of diverticulitis without any pericolonic inflammatory changes seen. Appendix is well visualized and normal.Small amount of free fluid is seen in the dependent pelvis of uncertain significance.BONES, SOFT TISSUES: Lytic lesion in the left iliac bone, consistent with known diagnosis of myeloma. Degenerative changes are also diffusely seen.OTHER: No significant abnormality noted
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1. Left iliac and lumbar spine changes consistent with known diagnosis of multiple myeloma. 2. No gastrointestinal tract abnormality seen -- specifically no evidence for diverticulitis or appendicitis. 3. Apparent small amount of free mesenteric fluid and dependent pelvis of uncertain etiology and significance.
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Generate impression based on findings.
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63-year-old male with history of bladder cancer. Status post cystectomy with ileal conduit with known pulmonary nodule. ABDOMEN:LUNG BASES: 9mm left lower lobe lung nodule, unchanged. No other nodule seen in the lung bases, however, the entirety of lungs not examined.LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver seen. No other abnormality seen and no mass lesions. Patient is status post cholecystectomy and no evidence of biliary duct dilatation is seen. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Kidneys show normal morphology bilaterally without mass lesions or hydronephrosis. No abnormal calcifications are seen. Prompt and symmetric excretion of contrast into a normal pyelocalyceal system is seen bilaterally. The ureters are visualized throughout nearly, their entire length, and show no abnormality.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prior prostatectomy without other abnormality.BLADDER: Prior cystectomy with continent neobladder unchanged in appearance and without diagnostic abnormality. No evidence of recurrent mass.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Nine mm left lower lobe lung nodule, unchanged since 12/18/12. 2. Prior cystoprostatectomy with continent neobladder unchanged in appearance without evidence of recurrent, residual or metastatic disease.
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Generate impression based on findings.
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70 year-old female with history of carcinoma of unknown primary, suspected pancreaticobiliary primary. Now on chemotherapy holiday for 5 months. CHEST:LUNGS AND PLEURA: Lung parenchyma shows scattered micronodules unchanged. No new nodules, masses or foci of air space consolidation seen. No pleural disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No change in the cluster of right axillary lymph nodes demonstrating mild enhancement. Reference lymph node measures 9 x 5 mm (series 3, image 27). No new foci of lymph node enlargement is noted.Left anterior chest wall Port-A-Cath again seen with tip of catheter in the proximal superior vena cava.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Small hypodense lesion again seen in the body of the pancreas unchanged in size, measuring 0.9 x 0.6 cm (series 3, image 116). This most likely represents either an IPMN involving the pancreatic duct sidebranch or a small unilocular cystic neoplasm. In either event, lesions with this small size, unilocular and without soft tissue components are most often benign and rarely metastasize and most likely not the underlying etiology for this patient's metastatic disease.No pancreatic ductal dilatation is seen.Remainder pancreatic parenchyma appears normal. Again, calcifications in the head of the pancreas is seen. It may lie within the common bile duct and represent small foci of choledocholithiasis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus, unchanged. No other abnormalities.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 change in the right axillary cluster of small enhancing lymph nodes. 2. No change hypodense, probably cystic, subcentimeter lesion in pancreatic body -- see above discussion. 3. No change punctate calcific densities, which may lie in the course of the common bile duct.
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Generate impression based on findings.
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Reason: metastatic prostate cancer, evaluation of disease. History: none LUNGS AND PLEURA: No suspicious pulmonary nodules. No pleural effusion. MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: Multiple lytic foci throughout the ribs, clavicles, humeral heads, sternum and vertebral bodies compatible with metastatic prostate cancer.Port catheter terminates in the central superior vena cava. Symmetric gynecomastia.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of pulmonary metastases.Extensive osseous metastases.
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Generate impression based on findings.
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Evaluate for bleed or other abnormality status post stem cell transplant. There is very mild patchy periventricular hypoattenuation which is stable from previous and most likely represents sequela of non-acute small vessel ischemic disease. There is no intracranial mass, edema or hydrocephalus. The midline is intact. Orbits, paranasal sinuses and mastoid air cells are unremarkable.
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No acute intracranial abnormality which would account for the patient's symptoms. Nonspecific mild hypoattenuation which could represent sequela of chronic small vessel ischemic disease.
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Generate impression based on findings.
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rule out bleed, seizure VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage.FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal.OTHER:Limited evaluation of the paranasal sinuses and orbits is unremarkable.
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No evidence of intracranial hemorrhage as clinically queried.
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Generate impression based on findings.
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69-year-old male with alcoholic hepatitis and cirrhosis. Follow-up of liver lesions. CHEST:LUNGS AND PLEURA: Biapical cortical scarring appears unchanged. There is a somewhat spiculated -- appearing nodular density in the left lower lobe on image 37/99. Although this may represent bronchial artery hypertrophy, the appearance has changed when compared to the prior chest CT and given the patient's history of head and neck cancer, continued follow-up is recommended in 6 months. There is also a new, irregular nodular density in the right middle lobe on images 68 and 69/99. There is basilar parenchymal scarring which is stable.MEDIASTINUM AND HILA: Multiple small to borderline lymph nodes are seen in the aorta- pulmonary window, prevascular space and pretracheal region which appear stable. No hilar adenopathy.CHEST WALL: Collaterals identified associated with portal hypertension.ABDOMEN:LIVER, BILIARY TRACT: Liver has a significant, cirrhotic morphology. A area of decreased attenuation in the right lobe is unchanged from prior studies and was considered benign by MR. Near the hepatic dome on image 15/95, arterial phase is a small focus of enhancement with potential washout on portal venous phase image 79/156. Most likely, this represents a flow abnormality rather than a small hepatocellular carcinoma. There is a second focal area of increased vascularity on image 43/95 inferior right lobe which is too small to characterize and not definitely seen on delayed imaging.The portal venous system is patent although there is a patent umbilical vein and other collaterals consistent with portal at retention.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructing calculus in both kidneys. Stable, small renal cysts and parenchymal loss right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Number one. Bilateral nodular densities within the lung. Follow-up recommended.2. Small hepatic lesions which are felt unlikely represent hepatocellular carcinoma.
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Generate impression based on findings.
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Male 76 years old; Reason: h/o bladder cancer s/p cystectomy and ileal conduit. r/o mets History: none ABDOMEN:LUNG BASES: Bibasilar atelectasis/scarring.LIVER, BILIARY TRACT: Subcentimeter hypodensity in the right lobe of the liver is too small to characterize, but likely represents a simple cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: Postoperative changes consistent with cystectomy and right lower quadrant ileal conduit.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Coronary artery calcifications.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Postoperative changes consistent with cystectomy and right lower quadrant ileal conduit.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postoperative changes consistent with cystectomy and right lower quadrant ileal conduit.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Surgical clips are identified within the pelvis.
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Postoperative changes consistent with the stated history of cystectomy and ileostomy with conduit without evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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Female 31 years old; Reason: hx kidney stones History: kidney stones ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate non obstructing nephroliths noted in the bilateral kidneys. No hydronephrosis, hydroureter, perinephric fluid collections or perinephric stranding detected.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Non-obstructing nephroliths without evidence of hydronephrosis, or perinephric edema.
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Generate impression based on findings.
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57-year-old female with stage IV pancreatic cancer. Reason: Pancreas cancer surveillance scan. Please provide index lesion measurements. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Multiple thyroid nodules are unchanged.CHEST WALL: Bilateral breast prostheses. ABDOMEN:LIVER, BILIARY TRACT: Index right hepatic lobe lesion measures 1.7 x 1.8 cm on image number 99, series number 3, larger since the previous study. Another index lesion adjacent to the gallbladder fossa is also unchanged measuring 9-mm in diameter image number 123, series number 3.SPLEEN: No significant abnormality noted.PANCREAS: Patient's known mass in the pancreatic head is difficult to measure and differentiate from surrounding organs but it measures 2.5 x 2.3 cm on image number 118, series number 3, stable compared to previous study. Significant dilatation of the pancreatic duct is unchanged. Splenic vein collaterals are unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Surgical clips in both groins.
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Increased size of patient's right hepatic lobe mass. Other lesions are unchanged.
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Generate impression based on findings.
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72 year old male. Reason: h/o RCC, surveillance Six month follow-up from the prior study. ABDOMEN:LUNG BASES: Linear opacities in the lung bases consistent with atelectasis and/or scarring. Left lower lobe scar, volume loss and pleural thickening are stable. LIVER, BILIARY TRACT: No significant abnormality. SPLEEN: No significant abnormality notedPANCREAS: Fatty infiltration of the pancreas. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal atrophy. Numerous bilateral hypodense renal lesions which do not meet criteria for simple cysts are unchanged since the prior study. The left inferior pole lesion measures 2.0 x 2.0 cm (image 71, series 4) on axial imaging. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Surgical clips are noted in the pelvis. Status post prostatectomy.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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Multiple renal lesions are unchanged from prior examination. The reference lesion in the left kidney is not significantly changed from prior examination.
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Generate impression based on findings.
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59 year-old male with dysphagia. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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60 year-old male with history of GIST. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: New small focus of hypoattenuation in the periphery of the right lobe with rim enhancement on arterial phase, best seen on image 29 of series 6, measuring 1.2 x 1.2 cm, is worrisome for metastasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral nephroureteral stents in place. Persistent right greater than left hydronephrosis. Punctate non-obstructing left lower pole calculus. Unchanged nonobstructive renal calculi in the right upper and middle poles. Unchanged left upper pole simple cyst.RETROPERITONEUM, LYMPH NODES: Scattered benign appearing retroperitoneal lymphadenopathy is unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder minimally distended with nephroureteral stents present with tips in the bladder. Large pelvic mass is compressing the dorsal aspect of the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Large heterogeneously enhancing pelvic mass abutting the colon, best seen on image 179 of series 7, has minimally increased in size now measuring 17.9 x 9.3 cm, previously 16.4 x 8.3 cm. Small mesenteric fat containing left inguinal hernia.
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1.New focus of hypoattenuation with rim enhancement in the periphery of the right liver is worrisome for metastasis.2.Large pelvic mass has minimally increased in size.3.Bilateral right greater than left hydronephrosis is unchanged.
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Generate impression based on findings.
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25 year-old male with facial trauma and pain in the maxillary region on the right. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There are comminuted fracture of the right maxillary sinus posterolateral and anterior walls. There are blood products in the right maxillary sinus and OMU. There is minimal adjacent soft tissue emphysema. There is mild right facial soft tissue swelling. There is mild mucosal thickening in the left maxillary sinus. The remainder of the paranasal sinuses are clear. There is rightward nasal septal deviation with a bony spur. The mandible, sphenoid boned, nasal bones, zygoma, hard palates, pterygoid plates, visualized cervical spine and TMJs are intact, without fracture. The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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Right maxillary sinus comminuted fractures with accumulation of blood products in the in the right maxillary sinus and OMU. Dr. Valenzi was text paged with the findings at 3:08 pm.
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Generate impression based on findings.
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History of lymphoma with SVC clot. LUNGS AND PLEURA: No focal lung opacities, effusions or pneumothorax.MEDIASTINUM AND HILA: Normal cardiomediastinal size. No evidence of enlarged lymph nodes. No pericardial effusion.CHEST WALL: Left subclavian venous access is again noted. The SVC clot has significantly decreased in size in the interval.UPPER ABDOMEN: Partial view of solid organs of the upper abdomen is normal.
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Interval improvement in the size of the SVC clot.
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Generate impression based on findings.
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60-year-old female. Ewing's sarcoma. Evaluate for metastases. LUNGS AND PLEURA: Status post right middle lobe wedge resection. 6-mm groundglass nodule in the right upper lobe (series 4, image 37), previously measured 5 mm on 8/2013 CT, and has been present dating back to 3/2012. New few scattered groundglass opacities, most likely inflammatory/infectious and continued surveillance recommended.Scattered benign appearing micronodules are unchanged.Subtle mosaic attenuation, centrilobular nodules, and mild bronchial bronchiolar wall thickening in the lung bases suggestive of small airways disease. MEDIASTINUM AND HILA: Right jugular catheter terminates in the SVC. No mediastinal or hilar lymphadenopathy. Mild to moderate coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Abdominal aorta calcifications. Hepatic hypodensities are stable, likely cysts.
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1. Right upper lobe ground-glass nodule is 6 mm compared to 5 mm previously. Continued annual follow-up recommended.2. New scattered right upper lobe groundglass opacities are most likely infectious/inflammatory and continued surveillance recommended.3. Findings suggestive of small airways disease in the lung bases.4. No evidence of metastatic disease.
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Generate impression based on findings.
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77-year-old male with a history of bladder carcinoma status post radical cystectomy with orthotopic neobladder. Please evaluate for metastatic disease. ABDOMEN:LUNG BASES: Scattered pulmonary micronodules, some of which are calcified, suggestive of prior granulomatous disease, appearing similar to the prior study. No new or suspicious pulmonary nodules or masses are identified. LIVER, BILIARY TRACT: Subcentimeter hypodensities in the liver are too small to characterize, but likely represent simple cysts, appearing similar to the prior study. Calcified granuloma in the liver.SPLEEN: Calcified granulomata in the spleen.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts, unchanged.RETROPERITONEUM, LYMPH NODES: Vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: Small hiatal hernia. Diverticulosis, without evidence of diverticulitis.BONES, SOFT TISSUES: Nonspecific sclerotic foci in the T11 vertebral body and iliac bones bilaterally are unchanged. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Post surgical changes consistent with the stated history of cystectomy with neobladder formation. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis, without evidence of diverticulitis.BONES, SOFT TISSUES: Nonspecific sclerotic foci in the T11 vertebral body and iliac bones bilaterally are unchanged. OTHER: No significant abnormality noted
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Post surgical changes consistent with the stated history of cystectomy with neobladder creation without evidence of residual or recurrent disease.
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Generate impression based on findings.
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23 year-old male with possible cribriform plate fracture after nasal trauma. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The skull vault is unremarkable. There is mild polypoid mucosal thickening in the maxillary sinuses. The paranasal sinuses and mastoid air cells are otherwise clear. There is mild nasal septal deviation. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal with no evidence of fracture or significant defect. The orbits, maxillofacial osseous structures and visualized soft tissues are unremarkable.
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1. No evidence of skull base fracture or significant defect . 2. No definite intracranial or maxillofacial abnormality.
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Generate impression based on findings.
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Male 55 years old; Reason: met renal cell carcinoma, evaluate for progression of disease. CHEST:LUNGS AND PLEURA: Numerous pulmonary, parenchymal nodules are again seen diffusely, bilaterally. These lesions are stable. Index lesion (series 5, image 65) measures 1.0 x 0.9 cm in the left lower lobe. Index lesion (series 5, image 86) measures 1.3 x 1.1 cm. Subjectively other nodules are stable in size and number. MEDIASTINUM AND HILA: The subcarinal reference lymph node now measures 1.1 X 2.8 cm (series 3, image 51) not significantly changed from prior exam. No other enlarged masses or nodes are seen.CHEST WALL: No significant abnormality notedABDOMEN: Lack of IV contrast limits the evaluation of solid organs. Within the limitations of a non-IV contrast enhanced examination, the following observations can be made.LIVER, BILIARY TRACT: Lack of IV contrast cyst, which limits ability of CT to evaluate forparenchymal mass lesions. There is, however, an area of decreased attenuation in themedial aspect of the inferior right lobe liver (series 3, image 113) measuring 1.7 x 1.7. Unchanged subcentimeter hypoattenuating lesion inferior right lobe, which most likely represents benign cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Prior right nephrectomy. Soft tissue mass in surgical bed measures 2.2 x 4.1 cm (series 3, image 116). This is not changed significantly. A satellite lesion lateral to this and just abutting the posterior margin of the liver (series 3, image 116) measures 1.7 x 1.4 cm.Left kidney shows no significant change and no diagnostic abnormalities. No perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lytic lesion in L2 vertebral body extending into the posterior elements, unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Overall stable examination.1. Stable size of pulmonary metastatic reference nodules. 2. Stable hypodense lesion seen in inferior right lobe of liver. 3. Soft tissue mass in right nephrectomy bed is stable. 4. Stable lytic lesion in L2 vertebral body. 5. Stable appearance to reference subcarinal lymph node.
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Generate impression based on findings.
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58-year-old male with history of advanced pancreatic cancer. CHEST:LUNGS AND PLEURA: Scattered nonspecific micronodules without significant change.MEDIASTINUM AND HILA: Right chest Port-A-Cath with tip at the cavoatrial junction. No evidence of mediastinal lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No evidence of suspicious lesions. No intra-or extra hepatic ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: Again identified is a hypoenhancing mass in the pancreatic body best seen on image 107 of series 3, measuring 2.5 x 2.4 cm, previously 3.3 x 2.5 cm with upstream pancreatic atrophy. The splenic vein is patent.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of suspicious lesions, hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: Stable benign-appearing retroperitoneal lymphadenopathy. Diffuse atherosclerosis of the abdominal aorta and its branches.BOWEL, MESENTERY: The bowel is normal in caliber. No evidence of obstruction, pneumatosis, or pneumoperitoneum. The appendix is well-visualized and unremarkable.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: Small amount of free peritoneal fluid in the dependent pelvic space.
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1.Pancreatic body mass has minimally decreased in size.2.Interval development of small amount of free peritoneal fluid in the dependent pelvic space of uncertain significance.3.Stable non-specific pulmonary micronodules.
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Generate impression based on findings.
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Reason: Lung cancer on treatment, please re-eval. Thanks. History: Lung cancer CHEST:LUNGS AND PLEURA: Significant interval increase in right pleural effusion.Volume loss, architectural distortion, and right paramediastinal/perihilar post radiation changes.Right upper lobe paramediastinal mass demonstrates interval increase in size (image 31, series 6) now measuring 4.2 cm by two . 2 cm, previously measuring 3.7 cm x 1.7 cm.Left lower lobe nodule noted on prior exam is not present on current exam and most likely inflammatory in origin.Upper lobe predominant centrilobular emphysema.MEDIASTINUM AND HILA: Partially occluding thrombus within the right upper lobar pulmonary artery.No, hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Moderate coronary artery calcification.CHEST WALL: Marked degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Increasing right lobe metastasis (image 97 and series 4, now measuring 6.3 cm x 4.6 cm, previously measuring 5 cm x 3 cm on outside exam dated 11/8/13SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of the aorta. Infrarenal IVC filter.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.Significant interval increase in right pleural effusion.2.Increasing is right upper lobe paramediastinal mass.3.Increasing size of right first hepatic metastasis.4.No new sites of disease identified.
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Generate impression based on findings.
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41 year-old male with adult onset of hydrocephalus. A stereotactic device is in place, which produces extensive streak artifacts obscuring visualization of the intracranial structures. There is redemonstration of moderate supratentorial ventriculomegaly, which is unchanged from prior. The aqueduct is not dilated. The fourth ventricle is normal in size. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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Unchanged moderate supratentorial ventriculomegaly on the present limited, preop planning exam.
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Generate impression based on findings.
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Reason: hx H\T\N ca, post CRT, evaluate dx and compare measurements to previous scans History: as above CHEST:LUNGS AND PLEURA: Left lower lobe benign appearing micro-nodule, unchanged since 7/2011.No sign of pulmonary or pleural metastases.MEDIASTINUM AND HILA: Scattered mediastinal and hilar lymph nodes still are within normal size limits and are unchanged. CHEST WALL: Left supraclavicular lymph node upper normal size limit unchanged since 7/1/2011.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 metastatic disease or other significant abnormality. No interval change.
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Generate impression based on findings.
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Reason: s'p resection of mandible tumor9/4; eval as new baseline and eval for mets History: none LUNGS AND PLEURA: Moderate to severe centrilobular emphysema.No evidence of pulmonary or pleural metastases.Thick-walled bronchi and bronchiectasis unchanged.MEDIASTINUM AND HILA: Mild to moderate coronary calcifications are present.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic cystlike hypodensities are unchanged, too small to characterize but probably benign. Left renal cyst.
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No evidence of metastatic disease, or other significant abnormality.
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Generate impression based on findings.
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Reason: right lower lobe pulmonary nodule - eval for interval change History: cough LUNGS AND PLEURA: 9-mm right lower lobe nodule image 234 series 6, previously 8 mm, at 9 mm on the study before that, so other scattered benign not significantly changed. Other benign appearing micronodules are stable.New ground glass region medially in the left lower lobe superior segment, with resolution of adjacent groundglass opacity. MEDIASTINUM AND HILA: No significant lymphadenopathy. Calcified lymph nodes are the result of prior granulomatous infection.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified splenic granulomata.
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Unchanged right lower lobe nodule, continued and follow-up recommended. New ground glass lesion right lower lobe described above, which could also be assessed in 6 to 12 months as the likelihood of cancers low since it was not present last year.
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Generate impression based on findings.
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76 years old Male. Reason: rule out disc disease, compression History: severe spasticity Solid organ evaluation is limited by suboptimal contrast bolus timing. THORACIC SPINEThere is calcium deposition along the ligamentum flavum predominantly along the upper thoracic spine. There is ligamentum flavum calcification dominantly along the left lamina at T1 where it results in mild spinal stenosis mainly affecting left hemicord with left neural foraminal encroachment. There is ligamentum flavum calcification dominantly along the left side at T2 where it results in mild spinal stenosis mainly affecting left hemicord with left neural foraminal encroachment. There is ligamentum flavum calcification bilateral at T3 left worse than right where it results in mild to moderate spinal stenosis with left neural foraminal encroachment. There is ligamentum flavum calcification bilateral at bilateral at T4 where it results in marked spinal stenosis with bilateral neural foraminal encroachment. There is mild stenosis resulting at T5 due to ligamentum flavum hypertrophy. At the T 1/2 level, right-sided neural foraminal narrowing is present. The patient was positioned with the left down which creates artifact which may obscure subtle findings.Within the visualized lung parenchyma, there is a 4-mm nodule in the left apex (series 517). A peripheral ground glass opacities is also present in the left upper lobe (series 5 image 26), likely infectious. LUMBAR SPINEFive lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a mild disc bulge at this level. There is facet hypertrophy at this level right worse than left with narrowing of the right facet joint and osteophyte formation and mild left sided facet hypertrophy. This results in bilateral encroachment of exiting nerve roots.At L4-5 there is marked bilateral facet hypertrophy associated with a disk bulge and 2-3mm anterior listhesis of L4 on L5 resulting in marked spinal stenosis and mild encroachment of the exiting nerve roots within the neural foraminaAt L3-4 there is marked bilateral facet hypertrophy associated with a disk bulge resulting in moderate spinal stenosis and mild encroachment of the exiting nerve roots within the neural foraminaAt L2-3 there is a disk bulge and mild facet hypertrophy at this level resulting in moderate spinal stenosis with effacement of fat at the lateral recesses.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is normal lumbar lordosis. The spine alignment is anatomic. Vertebral body heights are maintained. Degenerative changes are specified by the intervertebral level as follows: Within the visualized abdominal contents, note is made of bilateral renal cysts with the largest cyst in each kidney, measuring over 8 cm in maximal diameter.
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1.Multilevel thickening and calcification of the ligamentum flavum mainly in the upper thoracic spine, results in narrowing of the spinal canal at T1, T2, T3, T4 and T5 but significantly worse at T4 where there appears to be severe spinal stenosis. If clinically appropriate an MRI of the thoracic spine may be of benefit to further evaluate the effect on the spinal cord.2.Multilevel degenerative changes in the lumbar spine worse at L4-5 where there is severe spinal stenosis but also at L3-4 and L2-3 where there is moderate spinal stenosis as detailed above.3.There is bilateral encroachment of exiting nerve roots at L5-S1 due to degenerative changes.4.Nonspecific 4 mm nodule in the left apex. In high risk patients in the appropriate clinical setting, this can be followed in 12 months.5.Large renal cysts.
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Generate impression based on findings.
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71 year old male. History of rectal cancer. Reason: R/o obstruction History: decreased ostomy output, abdominal pain CHEST:LUNGS AND PLEURA: Scattered bilateral pulmonary nodules, not significantly changed from previous study.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: 1.3-cm right adrenal adenoma, unchanged.KIDNEYS, URETERS: Left nephroureteral stent is again noted.RETROPERITONEUM, LYMPH NODES: Index left para-aortic node measures 1.6 x 1 cm, image 68, series 3, stable compared to previous study.Index mesentery lymph node measures 1.2 x 1 cm image 87, series 3, stable compared to previous study.BOWEL, MESENTERY: New partial small bowel obstruction has developed with transition point at the left bladder mass with fecalization and dilation of the proximal bowel. The distal bowel is decompressed. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Soft tissue mass at the left bladder base and left ureterovesical junction measures 3.9 x 3.7-cm on image 118, series 3, stable compared to previous study.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Left lower quadrant ostomy, unchanged.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Small bowel obstruction has developed with transition at the pelvic mass invading the left bladder base near the ureterovesical junction.
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Generate impression based on findings.
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65 year old female. Pancreatic neoplasm. Stage IV pancreas cancer. Compare to previous. CHEST:LUNGS AND PLEURA: Multiple pulmonary micronodules are stable in size since the prior examination. The reference left upper lobe nodule measures 4 x 5 mm unchanged (image 40; series 5).MEDIASTINUM AND HILA: There is no evidence of mediastinal or hilar lymphadenopathy. The right-sided port catheter tip terminates in the distal IVC. There are dense calcific changes consistent with atherosclerotic disease seen within the arch of the aorta and coronary arteries. There is an artificial mitral valve in place.CHEST WALL: Right chest wall port catheter is again noted.ABDOMEN:LIVER, BILIARY TRACT: Unchanged minimal intrahepatic biliary ductal dilatation without evidence of extrahepatic biliary ductal dilatation. The hepatic and portal veins appear patent.SPLEEN: No significant abnormality noted.PANCREAS: The ill-defined hypo-dense lesion within the uncinate process of the pancreas appears stable in size compared to the prior examination and currently measures 3.3 x 3.2 cm (image 114; series 3). Vascular encasement again noted, unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right thigh lipoma. OTHER: No significant abnormality noted.
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Stable examination.
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Generate impression based on findings.
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Clinical question: Evaluate tumor. Signs and symptoms: Meningeal cancer. Enhanced neck CT:Unremarkable images through the skull base and including normal appearing bilateral cavernous sinuses and bilateral petrous bones.Unremarkable images through the nasopharynx, oropharynx, nasal passage and oral cavity.Unremarkable salivary glands.Soft tissue thickening of the larynx and supraglottic region remains identical to prior exam and consistent with posttreatment changes. No convincing evidence of mass.No detectable lymphadenopathy by CT size criteria.Previously noted thrombosed and expanded right jugular vein demonstrate interval significant decrease in the size and without evidence of recanalization.Patent bilateral common and internal carotid arteries.Normal appearing bilateral thyroid lobes and thyroid cartilage.Stable tracheostomy tube since prior exam.There is a well demarcated nonspecific lucency within the dens which has remained stable since multiple prior exams. Stable postoperative changes of posterior approach cervical fusion at C4 and C5.
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1.Stable symmetrical mucosal thickening of the larynx without interval change since prior study and representing post pain changes. No evidence of recurrence of tumor or cervical adenopathy by CT size criteria.2.Interval decrease in the size of the thrombosed right internal jugular vein compared to prior exam and no evidence of recanalization.
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Generate impression based on findings.
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Reason: evaluate for metastasis. History: osteosarcoma. LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: A residual thymic tissue within the intermediastinum.No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of the pericardial effusion.CHEST WALL: Right humeral head prosthesis.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. 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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51 year-old female with history of squamous cancer of unknown primary. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. The osseous structures are unremarkable. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No CT evidence of intracranial abnormality, including metastasis.
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Generate impression based on findings.
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Male, 54 years old, status post T4 through 6 compression fractures, status post fusion. Evaluate bony fusion. The patient is status post partial corpectomy of the T5 and T6 vertebral bodies. A spacer device has been placed within the defect. The posterior elements also been removed from T4 through T6. Posterior fusion hardware is also in place with bilateral pedicle screws from T2 through T4, left-sided pedicle screws from T7 through T9, and right-sided pedicle screws at T7 and T9. Screws are well positioned within the pedicles. No hardware complications are suspected. Bone fragments have been placed along the posterior elements through the fusion zone.As a result of the surgical intervention, focal kyphotic angulation seen on the prior examination centered at T5-6 has been corrected. The thoracic spine now demonstrates only a mild smooth exaggeration of thoracic kyphosis. There is a very mild grade 1 anterolisthesis of T8 relative to T9.Some fracture fragments of the T4 through T6 vertebral bodies remain present anterior to the spacer device. The unaffected vertebral bodies demonstrate preservation of height. No area of significant bony compromise of the spinal canal is suspected. Outside of the operative region, the neural foramina are patent. Within the operative bed, the remaining neural foramina are difficult to assess due to streak artifact.Multiple healed/healing rib fractures are identified bilaterally.
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Findings are demonstrated status post partial corpectomy of the T5 and T6 vertebral bodies, posterior spinal canal decompression from T4 through T6, and posterior spinal fusion from T2 down to T9. Focal kyphotic angulation of the spine seen on the prior examination has been corrected.
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Generate impression based on findings.
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59-year-old male. History of suspected PCP pneumonia and AMS. Evaluate for infection. LUNGS AND PLEURA: Significant decrease in bilateral ground-glass opacities, with only minimal scattered opacities remaining. Moderate left and trace right pleural effusions with bibasilar dependent atelectasis, similar to prior exam. Lower lobe bronchial wall thickening.MEDIASTINUM AND HILA: Right IJ catheter tip is at the cavoatrial junction. Moderate coronary calcifications. Heart size is at upper limits of normal with low density blood pool consistent with anemia.CHEST WALL: Stable diffuse osseous changes consistent with known myelofibrosis. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Splenomegaly. Interval increase in ascites.
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1. Significant decrease in bilateral ground-glass opacities, with only minimal scattered opacities remaining. 2. Moderate left and trace right pleural effusions are not significantly changed. Interval increase in ascites.
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Generate impression based on findings.
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69 year-old female with new onset AFib and progressive dementia. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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Reason: evalute for metastasis or recurrence. History: sarcoma. CHEST:LUNGS AND PLEURA: Postsurgical changes involving the left chest wall including fibrotic changes, left lung volume loss, and pleural thickening are similar in appearance to the prior exam.No new suspicious pulmonary nodules.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Evidence of right coronary artery stent.CHEST WALL: As noted above. Extensive postoperative changes involving the left anterolateral chest wall with numerous surgical clips and soft tissue stranding, unchanged.No new chest wall masses can be identified.Right breast implant redemonstrated.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of aorta.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.Postoperative changes involving the left chest wall without evidence of recurrent or metastatic disease.2.Fibrotic changes, volume loss, and pleural thickening in the left hemithorax, similar in appearance to the prior exam. No evidence of pulmonary metastases.
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Generate impression based on findings.
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82-year-old male. Metastatic renal cancer status post two cycles of therapy with VEGF inhibitor. LUNGS AND PLEURA: 4 mm nodule in the right middle lobe is unchanged (series 6, image 52). Other micronodules are also unchanged. New small bilateral pleural effusions.MEDIASTINUM AND HILA: Severe coronary artery and moderate thoracic aorta calcification. No significant lymphadenopathy. CHEST WALL: Degenerative arthritic changes and possible hemangiomas in the spine, unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Large left adrenal mass measures 9.5 x 12.8 cm, previously 10.2 x 13 cm (series 4, image 85). Mesenteric collateral vessels are noted. Ascites and peritoneal nodularity/stranding are seen, refer to same day MRI for further details.
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1. Stable 4 mm right middle lobe nodule. No new lung lesions identified.2. Stable left adrenal mass. Refer to same day MRI for further details on abdominal findings.
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Generate impression based on findings.
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51 year old female. Reason: eval appy History: abd pain: epigastric, RLQ > LLQ with n/v, WBC 24 ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatomegaly, the liver measures more than 20 cm craniocaudally. 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: Enlarged appendix with thickened enhancing wall and 1 cm diameter compatible with acute appendicitis. No abscess or perforation. 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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Acute appendicitis.
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Generate impression based on findings.
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67-year-old female with a history of metastatic ovarian cancer to right breast and axilla currently receiving chemotherapy. Restaging evaluation. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: There is interval decrease in size and number of the previously demonstrated subcutaneous nodules along the medial aspect of the right breast as well as within the right axillary region. The reference subcutaneous nodule in the soft tissues along the anterior aspect of the right hemithorax, measures 11 x 8 mm, previously 27 x 18 mm (47; series 3).Reference right axillary lymph node measures 7 x 6 mm, previously 20 x 16 mm (30; series 3). Left chest port tip terminates in the SVC. Note is made of multiple prominent axillary and retropectoral lymph nodes.ABDOMEN:LIVER, BILIARY TRACT: There is a persistent moderate amount of abdominopelvic ascites. The previously described extensive peritoneal carcinomatosis not appreciated on this examination. Calcified granuloma in the liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No measurable retroperitoneal lymphadenopathy is identified. There is interval resolution of the previously described left para-aortic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Note is made of a heterogenous mass which appears to abut the uterus which is incompletely characterized and may represent multiple uterine fibroids, however, further evaluation with MRI or US examination could be considered if clinically indicated. BLADDER: No significant abnormality noted.LYMPH NODES: Note is made of prominent inguinal lymph nodes. There is interval decrease in size of the right obturator lymphadenopathy which measures 11 x 6 mm, previously 32 x 17 mm (161; series 3).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Heterogenous mass which appears to abut the uterus which is incompletely characterized and may simply represent multiple uterine fibroids, however, further evaluation with MRI or US examination could be considered to further evaluate for gynecologic pathology. There is significant interval decrease in size of the previously described multiple subcutaneous nodules within the right breast and axilla as well as resolution of the previously described extensive peritoneal carcinomatosis.2. Persistent ascites.
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Generate impression based on findings.
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33-year-old male with clinical stage I testicular cancer -- assess for recurrence. CHEST:LUNGS AND PLEURA: No change subcentimeter right basilar lung parenchymal nodule (series 5, image 68). No new nodules are seen. No masses, airspace consolidation or other abnormalities. No pleural disease.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: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Scattered small periaortic retroperitoneal lymph nodes are again seen unchanged. The prior reference lymph node (series 3, image 138) measures 0.8 x 0 .8 cm, previously 0.8 x 0.9 cm. No new foci of lymph node enlargement is seen. No other retroperitoneal abnormalities.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: Lucencies within the L4 and L5 vertebral bodies are unchanged from prior exam and most likely represent benign changes. No other abnormalities seen.OTHER: No significant abnormality noted
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1. Stable subcentimeter pulmonary nodular density at right base. 2. Stable subcentimeter index left periaortic lymph node. 3. No other diagnostic abnormality seen and no evidence of new or metastatic disease.
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Generate impression based on findings.
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Female; 60 years old. Reason: patient with microscopic hematuria; delayed imaging to eval kidney and upper tracts History: frequency, urgency, microscopic hematuria ABDOMEN:LUNG BASES: Mild bilateral lower lobe scarring and atelectasis.LIVER, BILIARY TRACT: Multiple nonenhancing punctate foci of hypoattenuation in the left hepatic lobe are too small to characterize, but unchanged when compared to prior exams. Surgical clips in the right upper quadrant and left hepatic lobe compensatory hypertrophy consistent with prior right hepatectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of suspicious renal lesions. No hydronephrosis or nephrolithiasis. The left ureter was nearly completely visualized with the exception of the distal aspect and only the proximal third of the right ureter was visualized. No evidence of stricture, obstructing mass or ureteral stone.RETROPERITONEUM, LYMPH NODES: No evidence of lymphadenopathy. Diffuse calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: 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: Status post hysterectomy.BLADDER: The bladder is moderately distended without evidence of suspicious masses.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 radiographic evidence to account for the patient's symptoms.
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Generate impression based on findings.
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Female 38 years old; Reason: H/O Hodgkin Lymphoma s/p 4 cycles ABVD in need of restaging. Please compare to prior. History: Hodgkin Lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality noted. Incidental azygous lobe noted.MEDIASTINUM AND HILA: Previously seen large mediastinal mass has markedly decreased measuring 2.6 x 4.1 cm (series 401 image 25), previously 9.2 x 6.6 cm.CHEST WALL: There is evidence of right supraclavicular lymphadenopathy, please refer to CT neck dated 12/17/13 for full description.ABDOMEN:LIVER, BILIARY TRACT: There is no evidence of intrahepatic biliary ductal dilatation or focal mass lesion. The hepatic vasculature appears patent.SPLEEN: There is no evidence of splenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: There is no evidence of retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No evidence of mesenteric lymphadenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: The bladder is nondistended.LYMPH NODES: There is no evidence of pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Marked decrease in size of the mediastinal mass.2.Supraclavicular lymphadenopathy, refer to neck CT from the same day for full description.
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Generate impression based on findings.
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Female 72 years old; Reason: Restaging for metastatic colon cancer History: Colon cancer CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, unchanged. There are mild emphysematous changes in the upper lobes . The pleural spaces remain clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Mild enlargement of the main pulmonary artery, unchanged.The right chest wall port terminates at the cavoatrial junction.CHEST WALL: No significant abnormality noted.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post resection of the right lobe of the liver. Index lesion in the left lobe of the liver has increased in size and now measures 9.9 x 7 .9 cm, previously 8.7 x 7.1 cm on image number 78, series number 3. Additional segment 4 metastatic lesion in the liver is also dramatically increased in size when compared to previous study measuring 4.7 cm in the short axis, previously 1.0 cm (78; series 3).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral simple cysts, unchanged.RETROPERITONEUM, LYMPH NODES: Borderline enlarged retroperitoneal lymph nodes are stable. There is interval development of retroperitoneal lymphadenopathy adjacent to the lateral aspect of the IVC, measuring 2.6 x 1.6 cm (image 114; series 3). There is interval involvement of left external iliac lymphadenopathy measuring 4.9 x 3 .5 cm (image 160; series 3). Additionally, there is progressive interval increase in size of the mass, measuring 4.4 x 2 .7 cm, abutting the left iliacus muscle, previously measuring 2.6 x 1.9 cm (image 136; series 3).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Endometrial stripe is dilated. Multiple fibroids in the uterus some of which appear pedunculated.BLADDER: No significant abnormality notedLYMPH NODES: Borderline enlarged retroperitoneal lymph nodes are stable. There is interval development of lymphadenopathy adjacent to the lateral aspect of the IVC, measuring 2.6 x 1.6 cm (image 114; series 3). There is interval involvement of left external iliac lymphadenopathy measuring 4.9 x 3 .5 cm (image 160; series 3). Additionally, there is progressive interval increase in size of a mass, measuring 4.4 x 2 .7 cm, abutting the left iliacus muscle, previously measuring 2.6 x 1.9 cm (image 136; series 3).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Significant interval increase in abdominopelvic disease consistent with the stated history of metastatic colon cancer.
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Generate impression based on findings.
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Female, 38 years old, history of Hodgkin's lymphoma status post 4 cycles ABVD, in need of restaging. Bulky mediastinal adenopathy is only partially visualized on this examination, but nonetheless, has significantly decreased in size. Please refer to the separately dictated chest CT for full details.In the neck, no pathologic adenopathy is detected by size criteria. A previously referenced right level 4 lymph node measures 0.9 x 0.8 cm (image 59 series 1602), previously reported as 2.7 x 2.1 cm (though please note that this measurement may have been exaggerated by partial inclusion of the adjacent scalene muscle). An additional reference node just superior measures 0.7 x 0.6 cm (image 54 series 1602), previously 1.5 x 1.0 cm.Again seen is a small tonsillith within the right palatine tonsil. The aerodigestive mucosa is otherwise within normal limits. The salivary glands and thyroid are free of focal lesions. The cervical vessels are patent. No concerning osseous lesions are detected.
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Prior referenced lymph nodes within the lower right neck have decreased in size. There are no frankly pathologic lymph nodes in the neck by size criteria. Interval significant reduction in the size of mediastinal adenopathy is also seen, though this is incompletely visualized on the present study. Please refer to the separately dictated chest CT for full details.
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Generate impression based on findings.
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Female 72 years old; Reason: pt on Tykerb/Herceptin please eval disease status and compare to previous imaging History: metastatic breast cancer CHEST:LUNGS AND PLEURA: Spiculated mass in the left upper lobe measures 1.9 x 1.6 cm, previously 1.6 x 1.5 mm (image 31; series 6), slightly increased in size.MEDIASTINUM AND HILA: Right thyroid nodule. Heart size is normal. Trace pericardial fluid. No mediastinal lymphadenopathy. Calcific arteriosclerotic disease affects the aorta and coronary arteries.CHEST WALL: Left chest wall port terminates at the cavoatrial junction. Incidental note of right subscapularis lipoma.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodense nodule (image 79; series 801) in the dome of the liver probably represents a cyst and is unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: No significant abnormality noted.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: Left obturator lymph node measures 1.7 x 0.6cm previously 1.9 x 0.6 cm (image 167; series 801), unchanged compared to previous. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Gradual increase in the left upper lobe pulmonary lesion.2.Stable pelvic lymph nodes.
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Generate impression based on findings.
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Female 27 years old; Reason: abdominal fullness x1 year History: abdominal fullness x1 year CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No acute intra-abdominal process detected to explain the patient's abdominal fullness.
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Generate impression based on findings.
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Male 63 years old; Reason: 2 inch mass in epigastrium. Feels like bone. ?tumour. Has previously had barium peritonitis. History: Lost 13 pounds. Mass in abdomen. ABDOMEN:LUNGS BASES: No mass lesion detected. Calcifications are noted along the hepatic dome.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: Surgical clips are seen in the left upper quadrant. No bowel obstruction or free contrast extravasation/free air is noted. Patient is status post partial colectomy.BONES, SOFT TISSUES: Surgical sutures along the midline are noted from prior laparotomy. Dystrophic calcifications are seen along the anterior abdominal wall.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No mass detected as clinically questioned. Dystrophic calcifications in the anterior abdominal wall may correlate with physical findings.
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Generate impression based on findings.
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58-year-old male with history of PTLD Hodgkin lymphoma in need of restaging after 4 cycles of ABVD CHEST:LUNGS AND PLEURA: Right apical scarring, unchanged. No other significant nodules, masses or airspace abnormalities. No pleural disease.MEDIASTINUM AND HILA: Calcified lymph nodes from prior granulomatous disease. The prior referenced anterior precarinal node (series 3, image 40) now measures 2.9 x 0 .8 cm, minimally changed from previous (0.7 x 0.7) . No change in the appearance of the cardiac post transplant changes. CHEST WALL: Right chest wall Port-A-Cath again seen with tip of catheter in the distal superior vena cava. Substantial decrease in size of the prior noted nonocclusive superior vena cava thrombus with only minimal residual.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted in liver. Prior noted small gallstone is not visualized on current examination -- no gallbladder or biliary tract abnormality seen. SPLEEN: No significant abnormality noteddPANCREAS: No significant abnormality noteddADRENAL GLANDS: No significant abnormality noteddKIDNEYS, URETERS: Bilateral benign-appearing renal cysts and scattered collecting system calcifications, unchanged. No other abnormalities..RETROPERITONEUM, LYMPH NODES: Referenced abdominal lymphadenopathy is remeasured as below:Left gastrohepatic ligament (series 3, image 92) measures 1.0 x 1.0 cm (previously 1.1 x 0.9 cm..Left retroperitoneum, abutting left renal vein (series 3, image 111) measures 1.6 x 1 .1 cm, previously 1.6 x 1.4 cm.. No new foci of lymphadenopathy is seen in the remaining. Other small lymph nodes are unchanged in size.BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality noteddPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noteddBLADDER: No significant abnormality noteddLYMPH NODES: No significant abnormality noteddBOWEL, MESENTERY: No significant abnormality noteddBONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality notedd
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1. Either stable or minimally decreased residual lymph nodes as measured and described above in the chest and abdomen. 2. Evolving superior vena cava. Nonocclusive thrombus with minimal residual..
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Generate impression based on findings.
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Clinical question: Shunt evaluation. Signs and symptoms: headache. Unenhanced head CT:Examination demonstrates shunted supratentorial ventricular system with resultant complete collapse of right lateral ventricle and small left lateral ventricle without interval change in size or placement of catheter since prior exam.Tip of the catheter is within the left collapsed frontal horn similar to prior exam.Normal size of the fourth ventricle and stable small suboccipital midline craniectomy changes.No detectable acute intracranial process since prior study.
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1.Stable right-sided shunt and small size of supratentorial ventricular system since prior study.2.No detectable acute new findings.
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Generate impression based on findings.
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Clinical question : Out intracranial bleed, given DIC with gram-negative septic shock. Signs and symptoms:altered mental status not waking up on ventilator. Portable head CT:Unremarkable images through posterior fossa and with normal size of fourth ventricle in midline.No detectable acute intracranial process, CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.The cortical sulci and ventricular system remain stable and unchanged since prior exam. Supratentorial ventricular system are within normal size and with maintained midline.Calvarium, orbits and visualized paranasal sinuses are unremarkable.
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No acute intracranial process. Stable exam since prior study.
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Generate impression based on findings.
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Presenting with acute epigastric pain. Evaluate for bowel ischemia The study is limited due to lack of intravenous contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There are multiple hypodense lesions throughout the liver. Lack of IV contrast limits there optimal evaluation, however, these are suspicious for metastatic disease. Contrast enhanced CT or MRI may be helpful for further evaluation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Probable bilateral renal cysts, incompletely characterized its lack of intravenous contrast.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Minimal fat stranding around the cecum and descending colon, nonspecific.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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Limited study due to lack of intravenous contrast. Numerous hypodense lesions in the liver, suspicious for metastatic disease, however, incompletely characterized due to lack of intravenous contrast. Further evaluation with contrast-enhanced CT or MRI is recommended.
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Generate impression based on findings.
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Clinical question: Evaluate for stroke/TIA. Signs and symptoms: Word finding difficulty. Nonenhanced head CT:No detectable acute intracranial process CT however it is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Examination demonstrates periventricular and subcortical low attenuation white matter which considering patient's stated age of 86 likely representing age indeterminate small vessel ischemic strokes.There is a focus of calcification in the dorsal aspect of the pons in midline measuring approximately 9 times 5-mm in size. There is no surrounding density abnormality of the pons. Finding could represent a focus of dystrophic calcification its irregular appearance it is less likely representative of a cavernoma however this possibility cannot be excluded.Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces are otherwise for patient's stated age. Mild bilateral cavernous carotid and intracranial vertebral artery calcification is noted.Unremarkable images through the orbits.Calvarium is intact there is however a small focus bony thickening and sclerosis of the outer table of the skull in the right paramedian frontal region suspected on an osteoma.All visualized paranasal sinuses, bilateral mastoid air cells and middle ear cavities remain well pneumatized.
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1.No acute intracranial process.2.Small vessel ischemic strokes of indeterminate age is suspected.3.Focus of calcification in the pons likely dystrophic however less likely possibility of a cavernoma cannot be entirely excluded.4.Right frontal skull osteoma.
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Generate impression based on findings.
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Evaluate for pancreatitis ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver.SPLEEN: No significant abnormality notedPANCREAS: There parenchymal calcifications within the pancreas consistent with chronic pancreatitis. In addition there is peripancreatic fat stranding and small amount of fluid consistent with acute pancreatitis. No evidence of focal necrosis. No evidence of pancreatic ductal dilatation or common bile duct dilatation.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: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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Acute on chronic pancreatitis without evidence of complications or necrosis.Fatty infiltration of the liver.
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Generate impression based on findings.
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27-year-old female, with history of multiple blunt trauma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: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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No no CT evidence of acute traumatic injury.
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Generate impression based on findings.
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42-year-old male status post Whipple surgery with pancreatic leak and fevers ABDOMEN:LUNG BASES: Large right-sided pleural effusion and trace left sided pleural effusion with dependent atelectasis, stable.LIVER, BILIARY TRACT: Small amount of perihepatic fluid. There is a percutaneous drain within the collection. Pneumobilia, unchanged.SPLEEN: No significant abnormality notedPANCREAS: Postsurgical changes secondary to Whipple surgery. Interval increase in the size of the right retroperitoneal collection now measuring 10.7 x 3.2 cm on image number 62, series number 3. There are also smaller pockets more inferior to this large collection and towards the left side.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: A wall thickening of the jejunal loops anastomoses the pancreas and liver with s borderline enlarged mesenteric lymph nodes are stable. mall amount of interloop fluid. Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval increase in the size of retroperitoneal collection with other small collections as described above. Large right pleural effusion, unchanged.
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Generate impression based on findings.
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31-year-old male with 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: Nonspecific wall thickening involving the cecum. Appendix is not well-visualized however there is no evidence of inflammation in the right lower quadrant to suggest appendicitis.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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Nonspecific wall thickening of the cecum which may represent colitis. Appendix is not visualized, however, there is no CT evidence of acute appendicitis.
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Generate impression based on findings.
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33-year-old male with paraplegia,, presumed ureterostomy, chills and decreased ostomy output. Lack of IV contrast significantly limits evaluation of solid margins of the abdomen.ABDOMEN:LUNG BASES: Atelectasis/scarring at left base.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Significant calculi/partial staghorn involving the right kidney with large stone in the renal pelvis, as well as other nonobstructing calcifications within the caliceal system. No gross hydronephrosis. Large calculus left renal pelvis with smaller caliceal stones without gross hydronephrosis. No perinephric fluid collections. Evaluation for pyelonephritis is not possible without IV contrast.RETROPERITONEUM, LYMPH NODES: Vena caval filter just above the iliac bifurcationBOWEL, MESENTERY: Extensive fecal material within distended rectum. Rectal wall appears mildly thickened. No bowel obstruction. Mild gastric distention with fluid and gas. Ostomy identified in the right lower quadrant.BONES, SOFT TISSUES: Deformity associated with paraplegia. Several benign -- brain Lucent foci and foci within pelvic bones with central sclerosis.OTHER: Catheter/electrode in the thecal sac extending to stimulator in the anterior abdominal wall. No associated fluid collections.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Presumed cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Extensive fecal material within distended rectum. Rectal wall appears mildly thickened. No bowel obstruction. Mild gastric distention with fluid and gas. Ostomy identified in the right lower quadrant.BONES, SOFT TISSUES: Deformity associated with paraplegia. Several benign -- brain Lucent foci and foci within pelvic bones with central sclerosis.OTHER: No fluid collections
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Bilateral nephrolithiasis without hydronephrosis or obvious perinephric changes.Rectal distention with mild wall thickening which may be due to proctitis.Mild gastric distention.
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Generate impression based on findings.
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45 year-old female with abdominal pain ABDOMEN:LUNG BASES: Paracardiac borderline enlarged lymph nodes on the right side, not significantly changed from prudent study.LIVER, BILIARY TRACT: Mild fatty infiltration of the liver and acromegaly.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Bilateral mild adrenal thickening, unchanged.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The Appendix is unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: A small enhancing lesion within the endometrial cavity measuring 1 cm image number 123, series number 3. Further evaluation with pelvic ultrasound is recommended.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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Small enhancing lesion within the endometrial cavity. Pelvic ultrasound is recommended for further evaluation.Hepatomegaly and fat infiltration of the liver.
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Generate impression based on findings.
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Clinical question: Trauma. Signs and symptoms: Loss of consciousness. Nonenhanced head CT:No detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable images through the orbits.Well pneumatized alternatives of sinuses and bilateral mastoid air cells/middle ear cavities.
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Negative nonenhanced head CT.
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Generate impression based on findings.
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52 year-old female with possible stones or perinephric abscess This study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: Small amount of pericardial fluid.LIVER, BILIARY TRACT: CT findings the distal chronic liver disease. Focal liver lesions cannot excluded due to lack of intravenous contrast.SPLEEN: No significant abnormality notedPANCREAS: Calcifications throughout the pancreas consistent with chronic pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of renal stones or hydronephrosis. Nonspecific, minimal right perinephric stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Limited study due to lack of intravenous contrast. Findings consistent with chronic pancreatitis and chronic liver disease. No evidence of renal stones or hydronephrosis is questioned. Minimal right perinephric stranding, nonspecific.
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Generate impression based on findings.
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Clinical question: Status post cart with known brain bleed. Signs and symptoms : As a above. Portable head CT:There is no detectable acute intracranial process CT however is insensitive for early detection of acute nonhemorrhagic ischemic stroke.Portable technique and several motion artifact results seen mild deterioration of image quality. Subtle intracranial findings including edema cannot be properly assessed on this exam. Correlate with clinical findings and follow-up with CT or MRI.Cerebral cortex and cortical sulci are unremarkable. The ventricular system remains within normal and midline is maintained.Unremarkable orbits. Fluid level within the sphenoid sinus.
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No convincing evidence of acute intracranial findings
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Generate impression based on findings.
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Right lower quadrant pain for one day 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 are multiple borderline enlarged mesenteric lymph nodes. The appendix is not visualized, however, there is no inflammation in the right lower quadrant to suggest acute appendicitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Borderline enlarged bilateral inguinal lymph nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Nonspecific mesenteric and bilateral inguinal borderline enlarged lymph nodes. No CT evidence of acute appendicitis.
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Generate impression based on findings.
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20 year-old female with history of HIV and presenting with abdominal pain, nausea and vomiting ABDOMEN:LUNG BASES: A there is diffuse wall thickening of the esophagus suspicious for esophagitis in a patient with known history of HIV.LIVER, BILIARY TRACT: Periportal edema and gallbladder wall thickening suggestive of hepatitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: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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CT finding suggestive of esophagitis and hepatitis.
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Generate impression based on findings.
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93 year-old female, evaluate for diverticulitis small bowel obstruction or colitis ABDOMEN:LUNG BASES: Large hiatal hernia.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: Proximal small bowel loops are distended measuring up to 3.3 cm. Distal small bowel loops are decompressed. These findings are consistent with distal small 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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CT findings consistent with acute distal small bowel obstruction. The transition point is in the right lower quadrant, etiology is uncertain.
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Generate impression based on findings.
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Clinical question: Right-sided paralysis status post LVAD placement and TV repair. Signs and symptoms: Not moving right side. Nonenhanced head CT:Examination demonstrates a focus of low attenuation involving the cortex and subcortical white matter of left posterior parietal lobe with resultant subtle mass effect and complete effacement of adjacent cortical sulci. Finding is consistent with late acute to early subacute nonhemorrhagic ischemic stroke. There is also some mass effect on the trigone and occipital horn of left lateral ventricle. No evidence of midline shift.Unremarkable cerebral cortex, cortical sulci, ventricular system and the gray -- white matter differentiation otherwise.Calvarium and soft tissues of the scalp are unremarkable.Limited images through the orbits, paranasal sinuses and mastoid air cells are unremarkable.
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1.Late acute to early subacute left posterior parietal nonhemorrhagic ischemic stroke with regional mass-effect as detailed.2.Unremarkable nonenhanced head CT otherwise.
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Generate impression based on findings.
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Clinical question: Evaluate for postop hemorrhage. Signs and symptoms: Headache. Unenhanced head CT:There is no evidence of acute intracranial process in particular no evidence of hemorrhage as clinically is questioned area CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Examination demonstrates enlargement of right cavernous sinus consistent with tumor. There is also slight prominence of pituitary gland.There is evidence of prior transphenoidal hypophysectomy. Fluid and soft tissue density within the sphenoid sinus likely represent post operative changes and including packing. There is no evidence of intracranial hemorrhage or pneumocephalus.Unremarkable cerebral cortex, cortical sulci, ventricular system and the CSF spaces otherwise.
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1.No acute intracranial process.2.Enlargement of right cavernous sinus consistent with tumor invasion.3.Expected postoperative changes of transphenoidal hypophysectomy with fluid/soft tissue density within the sphenoid sinus.4.Slight prominence of pituitary gland.
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Generate impression based on findings.
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27 year-old female with altered mental status. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for polypoid mucosal thickening in the right maxillary sinus. There is mild left parietal scalp swelling. There is straightening of the cervical lordosis. The cervical spine alignment is anatomic. The vertebral bodies, dens, lateral masses, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of spinal canal stenosis. The neural foramen are patent. The intervertebral disk spaces are preserved. The paraspinal soft tissues are unremarkable.There is trace gas in the left retropharyngeal space, which is likely related to ET/enteric tube placement. In addition, an endotracheal tube is in placement.
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1. No acute intracranial abnormality. 2. No evidence of cervical spine fracture or subluxation, if spinal cord or ligamentous injury is suspected MRI is recommended.3. Trace gas in the left retropharyngeal space, which is likely related to ET/enteric tube placement.
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Generate impression based on findings.
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68-year-old male with tachycardia, desat, shortness of breath, EKG changes. Rule out PE. PULMONARY ARTERIES: Extensive intraluminal filling defects with saddle embolus, involving the central pulmonary arteries, lobar branches, and extending to the segmental arteries bilaterally. LUNGS AND PLEURA: Basilar wedge-shaped consolidation in the right lower lobe may represent involving infarct. Left lower lobe subsegmental atelectasis. No pleural effusions.MEDIASTINUM AND HILA: Cardiac size is normal without evidence of pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. The gallbladder is filled with air. Large gallstone noted within the gallbladder.
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Extensive bilateral pulmonary emboli with possible evolving right sided infarct .
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Generate impression based on findings.
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Male, 41 years old, congenital hydrocephalus, status post third ventriculocisternostomy. A burr hole defect in the right frontal bone as well as a small amount of intraventricular air are expected postoperative findings. There is a very subtle hypodense tract through the right frontal lobe from the burr hole to the right frontal horn. No parenchymal hematoma or significant extra-axial collections are seen. There is minimal layering blood product within the right occipital horn.Moderate supratentorial ventriculomegaly persists and is similar in degree to the preoperative exams. As before, the fourth ventricle is of normal caliber. Brain parenchymal morphology is otherwise unremarkable. No focal parenchymal edema or mass effect is seen. The basilar cisterns remain patent. The paranasal sinuses and mastoid air cells are clear.
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Expected postoperative findings as discussed above. Moderate supratentorial ventriculomegaly appears similar to prior exams.
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Generate impression based on findings.
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51-year-old female with chest pain, elevated d-dimer. Rule out PE. PULMONARY ARTERIES: No evidence of pulmonary emboli as clinically questioned.LUNGS AND PLEURA: Upper lobe predominant centrilobular emphysematous changes are redemonstrated. No focal air space opacity. No pleural effusions. Mild bronchial/bronchiolar wall thickening. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Scattered subcentimeter bilateral axillary lymph nodes.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small exophytic likely simple cyst of the left kidney is partially imaged.
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No evidence of pulmonary embolism, as clinically questioned.Mild upper lobe predominant centrilobular emphysema and bronchial/bronchiolar wall thickening.
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Generate impression based on findings.
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85 year-old male with increasing shortness of breath over the last 10 days, known prior PE. Additional history per prior reports: Mesothelioma. PULMONARY ARTERIES: No evidence of pulmonary embolus. Previously seen subacute to chronic left sided pulmonary emboli are not visualized on the current exam.LUNGS AND PLEURA: Right lower lobe atelectasis and small right pleural effusion without significant interval change from the prior exam. Redemonstrated left-sided pleural thickening and nodularity consistent with known mesothelioma. Scattered bilateral pleural plaques, consistent with prior asbestos exposure. Elevation of the left hemidiaphragm is redemonstrated with postsurgical changes from decortication/left diaphragmatic graft.MEDIASTINUM AND HILA: Scattered mediastinal lymphadenopathy is mildly increased from exam dated 7/10/2013 though unchanged from prior exam. Severe atherosclerotic changes of the thoracic aorta. Cardiac size is normal, with small pericardial effusion, unchanged.CHEST WALL: Soft tissue nodularity in the left lateral chest wall, and nodules in the left paravertebral region are unchanged and suspicious for tumor involvement. Left axillary, internal mammary, and intercostal lymphadenopathy is again seen, unchanged from prior exam.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Scattered subcentimeter mesenteric and retroperitoneal lymph nodes. A para-aortic lymph node measures 1.4 x 1.0 cm (image 258, series #6).Incompletely visualized right retroperitoneal nodule at the hepato- renal angle are unchanged and may represent tumoral involvement.Scattered punctate calcific densities in the spleen are consistent with prior granulomatous disease.The left adrenal is not well visualized.Atherosclerotic ossification of the partially imaged abdominal aorta and its branches.
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1.No evidence of PE as clinically questioned.2.Small right pleural effusion and underlying right basilar atelectasis unchanged.3.Findings consistent with known mesothelioma with postoperative changes, similar in appearance to the prior exam.
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Generate impression based on findings.
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70 year-old male patient with pain. Evaluate for fracture. No evidence of fracture or dislocation. Mild osteoarthritis affects the left hip.Vascular calcifications are noted.
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No evidence of fracture or dislocation.
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Generate impression based on findings.
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Clinical question: Status post ETV. Signs and symptoms: Status post ETV. Nonenhanced head CT:Examination demonstrate interval right frontal burr hole for surgical approach.There is an acute extra axial/subdural collection at the level of the burr hole and extending posteriorly. It also contains multiple small air bubbles. It measures maximum of 13.4-mm in thickness and 53-mm in longest AP axis. There is resultant subtle mass effect and flattening of the adjacent cerebral cortex. No appreciable mass effect on the right lateral ventricle.Examination also demonstrates an acute hematoma in the right basal ganglia measuring 15 x 21 x 18.3 mm in transaxial dimensions. No appreciable surrounding vasogenic edema. The finding results in subtle mass effect on the third ventricle. This hemorrhage on sagittal images appears to be communicating with the hemorrhage in the 3rd and right lateral ventricle (sagittal reformatted image 29). Examination also demonstrate post procedural air within the right frontal horn of lateral ventricle. There is revisualization of supratentorial ventriculomegaly. There is suggestion of a slight interval decrease in the size of third ventricle since prior exam. No convincing evidence of decrease in the size of lateral ventricles.Minute amount of blood in the dependent portion of bilateral occipital horns and minimally in the third ventricle is present.
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1.Interval right frontal burr hole and with evidence of an acute subdural collection under the burr hole measuring at 13.4-mm in thickness and approximately 53 mm in length. There is several associated mass effect.2.New acute hematoma in the right basal ganglia with measuring at 15 x 21 x 18 mm size which appears to be in continuity with a small amount of hemorrhage in the third ventricle. There is subtle associated mass effect.3.Stable enlarged lateral ventricles since prior study and possible minima decreased 3rd ventricle.4.Minimal hemorrhage in the third ventricle and dependent portion of bilateral occipital horns.
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Generate impression based on findings.
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Squamous cancer in abdomen, unknown primary. Evaluate for metastases. LUNGS AND PLEURA: No suspicious pulmonary nodules. There is nodular tumor thickening of the left posterior medial pleura with a maximal thickness of 23 mm (series 4, image 66), previously measured 20 mm. The thickening extends to the left lateral surface of the aorta with loss of fat planes.MEDIASTINUM AND HILA: Multiple periesophageal enlarged lymph nodes, some with internal low density suggestive of necrosis, extend from the upper to mid esophagus. This includes a 24 mm node at the level of the aortic arch (series 4, image 30).Para-aortic lymphadenopathy is seen in the lower chest; this includes a 28 mm lymph node that previously was 23 mm (series 4, image 74).CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Bulky retrocrural lymphadenopathy and retroperitoneal lymphadenopathy, progressed in size and has become confluent compared to prior exam making measurement of a discrete lesion inaccurate. Tumor encases the upper abdominal aorta and the celiac axis.Focal geographic hypoattenuation along the ligamentum teres is likely focal fatty infiltration, unchanged from prior exam.Left extrarenal pelvis.
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1. Periesophageal lymphadenopathy. 2. Nodular soft tissue thickening along the left inferior posteromedial pleura consistent with metastases, slightly increased in size from prior exam.3. Bulky lower thoracic and upper abdominal para-aortic and retrocrural lymphadenopathy, progressed from prior exam. 4. No evidence of a primary lung malignancy.
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Generate impression based on findings.
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Clinical question: Intracranial hemorrhage. Signs and symptoms: Left-sided weakness. Nonenhanced head CT:There is evidence of interval decreased size of right frontal acute subdural hematoma. It measures approximately 8.8 mm in thickness compared to prior study measurement of 13.4-mm. The longest AP axis of subdural also has decreased to 47-mm compared to prior study measurement of 53 mm.Acute hematoma in the right basal ganglia/thalamus measuring at 22 times 11-mm in thickness. Minimal apparent increased in the measurement of this hematoma in its long axis could be result of slice positioning/angulation of the head. Stable subtle mass effect on the third ventricle.Stable minimal hemorrhage in the third ventricle since prior exam.Revisualization of minimal blood in the dependent portion of bilateral occipital horns without any significant change.Revisualization of a stable postoperative air within the right frontal horn, right frontal parenchymal and subarachnoid air as well as residual air in the subdural hematoma and subdural space.Stable enlarged supratentorial ventricular system since prior exam.Stable expected postoperative changes of right frontal burr hole in the soft tissues of the scalp.
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1.No convincing evidence of any acute new finding since prior study.2.Interval decreased size of right frontal acute subdural hematoma. Measuring maximum of 8.8-mm compared to prior study measurement of 13.4.3.No convincing evidence of change in the size of acute right basal ganglia/thalamic hematoma and subtle associated mass effect on the third ventricle.4.Stable minimal hemorrhage within the third ventricle and dependent portion of occipital horns since prior exam.5.Stable supratentorial hydrocephalus since prior exam.6.Stable postoperative intracranial air in the right lower, right frontal parenchyma and right frontal subarachnoid space as well as subdural space since prior exam.
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Generate impression based on findings.
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Male, 70 years old, with history of recurrent palate cancer. Presents with fixed nodule inferior to left mandible. Please evaluate for mass. Extensive treatment-related changes are again identified throughout the neck, including anterior volume loss, effacement of fat planes, and thinning of the left hard palate.Multiple new calcified lesions are present in a linear pattern along the expected distribution of the left submandibular duct, compatible with sialoliths. The left submandibular gland appears hyperemic and enhances, and interval development of adjacent skin thickening and subcutaneous fat stranding are also noted. Multiple level 1b lymph nodes, one of which is necrotic, are more prominent than on the prior study (series 7, images 29 and 31). While these could represent pathologic lymphadenopathy considering the patient's history of cancer, purulent lymphadenitis is also a differential consideration given the presence of the local inflammatory changes described above. The airway is patent. The parotid glands are atrophic but unremarkable. The right submandibular gland is atrophic or absent. The thyroid gland is small but unremarkable.The cervical vessels are patent with evidence of atherosclerotic calcification at the bifurcations.Fibrotic changes are again noted at the lung apices. However, no suspicious lesions are seen.No evidence of osseous metastases. Multilevel degenerative disk disease is again demonstrated, most severe at C3-4 where there is a posterior disk osteophyte complex causing effacement of the thecal sac. There is opacification of the right mastoid air cells.
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1. Hyperemic, enhancing left submandibular gland containing multiple new sialoliths, associated with local inflammatory changes as described above. Findings suggest interval development of sialoadenitis s/p excision. 2. Increased prominence of multiple level 1B lymph nodes, one of which is necrotic. Differential considerations include pathologic lymphadenopathy given the patient's history of cancer and purulent lymphadenitis considering the presence of local inflammatory changes as detailed above.
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Generate impression based on findings.
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56-year-old tumor. History of metastatic breast cancer on treatment. Evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: Left basilar scarring. 7-mm right middle lobe nodule is stable dating back to 5/2013, but was not present on 3/2013 scan and priors. Additional micronodules are unchanged.MEDIASTINUM AND HILA: Right chest Port-A-Cath tip is in the SVC. Precarinal reference lymph node measures 5 mm, unchanged (series 3, image 36). Right hilar enlarged lymph node is unchanged. No new lymphadenopathy.CHEST WALL: Skin thickening of the breast bilaterally, left greater than right, similar prior exam. Right chest port. Right axillary lymph node measures 8 mm, and change.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Central hepatic hypodense poorly defined mass measures 19 x 22 mm, previously 19 x 19 mm (series 3, image 77). An ill-defined hypoattenuating lesion in the right hepatic lobe measures 13 x 9 mm is faintly visible on 10/2013 CT in retrospect, but not seen on exams prior to this. Stable hepatic cysts and vascular malformation in the right lobe. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. 7 mm right middle lobe nodule is stable dating back to 5/2013, but not seen on 3/2013 scan and priors. It remains suspicious for a metastasis. 2. Stable 19 x 22 mm right hepatic lobe lesion.3. A second smaller right hepatic lesion was faintly visible in retrospect 10/2013, but not on studies previous to this. It is concerning for a metastasis. 4. No new sites of disease identified compared to 10/2013.
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Generate impression based on findings.
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Reason: Is sarcoid involvement in lungs? If so, extent of? History: Mild restriction on PFT's, LUNGS AND PLEURA: Mild bilateral predominantly upper zone and peri-bronchovascular ground glass and reticular opacity with some architectural distortion and traction bronchiectasis consistent with fibrosis. This pattern is consistent with sarcoid and the findings are moderately increased since 2005.MEDIASTINUM AND HILA: Small hypodensities in the thyroid gland consistent with cysts.No significant lymphadenopathy. Mildly enlarged lymph nodes that were present previously have decreased in size.Cardiomegaly with ICD leads extending to the right ventricle.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Moderate chronic interstitial disease with evidence of fibrosis, slightly increased since 2005, consistent with sarcoidosis.
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Generate impression based on findings.
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Reason: Patient with history of cancer of tonsil, soft palate and floor of mouth. History: Please evaluate for metastasis LUNGS AND PLEURA: Apical radiation fibrosis.Scattered benign appearing micronodules are present, as well as a day he stable right lower lobe superior segment subpleural area of scarring.There is no specific evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Severe aortic and coronary artery calcifications are present.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Extensive vascular calcifications are seen in the upper abdomen. A gastrostomy tube is in place.
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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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Reason: LLL opacity seen on chest xray, concern for developing pneumonia History: shortness of breath, fever, neutropenia LUNGS AND PLEURA: Consolidation and atelectasis in the left lower lobe with focal air space opacity in the lingula and also in the right upper lobe, consistent with pneumonia.MEDIASTINUM AND HILA: No significant lymphadenopathy.Low blood pool opacity consistent with anemia.Catheter tip in the SVC.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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Bilateral airspace opacities, most severe in the left lower lobe, consistent with pneumonia.
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Generate impression based on findings.
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59 year-old female with worsening cough, congestion and wheeze. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There are bubbly fluids in the left maxillary with narrowed left infundibulum. The frontal sinuses are underdeveloped. The anterior/posterior ethmoids, sphenoid sinuses, and maxillary sinuses are well developed and clear. The osteomeatal complexes are normal with intact uncinate processes and patent right infundibuli. The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal apart from concha bullosa of the right middle turbinate. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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Evidence of acute left maxillary sinusitis.
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Generate impression based on findings.
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Reason: asthma severe uncontrolled History: SOB cough wheezing. LUNGS AND PLEURA: Diffuse bilateral bronchial thickening compatible with chronic asthma.No sign of pneumonia or other complications.MEDIASTINUM AND HILA: No significant abnormality noted.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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Diffuse bilateral bronchial thickening consistent with chronic asthma. No sign of pneumonia or other complications.
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Generate impression based on findings.
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Reason: polymyositis eval for ILD. restrictive pfts History: sob LUNGS AND PLEURA: Extensive bilateral predominately lower zone bronchiectasis and scarring. Small subpleural nodular and scar like opacities are unchanged.No new findings.No significant air trapping on the expiration scan.MEDIASTINUM AND HILA: Multiple mildly enlarged superior mediastinal lymph nodes, slightly increased compared to previous.Vascular stent in the LAD coronary artery.Mild pericardial thickening or minimal effusion, slightly increased.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis.
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Extensive bilateral bronchiectasis and scarring, without significant interval change.
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Generate impression based on findings.
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Lung neoplasm without specification of site. CHEST:LUNGS AND PLEURA: Extensive emphysema with and large lung volumes.The left lower lobe demonstrates multiple focal and somewhat confluent peripheral opacities greater in the anterior and basilar aspects of which some are cavitary. Adjacent pleural thickening and extensive interstitial changes are otherwise observed. The more discrete and partially cavitary lesion and/or lesion adjacent to a pre-existing bulla (image 47 series 5) measures 2.7 x 1.5 cm. Additional narrowing and/or questionable endobronchial involvement involving the left lower lobe cannot entirely be excluded, see image 61 series 5.Right lung is clear a focal abnormalities and no effusions.MEDIASTINUM AND HILA: Multiple nodule hypodensities throughout the thyroid greater on the right with mild enlargement, possible multinodular goiter are incompletely visualized. Consider dedicated imaging.Left hilar lymphadenopathy, for reference a right hilar lymph node measures 1.3 cm (image 56 series 3).Moderate coronary and annular calcifications without additional cardiac or pericardial distinct abnormality; however the confluent left lower lobe opacities extend along the major fissure and are adjacent to the pericardium of the left ventricle (image 69 series 3). Questionable invasion of what may be a malignant process cannot be excluded.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: A nodular abnormality in the left adrenal measuring 1.3 x 1.3 cm (image 106 series 3). Right adrenal unremarkableKIDNEYS, URETERS: Scattered renal cysts on the rightPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive aortic atherosclerotic disease and branchesBOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Diffusely ectatic skeletal hyperostosis with mild overlying degenerative changes. No discrete lytic or blastic lesions observed.OTHER: No significant abnormality noted.
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Nonspecific left lower lobe abnormalities representing questionable in infection versus suspected primary malignancy (probable adenocarcinoma) with associated hilar lymphadenopathy. Please correlate with prior outside pathology possible prior imaging if available.
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Generate impression based on findings.
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Female; 44 years old. Reason: intrabd pathology? History: leukocytosis, abd pain, vomiting. Exam is limited by motion artifact and poor contrast enhancement.ABDOMEN:LUNG BASES: Small bilateral patchy basilar infiltrates. Small right pleural effusion.LIVER, BILIARY TRACT: Dilated hepatic veins and borderline hepatomegaly. No evidence of cholelithiasis, pericholecystic fluid or gallbladder wall thickening. No intra-or extrahepatic ductal dilatation. No suspicious lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys bilaterally. No evidence of nephrolithiasis, hydronephrosis, or perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: Scattered periaortic retroperitoneal lymphadenopathy with reference enlarged left paraaortic lymph node best seen on image 69 of series 3 measuring 1.9 x 1.1 cm.BOWEL, MESENTERY: The bowel is normal in caliber. No evidence of obstruction, pneumoperitoneum or pneumatosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Cardiomegaly.PELVIS:UTERUS, ADNEXA: Calcified uterine fibroids are noted.BLADDER: No significant abnormality notedLYMPH NODES: Bilateral inguinal lymphadenopathy with reference enlarged left inguinal lymph node best seen on image 54 of series 80292 measuring 2.9 x 2.9 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Small right pleural effusion and bilateral basilar patchy infiltrates.2.Scattered retroperitoneal and inguinal lymphadenopathy.
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Generate impression based on findings.
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Reason: stage IV adenocarcinoma of the lung (to bone) on active surveillance, reimaging History: shortness of breath CHEST:LUNGS AND PLEURA: There is a small right pleural effusion. Focal area of consolidation with air bronchograms noted in the right perihilar region which presumably represents this patient's known neoplasm.Bilateral paramediastinal fibrosis most likely representing post radiation changes.No additional pulmonary nodules or masses noted.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal evidence of pericardial effusion.Moderate coronary artery calcification.CHEST WALL: Sclerosis of the T2 vertebrae with significant collapse presumably secondary to metastatic disease.Sclerosis within the T6 vertebrae with an impending fracture involving the superior endplate again most likely pathologic in origin.Focal area of sclerosis in the T3 vertebrae compatible with a metastatic focus.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy.Subtle hepatic hypodensity centrally within the right lobe suspicious for hepatic metastasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small left renal hypodensity incompletely evaluated.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of the aortaBOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Marked facet arthropathy at L3-4 and L4-5 on the left.OTHER: No significant abnormality noted.
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1.Right perihilar area consolidation compatible with known/residual neoplasm.2.Multiple osseous metastases within the upper thoracic spine with pathologic fractures at T2 and T6. Recommend MRI of the thoracic spine for further assessment.
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