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Generate impression based on findings.
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67-year-old with history of metastatic thyroid cancer. Follow up exam. Head CT:There is no evidence of intracranial mass, hemorrhage or infarction. No enhancing abnormality is seen.Neck CT:Postsurgical changes secondary to prior thyroidectomy is seen with redemonstration of a linear tiny 1 to 2-mm focus of enhancing tissue within the right thyroid bed (series 6 image 53) which may be vascular in nature. This is unchanged from the prior examination.The reference lymph node of the left neck measures measures 7 x 4 mm (series 6, image 50) which is unchanged from the prior examination. No evidence of intervally enlarged lymph nodes or enlarged lymph nodes by CT criteria throughout the neck.Parotid and submandibular glands are unremarkable. Aerodigestive tract is notable for augmentation of the left true vocal cord.A left lateral esophageal diverticulum at C7 is redemonstrated, suggestive of a Killian Jamieson diverticulum.Sclerotic foci within the posterior aspect of C7, T2 and T3 is unchanged dating back to 04/22/2011.
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1.Stable size of the reference left neck lymph node. No evidence of new adenopathy.2.No definite evidence of residual tumor in the thyroid bed. 3.No intracranial metastasis.
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Generate impression based on findings.
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71-year-old male with metastatic prostate cancer, rising PSA. Restage disease. CHEST:LUNGS AND PLEURA: Scattered nonspecific micronodules 3 mm or less in size throughout both lungs.No other significant abnormalities. No pleural disease.MEDIASTINUM AND HILA: No adenopathy. Coronary artery calcifications seen diffusely.CHEST WALL: Nonspecific right thyroid lobe nodule. Posterior thoracic spine stabilization rods and screws. Diffuse and scattered sclerotic metastatic bone lesions seen involving vertebral bodies, left scapula, multiple ribs.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Infrarenal inferior vena cava filter with expected position and appearance. No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Nodular prostate, consistent with BPH. No apparent periprostatic tumor is seen.BLADDER: No significant abnormality notedLYMPH NODES: No enlarged large, lymph nodes seen to suggest lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse nodular sclerotic changes seen throughout the pelvic bony skeleton, consistent with metastases.OTHER: No significant abnormality noted
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1. Multiple pulmonary micronodules nonspecific in appearance. 2. Diffuse sclerotic foci throughout. The skeletal system compatible with metastases. 3. No enlarged lymph nodes seen in chest, abdomen or pelvis to suggest lymphadenopathy.
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Generate impression based on findings.
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76 year-old male with history of base of tongue cancer. The orbits are unremarkable. The paranasal sinuses are clear. Limited view of the intracranial structure is unremarkable. Mild left mastoid air cells opacification appears unchanged.Again identified are postsurgical changes in the neck with asymmetry of the tongue base associated with loss of volume of the left hemitongue. Post therapy change including mucosal edema involving the oropharyngeal and hypopharyngeal soft tissues is not significantly changed compared to prior examination. No recurrent mass is identified. Redemonstrated is a left sided supraclavicular lymph node which measures 10 x 6 mm, (series 7 image 61), not significantly changed compared to previous examination, measuring 11 x 6 mm. No evidence of lymphadenopathy is identified. Degenerative changes are seen in the cervical spine.
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Stable post treatment changes of the neck. No evidence of pathological lymph nodes or recurrent tumor.
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Generate impression based on findings.
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Male 37 years old; Reason: COLON CANCER S/P HEPATIC RESECTION OF TUMOR IN MARCH 2013. EVALUATE FOR INTERVAL CHANGE History: COLON CANCER CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval takedown of the right lower quadrant ostomy with reanastomosis. There has also been interval resolution of the previously seen small bowel obstruction. No free air, pneumatosis, or residual obstruction detected.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Interval resolution of the previously seen small bowel obstruction with interval takedown of the right lower quadrant ostomy and re-anastomosis. No residual obstruction, free air, nor pneumatosis.2.No recurrent or metastatic disease 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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59 year old male. Reason: Stage IV colon cancer. Please compare to previous scan and provide index lesion measurements. CHEST:LUNGS AND PLEURA: Stable biapical scarring. Stable emphysema. Scattered pulmonary micronodules, unchanged.MEDIASTINUM AND HILA: There is interval resolution of the previously described nonocclusive thrombus associated with right central venous catheter, however, the caliber of the SVC appears diminished when compared to the prior study.CHEST WALL: Right sided venous access device is in the expected position with the tip terminating in the SVC. ABDOMEN:LIVER, BILIARY TRACT: The reference left lobe mass lesion has increased in size as seen on image 89 of series 3, now measuring 9.3 x 9.4 cm, previously 9 x 7.6 cm. The other numerous bilobar hepatic metastases appear similar with respect to size compared to the prior study. The reference segment 7 right lobe lesion as seen on image 98 of series 3 measures 3.7 x 2 .9 cm, previously 3.0 x 2.6 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable upper pole left renal focus best seen on image 114 of series 3 measuring 1.5 x 1.5 cm.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No change in sigmoid colonic mass.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Persistent bilobar hepatic metastatic lesions. While the reference hepatic lesions appear slightly increased in size, many of the metastatic lesions appear stable, when compared to the prior study2. Interval resolution of the previously described thrombus in the SVC. However, the caliber of the SVC appear significantly diminished when compared to the prior study and may have limited flow capability.
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Generate impression based on findings.
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54-year-old male with history bladder cancer. Status post multiple resections. Evaluate for recurrence. Within the limits of a non-IV contrast enhanced examination limiting evaluation of solid parenchymal organs and vascular structures, the following observations can be made:CHEST:LUNGS AND PLEURA: Since prior examination is been surgery in the left chest with resection of the prior noted left upper lobe nodule. No new nodules or air space consolidation foci are seen. Left lateral scarring/rounded atelectasis is seen laterally.MEDIASTINUM AND HILA: No enlarged lymph nodes are seen in the mediastinum or hilar regions -- the prior referenced paratracheal lymph node is no longer visualized and may have been removed at prior surgery.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Prior right nephrectomy. Left kidney left cyst, unchanged -- no other abnormalities, however, lack of IV contrast limits ability to evaluate parenchyma for small lesions. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes and anastomoses without intrinsic other abnormality. No free mesenteric fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Status post cystectomy with continent neobladder unchanged in appearance.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes -- No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Status post cystectomy with continent neobladder unchanged. 2. Status post interval left chest surgery with no evidence of recurrent or residual tumor seen. 3. No evidence of abdominal residual or metastatic tumor.
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Generate impression based on findings.
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Male 66 years old; Reason: stage IIB colon cancer completed therapy June 2011. Evaluate for disease recurrence History: Stage IIB colon cancer CHEST:LUNGS AND PLEURA: Stable micro nodules without new or suspicious nodule or mass detected. MEDIASTINUM AND HILA: No thoracic lymphadenopathy. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Normal hepatic contour. Fatty infiltration noted. No suspicious lesions detected. The gallbladder and biliary system are normal. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Large right renal calculus, without hydronephrosis, is unchanged. Subcentimeter nonobstructive left renal calculus is also unchanged. RETROPERITONEUM, LYMPH NODES: Stable mild aneurysmal dilatation of the infrarenal abdominal aorta, maximal AP diameter of 3 cm. Calcified and noncalcified atherosclerotic plaque particularly along the anterior and right lateral aspect of the aorta again seen.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: Stable postsurgical changes sigmoid colon.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of metastatic disease in the chest, abdomen, or pelvis. Stable examination.
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Generate impression based on findings.
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88 year old female with history of gross hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis. Multiple hemangiomas and benign cysts in the liver. Common bile duct is borderline dilated and there is minimal intrahepatic biliary prominence.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of renal stones, focal renal lesions or hydronephrosis.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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Cholelithiasis. Liver hemangiomas and benign cysts. No CT findings to explain patient's hematuria
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Generate impression based on findings.
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76 year-old male. T2N0 BOT SCC status post FHX 5/8/2009. Reevaluate. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative abnormalities of the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hepatic cysts, unchanged. Subcentimeter hypodense lesions in the liver are too small to accurately characterize but also likely cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Unchanged left adrenal nodule dating back to 2009, most likely a benign adenoma.KIDNEYS, URETERS: Right renal peripelvic cyst. Left renal upper pole cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastasis or other significant abnormality.
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Generate impression based on findings.
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Male; 52 years old. Reason: 52 M with stage III colon cancer s/p resection, please eval for evidence of disease recurrence. History: none CHEST:LUNGS AND PLEURA: Stable nonspecific bilateral pulmonary micronodules.MEDIASTINUM AND HILA: No evidence of mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest port with tip at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: No evidence of suspicious hepatic lesion. No intra-or extrahepatic ductal dilatation. The gallbladder is unremarkable.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: Interval decrease in size of mesenteric lymph node adjacent to the proximal colon, best seen on image 136 of series 6, which now measures 7 mm, previously 10 mm.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: Extensive sigmoid diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Interval decrease in size of mesenteric lymph node adjacent to the proximal colon near the anastomosis.
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Generate impression based on findings.
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65-year-old male. Cough. Follow-up abscess. Evaluate for underlying malignancy. LUNGS AND PLEURA: Unchanged right upper lobe linear scarring at site of prior consolidation seen on April and May 2013 CTs. No underlying suspicious mass is evident.6 mm right lower lobe peripheral nodule on series 5, image 62 is unchanged from 5/2012, new compared to 4/2013. As it is smoothly marginated, it is likely benign unless patient has a known extrathoracic malignancy. Additional scattered micronodules are stable and benign.Mild upper lobe centrilobular emphysema.MEDIASTINUM AND HILA: Mild prominent mediastinal and hilar lymph nodes, not significantly changed. Severe coronary artery calcifications.CHEST WALL: Moderate degenerative arthritic changes of the thoracic spine. Atrophy of right paraspinal musculature or lipomatous infiltration, unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted..
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1. Resolved right upper lobe infection with mild residual linear scarring. 2. 6-mm right lower lobe peripheral nodule is stable and likely benign. 12-18 month follow-up recommended.
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Generate impression based on findings.
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Reason: pe? History: elevated d-dimer, cp PULMONARY ARTERIES: No evidence of a pulmonary embolus.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Residual thymic tissue the anterior mediastinum.No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of pulmonary embolus. No significant pulmonary or pleural abnormalities.
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Generate impression based on findings.
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62-year-old female with metastatic stage IV colon cancer status post hepatic resection 2004. Completed therapy in June of 2005 Evaluate for interval change. CHEST:LUNGS AND PLEURA: Several scattered nonspecific micronodules are unchanged from prior study. No evidence of suspicious nodules.MEDIASTINUM AND HILA: Enlarged heterogeneous multinodular thyroid gland, unchanged. Normal cardiac size without pericardial effusion. No evidence of hilar, mediastinal or axillary lymphadenopathy.CHEST WALL: Right-sided central venous catheter with tip terminating in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Mild hepatomegaly without evidence for a focal mass lesion, unchanged Status post cholecystectomy. Right hepatic lobe calcification unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Ptotic right kidney, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of a right hemicolectomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Leiomyomatous uterus, unchanged.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable examination without evidence of recurrence.
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Generate impression based on findings.
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Reason: cardiopulm abnormality? History: shortness of breath LUNGS AND PLEURA: Patchy and ground glass opacity, greater at the apices with septal thickening and small pleural effusions.Multiple focal nodular air space opacities which may be due to infection or possibly edema.Bilateral basilar compressive atelectasis.MEDIASTINUM AND HILA: Dilated main pulmonary artery measuring 38 mm in diameter, consistent with pulmonary hypertension.Cardiomegaly and severe coronary artery calcification.No pericardial effusion.CHEST WALL: Moderate degenerative disease in the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple surgical clips in the left upper quadrant.
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1.Pulmonary hypertension with CHF, pleural effusions and extensive lower lobe atelectasis.2. Patchy bilateral airspace opacities suggestive of infection.
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Generate impression based on findings.
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75-year-old male with history of prostate cancer. Evaluate for metastatic disease. ABDOMEN:LUNG BASES: Scarring with calcification at left lung base -- No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Punctate calcifications most likely from prior granulomatous disease -- no other abnormalities.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No adenopathy -- No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes without significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No enlarged lymph nodes to suggest lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes without significant abnormality notedOTHER: No significant abnormality noted
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No evidence for metastatic disease in the abdomen or pelvis. No significant abnormalities detected.
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Generate impression based on findings.
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Reason: Eval possible mets History: HCC, HCV, cirrhosis LUNGS AND PLEURA: No suspicious nodules or pleural effusion.MEDIASTINUM AND HILA: No significant lymphadenopathy.No pericardial effusion.CHEST WALL: Moderate degenerative disease in the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Nodular liver with poorly visualized lesions, better defined on a recent abdominal CT scan.
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No evidence of pulmonary metastases.
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Generate impression based on findings.
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64-year-old male with history of prostate cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of metastatic disease.
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Generate impression based on findings.
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48-year-old male with history of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Stable micronodulesMEDIASTINUM AND HILA: Index precarinal node measures 1.2 x 0.8 cm on image number 41, series number 3 This is unchanged from prior study.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. No focal liver lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left nephrectomy. Right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: Retrocaval index node measures 2.1 x 1.6 cm image number 114, series number 3, minimally increased in size compared to previous study. A more superior aortocaval, enhancing mass invades inferior vena cava and now measures 3.2 by 2.1-cm image number 103, series number 3. This is not significantly changed in size compared to previous study.Enhancing mass invading the left hemidiaphragm is increased in size and measures 3.6 by 1.7 cm, image number 97, series number 3. Previously, it was measuring 3 x 1.4 cm on image number 86, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Minimal interval increase in the size of the retrocaval adenopathy and left mass invading the left hemidiaphragm.Enhancing metastatic lesion invading the inferior vena cava at the level of the portal confluence, not significantly changed from previous study.
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Generate impression based on findings.
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History of colorectal cancer CHEST:LUNGS AND PLEURA: Emphysema. Subpleural scarring in both lungs.MEDIASTINUM AND HILA: Small mediastinal lymph nodes, nonspecific.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst. Small, hypodense lesions in the left kidney, which are too small to accurately characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left lower quadrant colostomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No CT evidence of metastatic disease. Emphysema and bilateral subpleural scarring.
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Generate impression based on findings.
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History of posterior kidney disease presenting with bilateral flank pain and hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral kidneys are enlarged, with bilateral numerous cysts of varying density and size consistent with patient's known history of poses the kidney disease. Some of the cysts contain calcifications in their walls. Some of these calcifications may also represent stones. No definite enhancing mass is noted within the both kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Findings consistent with both cystic kidney disease. No obvious enhancing mass is noted in both kidneys. Possible stones versus cyst wall l calcifications in the kidneys.
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Generate impression based on findings.
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History of non-Hodgkin lymphoma CHEST:LUNGS AND PLEURA: Scarlike opacity in the right middle lobe and right lower linea atelectasis, unchanged.MEDIASTINUM AND HILA: Nodular, ill defined soft tissue in the anterior mediastinum is unchanged from previous study.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Splenic hypodense lesion is now smaller, measuring 4.3 x 3 cm, image number 82, series number 3.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: Index mesenteric lymph node measures 2.7 x 1 .3 cm, image number 126, series number 3, smaller compared to previous study. Hazy density of the small bowel mesentery is unchanged.BONES, SOFT TISSUES: Sclerotic lesion involving L1 vertebral body and sacrum are unchanged.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: Small amount of fluid in the pelvis.
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Slight interval decrease in the size of the splenic and mesenteric index lesions.
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Generate impression based on findings.
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Female 76 years old; Reason: 76 F with metastatic colon cancer, now without evidence of disease. Please eval for interval change. History: none CHEST:LUNGS AND PLEURA: No suspicious nodules. Scattered areas of linear atelectasis. The pleural spaces remain clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Stable borderline adenopathy with a mediastinal node measuring 1.1cm in short axis.The previously seen paraesophageal lymph node is not well visualized on this examination.CHEST WALL: Bilateral breast prosthesis.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious masses are noted. Subcentimeter hypodense focus in the left hepatic lobe is unchanged, likely benign.Mild intrahepatic ductal dilatation persists.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 enlarged abdominal nodes seen to suggest active lymphadenopathy. Prior measured portocaval node measures 7 mm in short axis, within normal limits.Moderate atherosclerotic disease of the aorta and branch vessels.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No recurrent or metastatic disease detected with reference 7 mm lymph node measurement provided above.
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Generate impression based on findings.
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22-year-old male with history of testicular cancer, status post orchiectomy and chemotherapy CHEST:LUNGS AND PLEURA: 6 x 4 mm left upper lobe lung nodule on image number 52, series number 6, smaller in size compared to previous study. Subcentimeter nodule in the right middle lobe on image number 54, series number 6, unchanged.Previous described left lower lobe nodule is no longer visualized.MEDIASTINUM AND HILA: Right aortic arch with aberrant left subclavian, normal anatomic variant, again noted.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Interval placement of right double J stent.RETROPERITONEUM, LYMPH NODES: Interval decrease in the size of the aortocaval adenopathy. Aortocaval node now measures 2.2 x 1 .4 cm on image number 122, series number 4. Previously, a closed, measuring 3.3 x 2 .7 cm, image number 31, series number two on CT dated 9/30/2013. Other retroperitoneal predominantly aortocaval and pericaval lymph nodes have also decreased in size within the internal.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval decrease in the size of the extensive retroperitoneal lymph nodes and pulmonary nodules.
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Generate impression based on findings.
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55 year-old male with posterior headache. The ventricles, sulci, and cisterns are symmetric. There is mild volume loss of the cerebellum. Incidental cavum septum pellucidum. 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. Bilateral staphylomasThere is diffuse left parietooccipital scalp swelling.
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1. No acute intracranial abnormality. 2. Diffuse left parietooccipital scalp thickening, which is nonspecific and may representing inflammation or subgaleal hematoma. Clinical correlation is recommended.
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Generate impression based on findings.
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56-year-old female with metastatic colon cancer. Evaluate for interval changes from prior therapy. CHEST:LUNGS AND PLEURA: No change in the right apical partially calcified soft tissue mass radiating from hila postero-laterally. Scattered granulomata, some calcified throughout the lungs are again seen, unchanged. No new foci of nodules, masses or airspace disease are seen. No pleural disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest wall Port-A-Cath with tip of the catheter in the distal superior vena cava.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: The solid mass seen on 2/20/13 CT examination and noted to be markedly decreased on 9/19/13 remains stable since most recent CT with mass now measuring 1.2 x 0.7 cm (series 3, image 92). There is, just lateral to this mass and unchanged a small unilocular cyst, which has always appeared separate from this mass. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: There is been substantial increase in size and number of periaortic and aortic caval lymph nodes since 9/19/13. Referenced, superior, abdominal node measures 1.8 x 1.3 cm (series 3, image 106) which has increased from prior 0.9 x 0.8 cm. the largest of these (series 3, image 118) measures 2.2 x 2.0-cm, which has increased since prior (1.4 x 0.8 cm)BOWEL, MESENTERY: The large cecal mass is again seen with minimal change, however, the adjacent, lymph nodes previously reported as small have markedly increased in size and the largest now measures 2.1 x 1.4 cm (series 3, image 125).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Large midline mass which appears most likely to arise from the uterus, as a large fibroid masses. No change from prior and no other abnormalities..BLADDER: No significant abnormality noted.LYMPH NODES: Pelvic lymph nodes have increased in size with the prior referenced left iliac lymph node (series 3, image 133) now measuring 1.7 x 1 .7 cm, previously 1.3 x 1.0 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Marked increase in retroperitoneal and pelvic lymphadenopathy. 2. Stable appearance to small residual pancreatic mass compared with original 2/20/13 CT examination. 3. Right cecal mass with minimal change, but with substantial enlargement and pericecal lymph nodes.
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Generate impression based on findings.
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2 year-old male with altered mental status. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear. There are fluids in the paranasal sinuses.
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1. No acute intracranial abnormality. 2. Evidence of acute sinusitis.
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Generate impression based on findings.
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77 year-old female with renal cancer. History, weight loss, and pulmonary nodules. Rule-out malignancy. CHEST:LUNGS AND PLEURA: The prior noted. Multiple nodules seen on prior chest CT have resolved without any residual. No new foci of airspace disease, nodules or masses are seen. No pleural disease..MEDIASTINUM AND HILA: Slightly prominent. Mediastinal lymph nodes are unchanged. The prior referenced precarinal lymph node (series 4, image 40) measures zero .9 cm, unchanged. No new foci of enlarged lymph nodes are seen.Coronary artery calcification and aortic calcifications again seen.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left nephrectomy without evidence of residual tumor seen. Right kidney shows duplicated right renal collecting system. The lower pole collecting system is unchanged in collapsed. The upper pole collecting system shows new hydronephrosis versus new parapelvic cyst. No delay excretory images were obtained, which could be helpful to differentiate these. No mass lesion is seen centrally to account for the apparent upper pole dilatation.No parenchymal solid mass lesions are seen with no change in the multiple benign cysts. RETROPERITONEUM, LYMPH NODES: No enlarged lymph nodes seen to suggest lymphadenopathy. No other abnormalities. Other than atherosclerotic changes in the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Marked degenerative changes throughout the lumbar spine with apparent marked spinal canal narrowing (series 4, image 130). No focal lesion seen to suggest metastatic disease.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus, unchanged.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes without focal lesion seen to suggest metastatic disease.OTHER: No significant abnormality noted.
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1. Status post left nephrectomy. No evidence of recurrent or residual tumor disease. 2. Bifid right renal collecting system with apparent dilatation of the upper pole moiety. As no delay excretory phase imaging was obtained this cannot be further evaluated. If further imaging would be helpful to clinically evaluate as patient, dedicated renal examination with delay excretory imaging could be helpful. 3. Marked degenerative changes in the lumbar spine with spinal stenosis.
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Generate impression based on findings.
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86 year-old male with syncope. There is patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality. Small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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82-year-old female. Evaluate interval change in size of pulmonary nodules and biliary system. CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules, some of which are clustered in the right upper lobe, are not significantly changed dating back to 3/2013. This includes the 12 mm largest nodule in the right lower lobe (series 5, image 60). These are likely post-inflammatory. Mild upper lobe paraseptal emphysema.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. CHEST WALL: Degenerative arthritic changes of the lumbar spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Again noted is a dilated common bile duct and prominent pancreatic duct down to the level of the ampulla. This is not significantly changed from 3/2013 CT. Consider MRCP for further evaluation.No focal liver lesion.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter renal hypodensities are too small to characterize but unchanged, likely cysts. Right interpolar renal cyst.PANCREAS: Atrophic pancreas and dilated pancreatic duct to the level of the ampulla, not significantly changed. No discrete mass is evident.RETROPERITONEUM, LYMPH NODES: Calcified atherosclerotic calcification of the abdominal aorta without aneurysmal dilatation.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. Multiple bilateral pulmonary nodules, not significantly changed dating back to 3/2013, and likely post-inflammatory/benign. Follow-up CT in 12 months is recommended.2. Unchanged biliary and pancreatic ductal dilatation. Consider MRCP for further evaluation.
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Generate impression based on findings.
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77 year-old female status post fall. The ventricles, sulci, and cisterns are symmetric and appropriate for the patient's age. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. Intracranial arterial calcification. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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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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52-year-old female. Cough and short of breath. Evaluate for pneumonia. LUNGS AND PLEURA: Multifocal bilateral nodular opacities, some with surrounding groundglass. There are some clustered micronodules in the left upper lobe.Mild centrilobular emphysema. Dependent bibasilar subsegmental atelectasis. No pleural effusion.MEDIASTINUM AND HILA: Previously seen hypodensity in the left lobe of the thyroid is not well visualized on today's exam, likely due to technique.Main pulmonary artery is enlarged at 3.9 cm in diameter consistent with patient's history of pulmonary arterial hypertension.Heart size is at upper limit of normal. Small unchanged pericardial effusion. Right jugular catheter tip is at the cavoatrial junction.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Unchanged hepatic subcentimeter hypodensities, too small to characterize, but likely cysts.
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Multifocal nodular opacities and clustered left upper lobe micronodules. Atypical infection, including fungal etiologies is most likely.
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Generate impression based on findings.
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Reason: follow up to ct from 10-29 / h/o post thigh excision sarcoma History: metastatic evaluation LUNGS AND PLEURA: Interval resolution only 3-mm left lower lobe micro-nodule, presumably due to infection.No suspicious nodules.MEDIASTINUM AND HILA: No mediastinal lymphadenopathy. The heart is normal in size without pericardial effusion. Right pericardial cyst again noted. Minimal coronary artery calcifications.CHEST WALL: Unchanged punctate sclerotic focus in T2 vertebral body. No new or suspicious osseous lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Interval resolution of left lower lobe micro-nodule, consistent with infection.No evidence of metastatic disease.
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Generate impression based on findings.
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Female 58 years old; Reason: H/o small bowel lymphoma, s/p chemo please restage History: N/V/abd pain CHEST:LUNGS AND PLEURA: Minimal left basal atelectasis. Scattered bilateral pulmonary micronodules, appearing similar to the prior study. No new or suspicious pulmonary nodules or masses are identified. Pleural spaces remain clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.Right chest wall port terminates at the cavoatrial junction.CHEST WALL: Bilateral breast prosthesis. Interval removal of right chest port.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. The common bile duct measures 12 mm at the head of the pancreas appearing similar to the prior study. There is mild intrahepatic ductal dilatation.Hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Post operative changes in the lumbar spine with pedicle screw fixation of the lower lumbar spine/upper sacrum.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic or inguinal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Stable exam without evident disease in the chest, abdomen or pelvis.2.Persistent mild intra-extrahepatic biliary ductal dilation.
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Generate impression based on findings.
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70 year-old male with parotid cancer and status post resection. The orbits are unremarkable. The paranasal sinuses are clear. There is partial opacification of the mastoid air cells. Limited view of the intracranial structure is unremarkable. Status post left parotidectomy and resection of the left condylar process. There are surgical clips and nonspecific soft tissue in the surgical bed, which is inseparable with the left SCM. No lymphadenopathy or mass is noted. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The right parotid, submandibular, and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent. Calcifications at the bilateral carotid bifurcations. DISH and mild degenerative disc disease of the cervical spine are present. The osseous structures are otherwise unremarkable. Limited view of the chest is unremarkable.
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Postsurgical changes status post left parotidectomy and resection of the left condylar process. Nonspecific soft tissue in the surgical bed, which could representing granulation tissue. However, Tumor cannot be ruled out entirely. Continued follow-up is recommended. No lymphadenopathy or mass is noted.
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Generate impression based on findings.
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54-year-old male with history of squamous cell carcinoma of the tongue. Post induction evaluation. CHEST:LUNGS AND PLEURA: 9-mm groundglass nodule in the right apex (image 63, series #4) is unchanged in size and appearance. Appearance is highly suspicious for atypical adenomatous hyperplasia, adenocarcinoma in situ, or minimally invasive adenocarcinoma.MEDIASTINUM AND HILA: The previously noted mildly enlarged subcarinal lymph node measures slightly smaller on the current exam at 9 mm in its short axis. Other scattered nonenlarged mediastinal lymph nodes are noted.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Sludge and/or small gallstones in the gallbladder.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Left adrenal nodule measures 1.7 x 0.9 cm and is incompletely evaluated though unchanged from 10/16/2013.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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1.Right apical ground glass nodule without perceptible change remains suspicious for indolent primary adenocarcinoma. Follow-up CT scan in approximately 6 months is recommended to evaluate interval growth.2.Incompletely evaluated all left adrenal nodule, stable and likely of benign etiology.
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Generate impression based on findings.
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Female 36 years old; Reason: Met breast cancer needs evaluation from treatment and compare to prior lung nodules. History: Met breast cancer needs evaluation from treatment and compare to prior lung nodules. CHEST:LUNGS AND PLEURA: There is interval increase in size and number of numerous bilateral pulmonary nodules and groundglass opacities consistent with the stated history of metastatic breast carcinoma. The reference right upper lobe mass measures 4.2 x 3.2 cm, previously 2.8 x 1.7 cm (image 39/series 5). There are multiple other parenchymal masses which also appear increased in size. A new nodule is identified in the left lower lobe. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. Extensive poorly enhancing mediastinal and hilar lymphadenopathy also appears increased in size. A right paratracheal mass measures 2.6 x 1 .9 cm, previously 2.4 x 1.7 cm (image 28/series 3). CHEST WALL: Bilateral mastectomies with postoperative changes in the axilla.Left chest wall port terminates at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: There is a smooth contour. There are several subcentimeter hypodense hepatic foci which are too small to characterize. Probable fatty infiltration of 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 significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The uterus is atrophic or surgically absent.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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Significant interval increase in size as well as number of the previously described pulmonary lesions as well as mediastinal lymphadenopathy suspicious for metastatic disease.
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Generate impression based on findings.
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25 years old Male. Reason: s/p bilateral lug transplant for cystic fibrosis History: recurrent bouts of pneumonia,headaches, fever and congestion The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There is diffuse mucosal thickening of the maxillary sinuses with near complete opacification with high-density material. The sphenoid sinuses are hypoplastic and contain fluid. Extensive ethmoidal soft tissue opacities are present. The right middle turbinate appears surgically absent. There is significant leftward deviation of the nasal septum, which contacts the left middle turbinate. The ostiomeatal units are patent and intact.The left lamina papyracea is thinned in multiple segments. No bulging of the sinus contents into the orbit is identified. No destructive osseous changes are evident.
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Extensive opacity throughout the paranasal sinuses with high-density in the maxillary sinuses, suggestive of a fungal sinusitis.
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Generate impression based on findings.
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64 year old female with metastatic breast cancer and left neck mass. Evaluate response to treatment. CHEST:LUNGS AND PLEURA: Left apical scarring/atelectasis, appearing similar to the prior study may represent post radiation/therapy changes. The reference right lower lobe nodule has resolved and may have simply represented fluid within the major fissure. Again seen are additional bilateral multiple pulmonary nodules, appearing similar to the prior study. No new pulmonary nodules or masses are identified. There is elevation of the left hemidiaphragm, unchanged.MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes are again seen. The reference left paratracheal node measures 1.1 x 1 .7 cm, previously 1.4 x 1.9 cm (series 3, image 28). Heart size normal. No pericardial effusion. Prominent main pulmonary artery measuring 3.1 cm in diameter.Right venous catheter terminates in right atrium.CHEST WALL: Infiltrative left supraclavicular mass extending into the left axilla and left lateral chest wall; reference left axillary centrally necrotic lesion measures 4.6 x 3.8 cm, previously 3.9 x 3.5 cm (series 3, image 28). Again seen is a mass lesion along the anterior aspect of the left humerus, appearing similar to the prior study.Please see dedicated neck CT report for findings regarding destructive, ulcerated left lower neck lesion.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: Multiple subcentimeter hypodensities in the left kidney, which are too small to characterize, but likely represent simple cysts, appearing similar to the prior study.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: Right iliac fossa kidney.
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Slight interval increase is size of the reference supraclavicular mass with persistent multiple pulmonary nodules and mediastinal lymphadenopathy consistent with the stated history of metastatic breast carcinoma. Please see CT of neck examination report for further details regarding the left lower neck lesion.
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Generate impression based on findings.
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Male 56 years old; Reason: nephrolithiasis? History: r sided flank pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Patient is status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. Atherosclerotic disease of the aorta and branch vessels are noted.BOWEL, MESENTERY: No significant abnormality noted. Patient is status post appendectomyBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No acute intra-abdominal process detected.
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Generate impression based on findings.
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Female 61 years old; Reason: h/o RCC History: none ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Fatty infiltration of the liver is noted. Small hypoattenuating lesion in segment 4 A. is seen, likely a cyst. There is no intra or extrahepatic ductal dilation. Small polyp is noted in the gallbladder which is stable.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: The left adrenal gland is nodular, without discrete mass. The right is normal.KIDNEYS, URETERS: Patient is status post right partial nephrectomy with resection of the previously seen inferior pole renal cell carcinoma. Hypodense soft tissue attenuating likely post operative in nature. Few too small to characterize lesions are noted in the kidneys bilaterally. No perinephric fluid collections or hydronephrosis is detected.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small right fat containing spigelian herniaPELVIS:UTERUS, ADNEXA: S/P hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Status post partial right nephrectomy with expected post operative changes in the right inferior pole. No recurrent or metastatic disease detected.
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Generate impression based on findings.
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61 year-old male. Reason: h/o spina bifida, tethered cord, myoclonus, intrathecal pump with sepsis and abd pain. Pump in LLQ with surrounding fluid collection. Eval for abscess and further etiology of abd pain. History: abdominal pain and guarding ABDOMEN:LUNG BASES: Stable benign micronodules along the pulmonary fissures. LIVER, BILIARY TRACT: Normal hepatic contour. Fat infiltration of the liver has resolved. SPLEEN: Splenic varices are stable. PANCREAS: Fatty atrophy of the pancreasADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The kidneys are symmetric. No renal abscess or perinephric fluid collection. Stable bilateral renal cysts. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: No retroperitoneal fluid collection. Infrarenal IVC filter is present. Left paraaortic nodularity is due to collateral venous drainage, and not lymphadenopathy. BOWEL, MESENTERY: Normal caliber bowel loops. BONES, SOFT TISSUES: Extensive postsurgical changes of the lumbosacral spine. Generator in subcutaneous left anterior abdominal wall, with lead coursing into the thoracic spine thecal sac. OTHER: Multiple abdominal wall collateral vessels are unchanged. Fat-containing umbilical hernia.PELVIS:PROSTATE, SEMINAL VESICLES: Prostate calcifications BLADDER: Suprapubic bladder catheter present. Diffuse bladder wall thickening, probably due to chronic inflammatory change.LYMPH NODES: Nonenlarged bilateral external iliac lymph nodesBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Extensive postsurgical changes of the posterior lumbosacral spine as seen on prior lumbar spine MRI from November 2012. Osseous hypertrophy and posteriorly along the lower sacrum. Soft tissue thickening posterior to the sacrum at the level of sacral postsurgical changes is incompletely characterized by CT, new since December 2009, and incompletely imaged on prior lumbar spine MRI. No CT evidence of osseous destruction.OTHER: Spinal stimulator in left upper quadrant with electrode in the thoracic spine.
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1. No renal abscess or perinephric fluid collection.2. Bladder wall thickening and suprapubic tube are unchanged, suspicious for chronic cystitis.3. Extensive postsurgical changes of the posterior lumbar spine. Soft tissue thickening posterior to the sacrum at the level of sacral postsurgical changes is incompletely characterized, but stable.
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Generate impression based on findings.
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Shortness of breath. Pre-op robotic mitral valve replacement. VESSELS:The distance from the sinotubular junction to the innominate artery is approximately 8cm.SINUS OF VALSALVA: 3.2 x 3.4 x 3.2 cmSINOTUBULAR JUNCTION: 2.9 X 2.9 cmASCENDING THORACIC AORTA AT LEVEL OF MAIN PULMONARY ARTERY: 3.2 X 3.2 cmASCENDING THORACIC AORTA IMMEDIATELY PROXIMAL TO THE INNOMINATE ARTERY: 3.1 X 2.9 cmPROXIMAL DESCENDING THORACIC AORTA IMMEDIATELY DISTAL TO THE LEFT SUBCLAVIAN ARTERY: 2.5 X 2.3 cmDESCENDING THORACIC AORTA AT LEVEL OF HIATUS: 2.3 X 2.6 cmSUPRARENAL ABDOMINAL AORTA: 2.3 X 1.9 cmINFRARENAL ABDOMINAL AORTA: 1.5 X 1.4 cmRIGHT COMMON ILIAC ARTERY: 9 X 8 mmRIGHT EXTERNAL ILIAC ARTERY: 7 X 7 mmRIGHT COMMON FEMORAL ARTERY: 7 X 6 mmLEFT COMMON ILIAC ARTERY: 9 X 10 mmLEFT EXTERNAL ILIAC ARTERY: 8 X 8 mmLEFT COMMON FEMORAL ARTERY: 7 X 7 mmCHEST:LUNGS AND PLEURA: Mild apical and basilar scarring. No significant abnormality otherwise noted.MEDIASTINUM AND HILA: Prominent left atrium. Minimal atherosclerotic calcification of the thoracic aorta. No significant abnormality otherwise noted.CHEST WALL: Moderate degenerative changes of the thoracic spine. No significant abnormality otherwise noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Prominent nodular-appearing adrenal glands bilaterally. KIDNEYS, URETERS: Bilateral renal cysts. Focal right renal cortical thinning likely represents sequelae of prior infection. Accessory left renal artery. No significant abnormality otherwise noted.RETROPERITONEUM, LYMPH NODES: Minimal atherosclerotic calcification of the abdominal aorta. No significant abnormality otherwise noted.BOWEL, MESENTERY: Small sliding type hiatal hernia. Small more of nonspecific fluid in the hepatic flexure. No significant abnormality otherwise noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus. No significant abnormality otherwise 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.
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1. No dissection or aneurysm of the aorta. Orthogonal dimensions of the access vasculature are as above.2. Prominent non-specific nodular-appearing adrenal glands. Correlation with lab values may be helpful, if clinically warranted.3. Small sliding-type hiatal herniaI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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40 year-old female with diminished pedal pulses. Assess aorta and iliac arteries for kidney transplant. Pre-kidney transplant evaluation. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The kidneys are small and atrophic.RETROPERITONEUM, LYMPH NODES: There is minimal atherosclerotic calcification along the posteromedial aspect of the common iliac arteries. There is approximately 3 mm of atherosclerotic calcification along the posteromedial right common iliac artery. There is punctate atherosclerotic calcification affecting the medial aspect of the left common iliac artery. No atherosclerotic calcifications are seen affecting the left or right external iliac arteries. Note is made of vascular calcifications of the aorta and its branches. There is concentric calcification of the SMA as well as the femoral arteries and their branches, bilaterally. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Note is made of a small fat-containing umbilical hernia.OTHER: 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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Minimal vascular calcification of the iliac arteries, as described above.
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Generate impression based on findings.
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25 year old female with a history of ARDS secondary to influenza A with fevers and rising leukocytosis. Concern for intra-abdominal infection. Please evaluate. CHEST:LUNGS AND PLEURA: Note is made of scattered bilateral, diffuse groundglass opacities and nodular consolidation with associated air bornchograms, consistent with the stated history of atypical infection with ARDS. There are small bilateral pleural effusions, right greater than left. There is no evidence of pneumothorax. ET tube terminates approximately 1 cm above the level of the carina. MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Note is made of a prominent supraclavicular lymph nodes.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: NG tube tip terminates in the body of the stomach.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: Rectal balloon in place. No dilated loops of bowel to suggest obstruction. No free intraperitoneal air, pneumatosis intestinalis, or portal venous gas.BONES, SOFT TISSUES: Sclerosis of the iliac bone along the left sacroiliac joint likely represents osteitis condensans ilii. OTHER: Note is made of a small amount of free fluid within the pelvis which is nonspecific, but may be physiologic.
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1. Diffuse bilateral groundglass and nodular opacities and air bronchograms consistent with a stated history of viral infection complicated by ARDS. The ET tube tip terminates 1 cm above the level of the carina. 2. Small bilateral pleural effusions.3. No findings to suggest intra-abdominal infection, as clinically questioned.
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Generate impression based on findings.
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33 year-old male with seizure. Extensive encephalomalacia in the bilateral frontal lobes, left greater than right related to prior intracranial hemorrhage is demonstrated. Left parietal lobe encephalomalacia is stable. There is no interval rehemorrhage. There is no evidence of mass effect or midline shift. The ventricles are mildly prominent at least partially related to ex vacuo dilatation. The visualized portions of the paranasal sinuses and mastoid air cells are clear except for mild paranasal sinus mucosal thickening.
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1.No evidence of new bleed or mass effect.2. Stable extensive encephalomalacia as detailed above
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Generate impression based on findings.
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Male; 74 years old. Reason: Multiphase renal CT scan to evaluate renal lesions seen on recent CT scan. History: Progressive weight loss. Innumerable renal lesions poorly characterized on contrast CT ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Liver parenchyma without evidence of suspicious lesions. Multiple punctate hypodensities are too small to characterize but likely represent simple cysts. No intra-or extrahepatic ductal dilatation. The gallbladder is unremarkable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Small nodule in the right adrenal gland measuring 1.4 x 1.0 cm with 82% washout consistent with a benign adenoma.KIDNEYS, URETERS: Numerous bilateral subcentimeter hypodense renal lesions are too small to characterize. A few of these lesions, with representative lesion best seen on image 45 of series 8, demonstrate thick, enhancing septae which may represent complex cysts although renal cell carcinoma cannot be excluded. Follow-up MRI is recommended for further evaluation.RETROPERITONEUM, LYMPH NODES: Severe diffuse atherosclerotic calcifications of the aorta and it's branches. Aortobifemoral graft is patent.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Numerous subcentimeter bilateral renal cysts, some complex, are too small to characterize. Renal cell carcinoma cannot be entirely excluded. Follow-up with MRI is recommended in 6 months.2.Benign right adrenal adenoma.
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Generate impression based on findings.
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83-year-old male status post status post retroperitoneal sarcoma resection with rectal injury and repair on 12/04/13, then developed abscess in the pelvis concerning for leak from rectal repair. Placed drain in the pelvic collection by IR. Please evaluate abscess. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is surgically absent. There is bilateral incompletely visualized ureteral stents and a Foley catheter in the neobladder. Foci of gas density within the neobladder may be related to recent instrumentation.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Again seen is a percutaneous drain in the midline and slightly to the left of the rectum in a previously described pelvic collection containing high density fluid and gas. The drain pigtail catheter is in the caudal portion of the aforementioned pelvic collection. The collection measures 9.1 x 4.5 cm, previously 9.7 x 5.4 cm in axial dimension (series 3 image 43) and 6.9 cm in the craniocaudal dimension, previously 8.9 cm (coronal image 50). Rectal contrast is noted in the rectum and distal sigmoid colon. Note is made of high density fluid within the aforementioned abscess collection which is suspicious for a rectal leak or fistula formation. There is thickening of the rectal wall. Multiple surgical clips are seen in the pelvis.BONES, SOFT TISSUES: Bilateral inguinal hernias contain mesenteric fat. Multilevel degenerative changes affect the visualized lower lumbar spine.OTHER: No significant abnormality noted
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Interval decrease in size of the previously described pelvic abscess with percutaneous drain in place. Note is made of high density material within the aforementioned abscess cavity, which may represent rectal contrast and raises the question of fistula formation or rectal leak.
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Generate impression based on findings.
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Reason: pt with lung ca s/p 6 cycles of chemo ended Sept 2013 History: doing so-so. Has gallstones and now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: New moderate right pleural effusion.Markedly increased right hilar and subcarinal mass consistent with lymphadenopathy, with associated atelectasis in the right middle lobe.The subcarinal component has increased from about 5 mm to 29 mm.The more anterior component, which includes the pulmonary artery, has increased from 21 mm to 34 mm.Smoothly marginated left lower lobe 7-mm nodule, unchanged and presumably benign.MEDIASTINUM AND HILA: Interval increase in right paratracheal lymphadenopathy, now 17 mm in short axis increased from 14 mm previously.Markedly increased right hilar and subcarinal lymphadenopathy as detailed above.Small pericardial effusion, increased from previous.Moderately severe coronary artery calcification.CHEST WALL: Right chest port with the catheter tip in the SVC.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypodensities compatible with cysts, unchanged.Inferior right lobe irregular hypodensity also unchanged, possibly a hemangioma.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small nonobstructing calculi.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small nonspecific retroperitoneal lymph nodes, unchanged.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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Marked increase in right hilar and mediastinal lymphadenopathy with a new right pleural effusion.
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Generate impression based on findings.
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54 year-old female with history of oral cancer. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. New since prior are postsurgical changes of a partial left mandibular alveolar ridge resection at level of the buccal space. There are several surgical clips along the buccal surface of the residual mandible body. The mandible appears sclerotic. No lymphadenopathy or mass is noted. There is redemonstration of asymmetry of the tongue base. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The parotid, submandibular, and thyroid glands are unremarkable. The left internal jugular vein is occluded. The carotid arteries and right jugular vein are patent. Limited view of the chest is unremarkable.
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Interval postsurgical changes of a partial left mandibular alveolar ridge resection. No lymphadenopathy or mass is noted.
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Generate impression based on findings.
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53 year old female. Follicular lymphoma. Reason: NHL restaging History: None CHEST:LUNGS AND PLEURA: Stable micronodules.Note is made of biapical scarring/atelectasis. No new or suspicious pulmonary nodules or masses are identified.MEDIASTINUM AND HILA: Stable right thyroid subcentimeter nodule. Stable mediastinal adenopathy; reference sub-carinal lymph node measures 1.6 x 1 .0 cm, previously 1.5 x 1.0 cm (image 38; series 3). Note is made of a prominent cardiophrenic lymph nodes, appearing similar to the prior study.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Stable mild splenomegaly PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: There is interval decrease in size of the previously described extensive, confluent retrocrural, retroperitoneal, and mesenteric adenopathy. Reference left periaortic lymph node mass (image 120; series 3) measures 2.5 x 2 .5 cm, previously 3.2 x 2 .9 cm. The confluent retroperitoneal and mesenteric lymphadenopathy measures 11.7 x 8 .1 cm, previously 15.0 x 11.0 cm (127; series 3). Additionally, right obturator lymph node measures 5 mm in the short axis, previously 10 mm (175; series 3).BOWEL, MESENTERY: Slight interval decrease in the previously described confluent mesenteric adenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality identified.BLADDER: No significant abnormality noted.LYMPH NODES: There is interval decrease in size of the previously described extensive, confluent retrocrural, retroperitoneal, and mesenteric adenopathy. Reference left periaortic lymph node mass (image 120; series 3) measures 2.5 x 2 .5 cm, previously 3.2 x 2 .9 cm. The confluent retroperitoneal and mesenteric lymphadenopathy measures 11.7 x 8 .1 cm, previously 15.0 x 11.0 cm (127; series 3). Additionally, right external iliac lymph node measures 8 mm in the short axis, previously 11 mm (171; series 3).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Interval decrease but with large residual in extensive, confluent retrocrural, retroperitoneal, mesenteric and pelvic adenopathy with reference measurements above.
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Generate impression based on findings.
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Female 73 years old; Reason: H/O DLBC Lymphoma s/p 6 cycles of DA EPOCH R in need of re staging scans. Please compare to prior. History: H/O DLBC Lymphoma CHEST:LUNGS AND PLEURA: Stable micronodulesMEDIASTINUM AND HILA: Stable large hiatal herniaCHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: atrophic and fatty replaced.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Very large stable ventral hernia. No obstruction or mass detected.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: Interval decrease in size of pelvic and right inguinal adenopathy. Reference large right inguinal mass as seen on image 197 of series 801 now measures 2.9 x 3.7 cm ; this is in comparison to 4.6 x 4.4 cm on 10/7/2013. Reference left obturator lymph node is now not measurable, previously 1.6 x 0.5 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Interval decrease in size of pelvic and right inguinal adenopathy. No new adenopathy.
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Generate impression based on findings.
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Reason: h/o recurrent oral cancer History: r/o chest mets LUNGS AND PLEURA: No evidence of pulmonary or pleural metastases.Mild centrilobular emphysema is present.MEDIASTINUM AND HILA: Coronary artery calcifications.No mediastinal or hilar lymphadenopathy noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of metastases, or other significant abnormality.
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Generate impression based on findings.
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Clinical question: Evaluate for meningioma and NPH. Signs and symptoms: 84-year-old female with memory issues, urinary incontinence, imbalance with gait. History of meningioma from 2011. Unenhanced head CT:Examination demonstrate no detectable acute intracranial process. CT however is insensitive for early detection of non-hemorrhagic ischemic strokes.There are extensive subcortical and periventricular low attenuation of white matter as was noted on prior MRI exam from 2011. Findings consistent with advanced age indeterminate small vessel ischemic strokes. There is prominence of ventricular system not significantly than prior MRI exam. This finding can be at least partially secondary to underlying parenchymal volume loss secondary to small vessel ischemic strokes. The third ventricle is not dilated and is within normal size for age. Findings CT tissue in the left upper cerebellopontine angle cistern and extending to the medial aspect of left middle cranial fossa corresponds to the patient's previously known meningioma with extension into the sella and the left cavernous sinus. Finding remains grossly similar to prior exam. Calvarium is intact.Limited images through the orbits are unremarkable.All paranasal sinuses and bilateral mastoid air cell/linear cavities remain well pneumatized.
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1.No acute intracranial findings.2.Advanced age indeterminate small vessel ischemic strokes.3.Prominence of lateral ventricles which is believed to be at these partially secondary to underlying volume loss secondary to small vessel ischemic strokes. The third ventricle is nearly normal in size.4.Isodense soft tissue at the level of the left upper cerebellopontine angle cistern and medial aspect of the left middle cranial fossa/cavernous sinus consistent with patient's known meningioma. This finding is grossly similar to prior brain MRI exam from 2011.5.Unremarkable orbits, paranasal sinuses and mastoid air cells.
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Generate impression based on findings.
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Female 63 years old; Reason: lower abdominal bloating and pain History: bloating and pain ABDOMEN:LUNGS BASES: Groundglass opacities bilaterally are incompletely characterized and not well visualized on this CT abdomen. Infectious etiology is considered.LIVER, BILIARY TRACT: Hyperenhancing lesion in segment IVb is likely a flash filling hemangioma.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: Prior tram flap surgical changes are noted in the anterior abdominal wall.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 evidence of metastatic disease. Hyperenhancing lesion in segment IVb is likely a flash filling hemangioma, however metastatic disease cannot entirely be ruled out
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Generate impression based on findings.
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23 year-old male with headache. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality.
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Generate impression based on findings.
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68-year-old female. History of non-small cell lung cancer. Cough for two weeks status post XRT. Evaluate for radiation pneumonitis or other lung abnormality. LUNGS AND PLEURA: Spiculated right upper lobe nodule containing a fiducial marker is consistent with the known primary lung malignancy, measuring 7 x 9 mm, previously 8 x 9 mm (series 4, image 140). The nodule demonstrates slightly decreased solid component.Severe upper lobe predominant centrilobular emphysema. No focal airspace consolidation or pleural effusion. No evidence of radiation pneumonitis as clinically questioned. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Severe coronary artery and thoracic aorta calcifications. Normal heart size without pericardial effusion. CHEST WALL: Sternotomy wires. Epicardial lead in the right medial chest subcutaneous tissues which terminates substernally, unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Severe upper scar calcification abdominal aorta. Left adrenal nodule is unchanged from 5/20/13 noncontrast CT (where it measured less than 10 HU), likely a benign adenoma, unchanged. Vascular calcifications in renal hila bilaterally.
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1. Right upper lobe spiculated nodule consistent with the patient's known primary lung malignancy shows interval slight decrease in solid component and size.2. No acute abnormalities or new sites of disease.
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Generate impression based on findings.
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Clinical question: 30-year-old male with left-sided level Ib mass. Signs and symptoms: Left jaw mass x 6 weeks. Enhanced neck CT:Limited intracranial contents is unremarkable.Images through the skull base and including cavernous sinuses, bilateral petrous bones remain within normal limits.Unremarkable images through the nasal phalanx and nasal passage.Unremarkable images through the oropharynx and soft tissues of the palm.Masticator muscles are unremarkable.Unremarkable bilateral parotid glands and submandibular glands.There is a low density middle demarcated masslike lesion measuring at 32 x 23-mm projecting immediately anterior to the left submandibular gland. There is no associated significant mass effect. There is no evidence of enhancement of this finding. There is no evidence of any surrounding fat stranding to suggest presence of inflammatory changes. There is no evidence of any abnormality of the mandible or the teeth. There is no evidence of any abnormal calcification or stone formation. The overall appearance of this finding is suggestive of a cystic lesion is likely possibility of a new cannot be entirely excluded. Recommend follow-up with an MRI exam for further assessment. This lesion is amenable for transcutaneous biopsy.There is known heaviness of any additional similar findings.There is no evidence of cervical lymphadenopathy by CT size criteria.Vasculature of the neck remains within normal limits. Bilateral thyroid glands are unremarkable.Images through the larynx and trachea are unremarkable.No detectable supraclavicular abnormalities.The osseous structures of division of the exam are unremarkable.
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1.A well demarcated low attenuation non-enhancing lesion (likely cystic) in the left submandibular gland measuring 32 x 23 mm sized. The appearance is not suggestive of a node. Recommend follow-up with MRI for better assessment. Lesion appears accessible for transcutaneous biopsy/aspiration.Please see above comments.2.Unremarkable enhanced neck CT otherwise.
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Generate impression based on findings.
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Male 54 years old; Reason: SCC of tongue. Post induction evaluation. History: as above Head:The ventricles and sulci are normal in size. Again seen is the extra-axial enhancing right paraclinoid mass abutting the orbital apex and is unchanged in size measuring 3 mm (series 10, image 11). There is no mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. There is no abnormal enhancement within the brain. Neck:Again seen is the enhancing infiltrate left tongue mass which involves the body of the tongue, left palatine tonsil and left lingual tonsil. The mass extends across the midline and measures 65 mm x 36 mm (series 6, image 25) which is reduced in size from 90 x 52 mm previously. The reference level 2 lymph node on the left side has decreased in size measuring 7 mm (series 6, image 31) compared to 14 mm previously. The right sided level 2 lymph node is unchanged and measures 11 mm (series 6, image 29). The seroma underlying the left platysma muscle seen on previous exam has resolved.The left submandibular gland is somewhat enlarged. The parotid and thyroid glands are unremarkable. The major cervical vessels are patent. There is unchanged moderate multilevel degenerative spondylosis with multiple osteophytes which cause narrowing of the spinal canal at levels C4, C5 and C6, but is unchanged. Refer to accompanying chest CT for pulmonary findings.
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1.Interval decrease in the size of the tongue mass and the neck lymphadenopathy.2.Interval resolution of the left-sided seroma.3.Unchanged enhancing right paraclinoid extra-axial lesion, likely meningioma.
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Generate impression based on findings.
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Male; 49 years old. Reason: necrotizing pancreatitis History: necrotizing pancreatitis ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No evidence of suspicious hepatic lesion. No intra-or extrahepatic ductal dilatation. The gallbladder is unremarkable. There is complete thrombosis of the splenic vein. Near complete thrombosis of the superior mesenteric vein. The portal vein is patent.SPLEEN: No significant abnormality noted.PANCREAS: Interval removal of a pancreatic drainage catheter. Fluid collection measuring 4.0 x 5.8 x 1.6 cm, best seen on image 41 of series 10, arising from the body of the pancreas likely represents pseudocyst reaccumulation. There is extensive inflammatory changes surrounding the pancreas and ascending duodenum.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Interval increase in moderate right sided hydronephrosis without evidence of nephrolithiasis or obstructing lesion. There is thickening of the left anterior renal fascia.RETROPERITONEUM, LYMPH NODES: Right-sided retroperitoneal fluid collection over the psoas muscle, best seen on image 72 of series 10, has decreased in size now measuring 3.0 x 0.8 cm, previously 3.8 x 0.9 cm. Scattered mesenteric lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild compression fracture of L1.OTHER: No significant abnormality noted.
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1.Reaccumulation of pancreatic pseudocyst with local inflammatory changes as described above.2.Complete thrombosis of the splenic vein and near-complete thrombosis of the superior mesenteric vein.3.Moderate right-sided hydronephrosis.4.Right retroperitoneal fluid collection has minimally decreased in size.
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Generate impression based on findings.
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79-year-old male with history of bladder and prostate cancer. Status post cystectomy -- evaluate for new or metastatic disease. ABDOMEN:LUNG BASES: Left pleural effusion. Aneurysmal dilatation of the aorta is seen (approximately 4.8 cm) with peripheral chronic atherosclerotic thrombus. The aorta is only included in its distal portions as it approaches the abdomen at the diaphragmatic hiatus and there the aorta achieves normal caliber.LIVER, BILIARY TRACT: No significant abnormality noteddSPLEEN: No significant abnormality noteddPANCREAS: No significant abnormality noteddADRENAL GLANDS: No significant abnormality noteddKIDNEYS, URETERS: Kidneys are slightly small with age-appropriate thinning of the renal cortex. Benign cysts are seen in the right kidney without other masses. Prompt and symmetric excretion is seen into normal pyelocalyceal systems bilaterally. The right kidney shows duplicated collecting system with two ureters into the pelvis to the right liver quadrant neobladder. Single left collecting system and ureter is seen with good visualization to near the neobladder. No abnormalities are seen to suggest urothelial lesion in the portions that are visualized. RETROPERITONEUM, LYMPH NODES: No enlarged lymph nodes seen to suggest lymphadenopathy.. Endovascular aortic graft with by iliac extension. The right common iliac artery shows aneurysmal dilatation beyond the stent, but the aneurysm sac, measuring 3.9-cm (series 6, image 108). No evidence of endo- leak is seen around the stent.BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality noteddPELVIS:PROSTATE, SEMINAL VESICLES: Prior prostatectomy without abnormality in the prostate bed.BLADDER: Prior cystectomy with right lower quadrant. Neobladder with left lower quadrant ostomy.LYMPH NODES: No enlarged lymph nodes seen to suggest lymphadenopathy. BOWEL, MESENTERY: No significant abnormality noteddBONES, SOFT TISSUES: Edema and overlying skin thickening in the lower pelvis centrally and anteriorly without discrete fluid collection -- this may relate to prior surgical procedures -- old films could characterize this for interval changes.OTHER: 4.9 x 4.1 cm near water density lesion seen in left external iliac chain region (series 6, image 120). This does not have an appearance typical of solid tumor. Metastases and most likely represents a lymphocele as patient has had prior lymphadenectomy. Prior imaging, if available, would be helpful to compare to confirm this.
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1. Prior cystectomy with no evidence of residual or recurrent tumor. 2. No evidence of lymphadenopathy or other abdominal metastases. 3. Distal thoracic aortic aneurysm and right iliac artery aneurysm (aortobiiliac endovascular stent described above.). 4. Near water density lesion in left external iliac chain, most likely lymphocele. 5. Edema and skin thickening inferior, anterior, central pelvis.
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Generate impression based on findings.
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51-year-old female with history of stage IV pancreas cancer. Compare to prior scans and provide index lesion measurements. CHEST:LUNGS AND PLEURA: Bilateral scattered micronodules, unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Patient's known metastatic lesion near the caudate lobe of the liver measures 2.9 x 1 .7 cm, previously 3.0 by 2.0 cm on image number 91, series number 3. SPLEEN: No significant abnormality noted.PANCREAS: Patient's known pancreatic body mass measures 2.8 x 2 .8 cm, previously 2.7 x 2.8 cm on image number 99, series number 3. There is encasement and attenuation of the splenic vein, appearing similar to the prior study. Pancreatic ductal dilatation is unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Metastatic retroperitoneal adenopathy, again noted. Index lesion measures 3.1 x 3 .0 cm, previously 2.9 x 3 cm on image number 120, series number 3. While this measures similar to the prior this is a measurement of a conglomerate lymph node which grossly appears decreased when compared to the prior study. Prominent gastrohepatic lymph nodes, unchanged.BOWEL, MESENTERY: Peritoneal carcinomatosis, again noted. Index lesion about the liver now measures 0.8 x 0 .8 cm, previously 1.2 by 1 cm image number 110, series number 3 . Other extensive peritoneal nodules are also unchanged.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: Peritoneal carcinomatosis. Reference lesion along the undersurface of the anterior right pelvic wall measures 4 mm, previously 7 mm (160; series 3). The second reference lesion along the undersurface of the anterior right pelvic wall measures 4 mm, previously 7 mm (157; series 3).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No significant interval change in the size of the pancreatic body mass. However, the previously described extensive carcinomatosis and retroperitoneal lymhadenopathy, appears slightly decreased, when compared to prior study.
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Generate impression based on findings.
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14-year-old female status post SCFE repair in 2010 now with worsening right hip pain, evaluate for whether pin from right SCFE surgery is within the joint capsule PELVIS:The BMI is abnormally increased. Phlebolith in the left hemipelvis.It appears that the right orthopedic screw tip reaches the cortex of the femoral head. The right femoral head is flattened. The acetabulum is flattened and conforms to the contour of the femoral head. Coxa vara deformity is present. A CAM type femoral acetabular impingement deformity is seen at the anterolateral femoral neck. No fracture is evident. There is subchondral cyst formation at the right acetabulum. The left orthopedic screw tip is within the femoral head with no hardware complications.
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Probable disruption of the right femoral head cortex by the orthopedic screw.
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Generate impression based on findings.
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85 year-old male with new diagnosis of lung cancer and confusion. There is patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and prominent, representing age related volume loss. 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. mild deformity of the right lamina papyracea. There are foci of lucency in the calvarium. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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1. No acute intracranial abnormality including intraparenchymal metastasis. 2. Small vessel ischemic disease of indeterminate age. Moderate brain volume loss. 3. Foci of lucency in the calvarium are nonspecific finding.
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Generate impression based on findings.
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33 year-old male with questionable seizure. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for mild maxillary sinus mucosal thickening.
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No acute intracranial abnormality.
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Generate impression based on findings.
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45 year-old female with new psychosis. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality.
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Generate impression based on findings.
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66 year-old male with headache, blurred vision and syncope. The ventricles, sulci, and cisterns are symmetric and mildly prominent, representing age related volume loss. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. There appears chronic blowout fracture of the right orbital floor.
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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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Male 61 years old; Reason: assess for progression of cancer, new mets, sbo History: abd pain, hx colon ca s/p resection The exam is insensitive detecting lesions in the solid organs of vasculature due to lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNGS BASES: Pleural thickening and calcifications redemonstrated on the right. Small pleural effusion. Minimal atelectasis or fibrotic change right lung base. No nodule seen in the visualized portion.LIVER, BILIARY TRACT: No definite metastases seen on this noncontrast study. If clinically indicated more detailed examined be done without IV contrast using MR along with an ultrasound exam to supplement noncontrast CT.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: Expected postsurgical changes. No evidence of ascites or carcinomatosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Expected postsurgical changes. Suture line in the sigmoid colon. No evidence of ascites or carcinomatosis.BONES, SOFT TISSUES: Several lucent lesions in the iliac bones are unchanged from prior exam nonspecific.OTHER: No significant abnormality noted.
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1.No definite evidence metastasis given limitation examination. Osseous lesions unchanged prior exam.
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Generate impression based on findings.
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71 year-old male status post fall. There is mild patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and appropriate for the patient's age. 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. Mild small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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27 year-old female status post MVC and neck pain. 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. There are fluids in the nasal cavity. There is normal 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.
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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.
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Generate impression based on findings.
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48-year-old female patient. Assess for gluteal abscess. There is an ill-defined area of soft tissue stranding and gas involving the soft tissues of the right buttock measuring approximately 8 x 5 cm in the axial dimension (series 3 image 84) and 14 cm in the craniocaudal dimension (coronal series 8028 image 28). Soft tissue stranding extends towards, but does not involve, the underlying musculature and gluteal crease. Skin thickening of the right buttock. There is no discrete rind or evidence of maturity. No evidence of bone involvement. There may be an area of drainage in the medial upper thigh (series 3 image 19). Perirectal fat planes are preserved. There is minimal fat stranding involving the contralateral perianal region.Moderate hip osteoarthritis with joint space narrowing and subchondral cysts.There is a fat and fluid-containing tract scar from the intraperitoneal cavity to the right anterior abdominal wall that likely represents site of old surgical drain. Correlate with patient history.Uterus and adnexa without significant abnormality.
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Right gluteal collection without bone or muscle involvement.
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Generate impression based on findings.
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52 year-old female with fever and sinus congestion. The orbits are unremarkable. There is partial opacification of the right mastoid, and the left is are clear. Limited view of the intracranial structure is unremarkable. The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, sphenoid sinuses, and maxillary sinuses are well developed and clear. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. 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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No evidence of acute sinusitis.
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Generate impression based on findings.
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Female 51 years old Reason: abdominal pain History: abdominal pain. Additional history based on prior CT reports indicate cirrhosis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cirrhotic morphology of the liver. No focal masses. No biliary dilatation. Gallbladder is prominent and several round low density foci are seen in neck of the gallbladder concerning for cholesterol stones. Possibility cholecystitis cannot be excluded. Pericholecystic fluid may be related to generalized minimal ascites secondary cirrhosis however. Correlate clinically and with ultrasound for more specific signs.SPLEEN: Spleen 16 cm length, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypodensities likely renal cyst. Left kidney compressed by splenomegaly. Small nonspecific hypodensity upper pole spleen likely cyst or hemangioma.RETROPERITONEUM, LYMPH NODES: Shotty aortocaval and left periaortic nodes. These are unchangedBOWEL, MESENTERY: Moderate generalized ascites.BONES, SOFT TISSUES: Surgical changes anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Atrophic or surgically absent.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of generalized ascites. Previously seen colonic thickening is no longer present.BONES, SOFT TISSUES: Posterior changes anterior abdominal wall. Minimal anasarca.OTHER: No significant abnormality noted
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Cirrhotic morphology, splenomegaly and a small amount of ascites. Probable cholesterol gallstones. Correlate clinically and if indicated ultrasound may be obtained to evaluate for cholecystitis. The pericholecystic fluid is nonspecific given the generalized ascites.
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Generate impression based on findings.
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Female, 59 years old, status post fall with headache. Mild stranding is seen in the left parietal scalp which may reflect an a soft tissue injury. The underlying bone to calvarium are intact.Patchy periventricular and subcortical hypoattenuation is a non-specific finding which most commonly represents age-indeterminate small vessel ischemic disease. Findings appear similar to the prior exam.No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.The inferior orbital walls seem to be deformed bilaterally with downward herniation of intraorbital fat. Findings are unchanged and may reflect remote orbital trauma. Cervical spine alignment is anatomic. Vertebral body heights are preserved. No fracture or acute malalignment is detected.Degenerative disk disease is seen at several levels, most conspicuously at C5-6 where there is loss of disk height, endplate irregularity and a small posterior disk-osteophyte complex. The left C5-6 neural foramen is mildly narrowed.
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1. No acute intracranial abnormality. Age indeterminate small vessel ischemic disease is suspected.2. No cervical spine fracture or acute malalignment.
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Generate impression based on findings.
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Male 53 years old; Reason: Stage IV Hodgkin lymphoma, now s/p stem cell transplant; reevaluate disease status History: s/p stem cell transplant CHEST:LUNGS AND PLEURA: Bibasilar dependent atelectasis. No pleural effusions. No nodules or masses.MEDIASTINUM AND HILA: Slight increase in the pericardial effusion.CHEST WALL: Redemonstrated are post surgical changes in the right axilla. Retropectoral lymph node 5 x 8 mm (series 3 image 33). Stable right axillary lymph nodes.Left chest port with tip at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver parenchyma.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Two stable lower pole hypoattenuating lesions within the left kidney are stable compared to examination in 6/2012 and most likely represent cysts. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Reference left periaortic lymph node measures 5x 8 (series 3 image 134), previously 7 x 4 mm .BOWEL, MESENTERY: There is rapid progression of oral contrast through normal-appearing stomach and small bowel. Clonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: L4 vertebral body lytic lesion is stable compared to prior examination.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: There is rapid progression of oral contrast through normal-appearing stomach and small bowel. Clonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: L4 vertebral body lytic lesion is stable compared to prior examination.OTHER: No significant abnormality noted.
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1.Stable right axillary and periaortic lymph nodes.2.Fatty liver.3.Stable lytic lesion in the L4 vertebral body
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Generate impression based on findings.
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Female 66 years old Reason: s/p cholecystectomy with duodenal fistula and drain decreased output and tachycardia evaluate for fluid collection. ABDOMEN:LUNG BASES: A small right pleural effusion. Bibasilar atelectasis or fibrosis.LIVER, BILIARY TRACT: The biliary stent in place. Expected pneumobilia. No definite focal liver lesions are vascular thrombus. Small periportal collection see bowel mesenteric paragraph below.SPLEEN: Vascular calcification splenic artery. Surgical clips splenic hilus.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multifocal bilateral calcifications most of which I believe represents small vessel vascular calcification. Some nephrolithiasis cannot be excluded. There are also several renal cysts. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Caval filter in place. Atherosclerotic changes aorta no evidence of aneurysm.BOWEL, MESENTERY: Small sliding type hiatal hernia. Percutaneous G-tube in place.2.2 x 2.6 thick walled cavity containing air fluid levels and oral contrast continuous with descending duodenum similar to the prior exam. See series 3 image 51. Percutaneous drain seen within this cavity. No new fluid collection seen.No evidence of bowel thickening or dilatation.BONES, SOFT TISSUES: AP midline surgical wound. Mild anasarca. No loculated fluid collections.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Surgical changes anterior abdominal wall. Left prosthesis. Bone islands.OTHER: Atherosclerotic calcifications.
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Pigtail catheter within a loculated collection porta hepatis. The collection is continuous with the duodenum. Other findings as above.
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Generate impression based on findings.
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86 year old female with dementia and sepsis of unclear etiology. Complains of worsening abdominal pain. Lack of intravenous contrast limits evaluation of solid organs. Lack of enteric contrast limits evaluation of bowel. Given these limitations, the following observations are made:ABDOMEN:LUNG BASES: Note is made of a small bilateral pleural effusions with underlying atelectasis/consolidation. Patchy left basilar consolidation. There is elevation of the left hemidiaphragm, appearing similar to the prior chest radiographs when allowing for differences in technique.LIVER, BILIARY TRACT: Note is made of a calcified granuloma in the liver. There are multiple hypodensities in the liver, which are incompletely characterized on a noncontrast examination.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple hypodensities are identified within the kidneys, which are incompletely characterized on this noncontrast examination, but may represent simple cysts. RETROPERITONEUM, LYMPH NODES: IVC filter in place. There are vascular calcifications of the aorta and its branches. Note is made of severe coronary artery calcifications. The abdominal aorta is ectatic. There is aneurysmal dilation of the suprarenal abdominal aorta, measuring 3.9 cm in its greatest diameter (coronal image 44). More distally, there is an additional infrarenal abdominal aortic aneurysm measuring 3.8 cm in its greatest diameter (Coronal image 47). There are bilateral common iliac artery aneurysms. The left measures 2.5 cm in diameter. The right measures 2.5 cm in diameter (image 64; series 3).BOWEL, MESENTERY: Note is made of diverticulosis, without evidence of diverticulitis.BONES, SOFT TISSUES: None is made of anasarca. There is fatty atrophy of the abdominal and pelvic musculature. Multilevel degenerative changes affect the visualized thoracolumbar spine, most pronounced at the level of T10/11.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter in place.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. Left basilar patchy consolidation. Differential considerations include infection as well as aspiration. There are small bilateral pleural effusions with underlying atelectasis/consolidation.2. Ectatic abdominal aorta with multiple abdominal aortic aneurysms. Aneurysmal dilation of the common iliac arteries bilaterally.
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Generate impression based on findings.
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92 year old female with history of shortness of breath. Evaluate for pulmonary embolus. PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Minimal left greater than right dependent atelectasis.MEDIASTINUM AND HILA: Small pericardial effusion. No appreciable lymphadenopathy. Nonspecific hypoattenuating lesions in the thyroid gland can be further evaluated with ultrasound if clinically warranted. Mild coronary artery and aortic valve calcifications.CHEST WALL: Degenerative disease affects the visualized spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Coarse calcifications are noted in the liver parenchyma, unchanged from prior.
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No pulmonary embolus. Small pericardial effusion, and other findings as above.
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Generate impression based on findings.
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Reason: please evaluate for focal consolidation, lower respiratory tract involvement given RSV positive History: 33M with history of T cell lymphoblastic leukemia presenting with RSV positive LUNGS AND PLEURA: Right middle lobe tree in bud and nodular opacities. Right upper lobe solid and ill-defined clustered ground glass nodules, most consistent with atypical infection (consider fungal and mycobacterial etiologies). No pleural effusions. Subsegmental atelectasis involves the posterior basal segment of the left lower lobe.MEDIASTINUM AND HILA: Cardiomegaly with left ventricular chamber dilatation. The density of the blood pool is indicative of anemia. No pericardial effusion.Subcarinal and right hilar lymph nodes are partially calcified compatible with prior granulomatous disease. No interval mediastinal lymphadenopathy.CHEST WALL: Mediport catheter terminates within the right atrium. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Laminectomies in the thoracic region with associated fluid collection soft tissue induration, not significantly changed.
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Right middle lobe tree in bud and nodular opacities. Right upper lobe solid and ill-defined clustered ground glass nodules, most consistent with atypical infection (consider fungal and mycobacterial etiologies).
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Generate impression based on findings.
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65 years old Male. Reason: evaluate for brain metastasis History: rcc, evaluate for brain metastasis Evaluation for intracranial metastases is limited by lack of intravenous contrast. Mild cerebral volume loss associated with aging is present. 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 orbits are symmetric and normal. The osseous structures are unremarkable. A small nonobstrutcive mucous retention cyst is noted in the right maxillary sinus. The paranasal sinuses and mastoid air cells are otherwise clear.
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Negative nonenhanced head CT. No vasogenic edema or mass-effect to suggest cerebral metastases, however contrast enhanced CT or MRI are more sensitive exams.
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Generate impression based on findings.
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27-year-old male with Kawasaki disease and chronic HCV, now with cough/sore throat/fever for 5-7 days. Now with hypoxia despite oxygen therapy and +RVP c/w H1N1 pneumonia. PULMONARY ARTERIES: No pulmonary embolus. The proximal main pulmonary artery measures approximately 3.4 cm in diameter, which can be seen in pulmonary hypertension.LUNGS AND PLEURA: Scattered regions of patchy ground-glass opacities, with predominantly middle and lower lobe foci of consolidation.MEDIASTINUM AND HILA: Several mildly enlarged lymph nodes are seen, likely reactive.CHEST WALL: No acute abnormality.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Coarse appearing calcifications in the superior hepatic parenchyma, nonspecific.
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1.No pulmonary embolus2.Scattered regions of patchy ground-glass opacities, with multiple foci of consolidation. These findings are nonspecific, but are most compatible with multifocal pneumonia.
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Generate impression based on findings.
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Female; 49 years old. Reason: S/P LVAD. hx of line sepsis with GPC and soft tissue infection; Eval for fluid collection History: Fever Lack of intravenous contrast enhancement limits the evaluation of solid organ parenchyma and vascular structures. Given these limitations, the following observations can be made:CHEST:LUNG BASES: Small bilateral pleural effusions. Mild basilar edema/atelectasis.MEDIASTINUM/HILUM: Cardiomegaly and small pericardial effusion. LVAD and pacemaker leads in the expected location. Scattered non-pathologic mediastinal lymphadenopathy.CHEST WALL: LVAD in lower chest without surrounding fluid collection. Midline skin staples over the chest. Pacemaker in left upper chest.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of acute cholecystitis. No suspicious hepatic lesions. No intra or extrahepatic ductal dilatation. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral multifocal renal scarring. No evidence of hydronephrosis or nephrolithiasis. No perirenal fluid collections.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications of the aorta and its branches. Small retroperitoneal lymphadenopathy.BOWEL, MESENTERY: The bowel is normal in caliber. No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No evidence of loculated fluid collection.PELVIS:UTERUS, ADNEXA: The uterus is atrophic or surgically absent. The ovaries are normal.BLADDER: The bladder is moderately distended and unremarkable.LYMPH NODES: Small left chain lymphadenopathy likely secondary to hip surgery.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No evidence of loculated fluid collection. Bilateral hip prostheses.
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1.Small bilateral pleural effusions and pericardial effusion with bibasilar edema/atelectasis.2.No evidence of abnormal chest or abdominal loculated fluid collection as clinically queried.
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Generate impression based on findings.
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Male, 53 years old, stage IV Hodgkin's lymphoma now status post stem cell transplant. Redemonstrated are scattered small lymph nodes involving the neck as well as right subpectoral space and right axilla. As before, none of these meets imaging criteria for pathologic enlargement. There is no significant interval change, and there is no evidence of new or progressing lymph nodes. Previously referenced lymph node measurements are as follows:1. Left level 4 (image 18 series 6): 7 x 5 mm, previously 8 x 7 mm.2. Right supraclavicular (image 18 series 6): 10 x 6 mm, previously 10 x 5 mm. 3. Left level 3 (image 26 series 6): 4 x 4 mm, previously 6 x 4 mm.Aerodigestive tract is unremarkable. The salivary glands and thyroid are free of focal lesions. Cervical vessels remain patent. Lung apices are unremarkable. No suspicious osseous lesions are identified.Sinus mucosal thickening persists bilaterally. Chronic deformity of the right lamina papyracea is also redemonstrated.
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No significant interval change in reference lymph node measurements through the neck. No evidence of new or pathologic adenopathy is seen.
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Generate impression based on findings.
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34-year-old female with relapsed ALL and bacteremia. Rule out colitis versus abscess. Lack of intravenous contrast limits evaluation of solid organs and vasculature.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Note is made of fatty replacement of the liver. There is mild hepatomegaly. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy measures 13 mm in the short axis (82; series 3). There are multiple additional prominent retroperitoneal lymph nodes.BOWEL, MESENTERY: No dilated loops of bowel suggest obstruction. No findings to suggest colitis as clinically questioned. No focal fluid collection to suggest abscess.BONES, SOFT TISSUES: Note is made of a small fat containing umbilical hernia.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No evidence of lymphadenopathy. BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Borderline retroperitoneal lymphadenopathy, as described above. No evidence of colitis or intra-abdominal abscess, as clinically questioned.
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Generate impression based on findings.
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22 year old female with history of shortness of breath and painful inspiration. PULMONARY ARTERIES: No pulmonary embolus within the limitations of mild motion artifact and patient body habitus.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Vertebral body hemangioma in T7.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips are noted. Note is made of a prominent suprahepatic IVC which causes mild compression of the distal thoracic esophagus. Patency of the hepatic veins and IVC cannot be assessed due to inadequate contrast opacification related to contrast timing.
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No pulmonary embolus. Note is made of a prominent suprahepatic IVC which causes mild compression of the distal thoracic esophagus, of uncertain clinical significance. Patency of the hepatic veins and IVC cannot be assessed due to inadequate contrast opacification related to contrast timing.
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Generate impression based on findings.
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Male 63 years old; Reason: 63M s/p cystectomy/neobladder 11/14 c/b SBO s/p ex lap, end jejunostomy, ileal mucus fistula, now with elevated WBC, concern for abscess, fascial dehiscence ABDOMEN:LUNG BASES: Coronary artery calcifications. Distal tip of the central venous catheter in the cavoatrial junction. Calcified granulomas in the left lower lobe.LIVER, BILIARY TRACT: Numerous hepatic cysts, appearing similar to the prior study. Calcified hepatic granulomata. Note is made of mild wall thickening of the gallbladder without evidence of radiopaque gallstone. There is no intra-or extrahepatic biliary ductal dilation. SPLEEN: Calcified splenic granulomata. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Air is again seen within both renal collecting systems / pelves likely related to recent instrumentation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is interval resolution of the previously described small bowel lesion. Postoperative changes consistent with the stated history of jejunostomy with ileal mucous fistula in the right lower quadrant.BONES, SOFT TISSUES: There is dehiscence of the midline abdominal incision along its inferior margin. There are associated foci of gas density and fat stranding in the surrounding area which are presumably postsurgical, however, superimposed infection cannot be completely excluded.OTHER: No a small amount of free intraperitoneal air, presumably postsurgical in etiology.PELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy. BLADDER: Status post cystoprostatectomy. Foley catheter in a decompressed neobladder. Note is made of a fluid collection in width in the pelvis with a similar morphology to the prior examination which likely represents the superior aspect of the neobladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colon and rectum are decompressed from proximal small bowel obstruction. See abdomen above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Surgical drains in place with the tip terminating along the right superior aspect of the neobladder within the pelvis. Midline surgical skin staples.
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1. Near complete interval resolution of the previously described dilated loops of small bowel.2. Post-op changes of cystoprostatectomy and neobladder formation. There is dehiscence of the midline abdominal incision along its inferior margin. There are associated foci of gas density and fat stranding in the surrounding area which are presumably postsurgical, however, superimposed infection cannot be completely excluded. No drainable fluid collection is identified. 3. Mild wall thickening of the gallbladder without evidence of radiopaque gallstone. Further evaluation with ultrasound could be considered if clinically indicated to exclude the possibility of cholecystitis.
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Generate impression based on findings.
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Female; 64 years old. Reason: metastatic breast cancer - evaluate response to treatment. Compare with 10/24 scan History: left neck mass. Postsurgical changes compatible with neck mass excision, including an open skin defect in the left anterior neck, are again noted. The overall configuration of the remaining left anterior neck mass is unchanged, with an exophytic soft tissue component near the skin surface giving way to a a more conspicuous pocket of air/fluid deep to the skin defect. This air/fluid pocket extends from the sternoclavicular joint superiorly to the exophytic soft tissue component of the neck mass and demonstrates increased foci of air when compared to the prior CT, with slight decreased amount of surrounding soft tissue thickening. The exophytic soft tissue component of the neck mass is significantly decreased in size and measures 2.6 x 1.4 cm, previously 4.9 x 2.6 cm (coronal series 80447, image 45). It also exhibits increased dystrophic calcifications along its surface. Inferior to the neck mass, there is a triangular air pocket in the location of prior surgical clips, which are no longer visualized and may have been removed. Infiltration of the left paraspinal and platysma muscles, extensive surrounding skin thickening, and subcutaneous fat stranding are increased since the prior exam and presumably treatment related. In addition, the mass continues to extend into the superior left lateral chest wall and left axilla. The left subclavian artery extends through the lesion but appears patent throughout its visualized course. The left vertebral artery and left common carotid artery are also encased within the mass but remain patent. Obliteration of the left internal jugular vein is unchanged. The visualized airway is patent. Chronic effacement of the left piriform sinus is unchanged. The left greater than right submandibular gland demonstrates a post-radiation atrophic appearance. The remaining salivary glands and thyroid gland are unremarkable. Erosion of the left sternomanubrial articulation and left first rib-sternal articulation are again noted and may be secondary to tumoral invasion. Necrotic left axillary mass, apical lung nodules, and superior mediastinal lymphadenopathy are incompletely imaged; please see separate chest CT report from same day for further details. Two prominent left posterior chest wall nodes are also noted. The more anterior node is slightly decreased in size and has a necrotic center, measuring 1.4 x 1.1 cm, previously 1.9 x 1.5 cm (series 6, image 66). The more posterior node is significantly more prominent than on the prior study, measuring 1.3 x 1.3 cm (series 6, image 70). This again demonstrates a central area of hypodensity.
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1.Significant interval decrease in size of exophytic soft tissue component of left anterior neck mass as described above, with increased conspicuity of central areas of fluid density. Stable effacement of the left internal jugular vein. 2.Enlarged left posterior chest wall lymph nodes suspicious for tumor involvement, the more posterior of which demonstrates significant interval increase in size. 3.Partially imaged mediastinal lymphadenopathy, apical lung nodules, and necrotic left axillary lesion arising from extension of neck mass into left upper chest wall. Please refer to the dedicated chest CT report from 12/19/2013 for further details.
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Generate impression based on findings.
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Female, 68 years old, status post intracerebral hemorrhage. A hyperdense region is present within the left frontal lobe compatible with acute or early subacute hematoma measuring 1.9 x 1.4 cm on sagittal imaging. There is a mild degree of surrounding parenchymal edema and minimal if any local mass effect. No evidence of generalized mass-effect is seen.No evidence of subdural, subarachnoid or intraventricular hemorrhagic extension is seen at this time. Mild periventricular hypoattenuation is suspected, a non-specific finding which most commonly represents age-indeterminate small vessel ischemic disease. No significant mass effect is detected. Ventricular system is patent and within normal limits for size.Fluid levels throughout the paranasal sinuses are likely related to nasal and ET tubes.The bones of the calvarium and skull base are intact.
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Left frontal parenchymal hematoma with mild surrounding edema and minimal mass effect.
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Generate impression based on findings.
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Female; 54 years old. Reason: evaluate right renal mass; no need for oral contrast; please get w/wo History: none ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hypodensity in the periphery of the right hepatic lobe, best seen on image 65 of series 6, is unchanged measuring 1.3 x 1.3 cm, previously 1.4 x 1.4 cm. Given the characteristics and prior MRI, this lesion may represent an adenoma. Subcentimeter enhancing lesion in the right hepatic lobe with surrounding vascular flow phenomenon, best seen on image 28 of series 8, is unchanged and likely represents a flash filling hemangioma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Minimally enhancing solid mass in the lower pole the right kidney, best seen on image 150 of series 6, is stable in size measuring 1.2 x 1.2 cm, previously 1.2 x 1.2 cm. This lesion is concerning for a neoplasm. The proximal right ureter was visualized in the delayed phase and is unremarkable. No evidence of hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: The bowel is normal in caliber. No evidence of obstruction or pneumoperitoneum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Left breast implant is unremarkable.
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1.Small right lower pole kidney mass is stable in size and appearance, but concerning for a neoplasm.2.Stable hepatic lesions as described above.
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Generate impression based on findings.
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71 year-old female with histiocytic brain lesions and a history of fallopian tube carcinoma. Evaluate for tumor or lymphadenopathy. CHEST:LUNGS AND PLEURA: Note is made of biapical scarring/atelectasis. There is left lower lobe scarring/atelectasis. There are scattered pulmonary micronodules, appearing similar to the prior study. Left lower lobe pleural based nodule measures 4 mm, unchanged (84; series 5). No new pulmonary nodules or masses are identified. There is no pleural effusion, pneumothorax, or focal consolidation.MEDIASTINUM AND HILA: Marked coronary artery calcification. There are vascular calcifications of the aorta. No cardiomegaly. No pericardial effusion. Note is made of a moderate-sized hiatal hernia, increased compared to the prior study.CHEST WALL: Interval removal of right chest port. Again seen are calcified nodules in the right breast. Correlation with recent mammography is recommended.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: Exophytic simple cyst along the inferior pole of the left kidney, appearing similar to the prior study. RETROPERITONEUM, LYMPH NODES: Retroperitoneal surgical clips and likely represent prior lymph node dissection.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat-containing ventral hernia.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The uterus is surgically absent.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of mass lesion or lymphadenopathy, as clinically questioned.
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Generate impression based on findings.
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Female 44 years old; Reason: kidney donor History: kidney donrs ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild periportal edema. No focal mass detected.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The right kidney measures 4.3 x 8.7 x 5.1 cm.. The left kidney measures 9.6 x 5.7 x 5.3 cm. There are single renal arteries bilaterally. No enhancing mass identified.There are single renal veins, the left being pre-aortic. No renal stones identified. Single collecting systems are noted bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. Conventional Celiac artery anatomy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Fibroid uterus. Intrauterine contraceptive device noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Single renal arteries and veins. Single collecting systems with no masses or filling defects noted.
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Generate impression based on findings.
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65 year old female with history of wheezes, crackles and history of bronchitis LUNGS AND PLEURA: Scattered ground glass and nodular opacities are seen bilaterally. Anterior right middle lobe and lingula foci of consolidation, nonspecific but may be related to patient aspiration. Extensive bronchial wall thickening and tree in bud opacities, particularly in the left lower lobe. No bronchiectasis.MEDIASTINUM AND HILA: Small hiatal hernia.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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Scattered ground glass and nodular opacities are seen bilaterally, with bronchial wall thickening and tree in bud opacities. Additional right middle and lingula foci of consolidation. These findings are nonspecific, suggestive of MAI or other mycobacterial infection. Aspiration bronchiolitis is in the differential.
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Generate impression based on findings.
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70 year-old female with head and neck cancer. Redemonstrated are extensive post-treatment changes which are unchanged. The patient is status post total laryngectomy, left neck dissection and tracheostomy. There are no new discrete foci of contrast enhancement. There are no new soft tissue masses. There is no new clinically significant lymphadenopathy. The carotid arteries and right jugular vein are patent. The left jugular vein is absent. Mild degenerative changes of the cervical spine, particularly at C5-C6 are stable. Left apical scarring appears unchanged. Please see dedicated chest CT report for additional findings.The paranasal sinuses and mastoid air cells are clear.
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1.Stable post-treatment changes. No definite evidence of tumor recurrence.2.No evidence of clinically significant lymphadenopathy.
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Generate impression based on findings.
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Male 64 years old; Reason: metastatic Prostate cancer, evaluation of disease for initiation of investigational therapy. History: metastatic Prostate cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: The mediastinal and pericardiac nodes. Reference retrosternal lymph node measures 1.4 x 1.9 cm.CHEST WALL: Extensive sclerotic metastases are seen throughout the thoracic osseous structures.OTHER: Conglomerate chest wall/diaphragmatic nodal mass invading into the right ribs measures approximately 5 x 9.3 cm compatible with metastatic disease.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic disease noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomyBLADDER: No significant abnormality notedLYMPH NODES: Status post lymph node dissection in the pelvis with few residual left external iliac chain nodes measuring 9 x 3.2 cm.BOWEL, MESENTERY: Penile prosthesis pump in the right inguinal canal.BONES, SOFT TISSUES: Extensive osseous metastasis are noted numerous sclerotic foci in the sacrum and spine.OTHER: No significant abnormality noted
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1.Metastatic prostate cancer as described above with reference lesions provided.
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Generate impression based on findings.
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57 year old female with left lower extremity unilateral swelling. Would like CT abdomen and pelvis to rule out some sort of malignancy. ABDOMEN:LUNG BASES: There is minimal bibasilar scarring/atelectasis. Left lower lobe pulmonary micronodule.LIVER, BILIARY TRACT: Multiple subcentimeter hypodensities in the liver are too small to characterize, but likely represent simple cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Note is made of a calcified nonobstructing renal calculus in the interpolar region of the left kidney. There is no hydronephrosis, hydroureter, or perinephric fat stranding. There is a subcentimeter hypodensity in the superior pole of the left kidney, which is too small to characterize, but likely represents a simple cyst.RETROPERITONEUM, LYMPH NODES: There are vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is a small fat containing ventral hernia.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Left inguinal lymphadenopathy with the largest measuring 17 mm in the short axis (133; series 3). Prominent left external iliac lymph nodes. The arteries in the surrounding area appear widely patent. There is no attenuation of the external iliac or femoral arteries or veins.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Nonspecific left inguinal lymphadenopathy.
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Generate impression based on findings.
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Reason: T1N2bM0 SCC of oropharynx. Post induction evaluation. History: as above CHEST:LUNGS AND PLEURA: Benign-appearing micronodules, some calcified, unchanged.No evidence of pulmonary or pleural metastases.Mild apical paraseptal predominant emphysema.MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes being within normal size limits, but may be slightly larger than before especially in the para-aortic region image 47, series 4. Continued monitoring of this are recommended.Calcified left hilar and mediastinal lymphadenopathy from healed granulomatous disease noted.Severe coronary artery calcifications are present. An axial hiatal hernia is unchanged.CHEST WALL: Mild degenerative abnormalities affect the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Calcified splenic granulomata.ADRENAL GLANDS: Stable low attenuation bilateral adrenal nodules, likely adenomas.KIDNEYS, URETERS: Scattered renal cystlike hypodensities.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Vascular calcifications involving the aorta are severe.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. No suspicious pulmonary nodules identified.2. Slight enlargement of scattered mediastinal lymph nodes, all still within normal size limits but continued monitoring of these is recommended.3. Stable adrenal nodules, likely adenomas.
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Generate impression based on findings.
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44F with ?hyperparathyroidism and possible right chest parathyroid adenoma. Please evaluate for possible adenoma in the chestSigns and Symptoms: hypercalcemia, kidney stones There are several nodules present in the soft tissues of the lower neck . Their locations and serial Hounsfield units on dynamic CT or listed below along with some density units of normal structures:Houndsfield units through nodules (0seconds, 25 seconds, 55 seconds, 85 seconds):Right thyroid (image # 322 ):: 115HU, 201HU, 203HU, 187HURight Carotid artery (image # 276 ):: 60.6HU, 501.2HU, 172HU, 159HURight Jugular vein (image # 275 ):: 57.7HU, 386HU, 203HU, 165HURight submandibular gland (image # 206 ): 32.3HU, 50.5HU, 113HU, 112HURight sternocleidomastoid muscle: (image # 164 ): 71.3HU, 41.7HU, 73.2HU, 74.9HURight sternocleidomastoid muscle (image # 322): 62.8HU, 63.2HU, 96.1HU, 95.5HULymph node (image # 234 ): 79.4HU, 45.2HU, 84.2HU, 73.8HU, 49.5HU, 4mm nodule image 366 anteromedial to the right ICA below thyroid: -7HU, 86HU, 55HU,34HU. Venous drainage from this nodule goes to the innominate vein junction.4mm nodule (image #272): right neck anterior to right carotid space at level of cricoid: 61.8HU, 63HU, 114HU, 109HU image 271: 46.4HU, 60.8HU, 118HU, 114HUCT neck:Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits and paranasal sinuses are intact. The mastoid air cells are clear. There is mucosal thickening in the right maxillary sinus. The ethmoid air cells and frontal sinuses and the upper parts of the maxillary sinuses are not included on this exam.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There degenerative changes present with uncovertebral osteophytes at the C3-4 where there is a narrowing of the right neural foramen.Parathyroid sampling:Intraprocedural images demonstrate the location of venous sampling.Reported PTH, Intact values (REF 15-75 pg/mL):FEMORAL VEIN: 99SUPERIOR VENA CAVA: 158INNOMINATE VEIN JUNCTION: 254LEFT INNOMINATE VEIN: 162LEFT INTERNAL JUGULAR VEIN, LOWER: 199LEFT INTERNAL JUGULAR VEIN,MID: 93LEFT INTERNAL JUGULAR VEIN, UPPER: 88RIGHT INTERNAL JUGULAR VEIN, LOWER: 101RIGHT INTERNAL JUGULAR VEIN, MID: 101RIGHT INTERNAL JUGULAR VEIN, UPPER: 98
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1.There is a 4mm nodule below the right thyroid lobe suspicious for a parathyroid adenoma2.Parathyroid venous sampling.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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40-year-old male with history of metastatic germ cell tumor status post chemo and surgery. Evaluate for recurrence. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No significant abnormality noted. Redemonstration of postsurgical changes in the anterior mediastinum similar to the prior study.CHEST WALL: Sternotomy wires in place.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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Male; 53 years old. Reason: 53 yo with chronic RLQ abd pain, h/o diverticulitis now with persistent pain and wt loss. r/o tumor (colon or TI), colitis, diverticulitis, epiploic appendagitis History: 53 yo with chronic RLQ abd pain, h/o diverticulitis now with persistent pain and wt loss. r/o tumor, colitis, diverticulitis, epiploic appendagitis ABDOMEN:LUNG BASES: Stable granuloma in the right lower lobe.LIVER, BILIARY TRACT: Subcentimeter hepatic hypodensities in the right and left hepatic lobes are too small to characterize, but unchanged. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Previously identified area of inflammation adjacent to the sigmoid colon is now resolved. Diverticulosis of the sigmoid colon again noted. The appendix is unremarkable. No evidence of loculated fluid collections.Two areas of small bowel intussusception without lead point mass identified in the jejunum, best seen on image 64 series 4.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No radiographic evidence to account for the patient's right lower quadrant pain.2.Resolved diverticulitis.3.Two foci of non-obstructive jejunal intussusception without visible lead mass.
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Generate impression based on findings.
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59-year-old female with history of tachypnea, shortness of breath and hypoxia. Evaluate for mass. LUNGS AND PLEURA: Moderate emphysema, worse at the apices. Left lower lobe scarring, slightly increased when compared to 2004.MEDIASTINUM AND HILA: Scattered, mildly enlarged lymph nodes are seen within the mediastinum.CHEST WALL: Coronary artery and aortic calcifications.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. The liver is smaller than expected, with lobular contour, which may be seen in cases of cirrhosis. Several dilated veins consistent with varicosities are seen in the anterior abdomen.
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1.Moderate emphysema.2.Scattered, mildly enlarged lymph nodes within the mediastinum are nonspecific and may be reactive in nature.3.Cirrhotic liver morphology with anterior abdominal varicose veins.
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