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Generate impression based on findings.
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64 year-old female with somnolence. There is minimal hypodensity in the periventricular 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. Internal carotid artery calcification. The paranasal sinuses and mastoid air cells are clear. Probable left frontal scalp sebaceous cyst. Left lens prosthesis.
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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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89 year old female with weakness and trouble ambulating. There is mild patchy hypoattenuation in the cerebral white matter and a focus of hypoattenuation in the right basal ganglia. 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. Mild intracranial arterial calcification. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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1. No acute intracranial abnormality. CT is insensitive to early detection of CVA or neoplasm. MRI should be considered if clinical suspicion persists. 2. Mild small vessel ischemic disease of indeterminate age. Right basal ganglia hypodensity may be perivascular space versus age indeterminate lacunar infarct.
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Generate impression based on findings.
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20 year-old male with AML, to rule out baseline sinusitis. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There is moderate mucosal thickening in the right maxillary sinus, infundibulum, OMU, frontal sinus and frontal-ethmoid recess. There is a retention cyst in the right sphenoid sinus. There are small retention cyst and mild mucosal thickening in the left maxillary ethmoid sinuses. The right maxillary infundibulum is narrowed, and the left is patent. There is a leftward nasal septal deviation with a spur. There are intact uncinate processes. The intersphenoid septum is normal. The nasal turbinates are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. There is probable oroantral fistula at the location of the left third molar (which is absent), containing trace gas and filled and covered by thickened mucosa. The osseous structures are otherwise unremarkable.
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1. No evidence of acute sinusitis. 2. Marked right and mild left paranasal sinus inflammatory disease. 3. Probable oroantral fistula on the left. 4. Leftward nasal septal deviation with spurring.
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Generate impression based on findings.
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76 year-old male with recent right lower gingival biopsy positive for invasive squamous cell carcinoma. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear except for a left maxillary sinus retention cyst. There is soft tissue mass eroding buccal aspect of the right mandibular alveolar ridge centered at the first and second molars. The mass has an ill defined margin and appears inseparable from the gum, which is just a little better appreciated on the delayed angled images. The mass measures approximately 35 x 21 mm (image 5, series 8), which may not be accurate due to the poorly defined margin. The mandibular canal courses just beneath the lesion and appears spared. No lymphadenopathy by CT size criteria is noted. The 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 carotid arteries and jugular veins are patent. There is mild degenerative change of the cervical spine. Nonunion of the C1 posterior arch. Tori palatini. Limited view of the chest is unremarkable.
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1. Findings are compatible with right lower gingival squamous call carcinoma with alveolar ridge erosion at the right mandibular first and second molars. No lymphadenopathy by CT size criteria. 2. No intracranial metastasis.
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Generate impression based on findings.
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23 year-old male with history of Burkitt's, restaging. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. The osseous structures are unremarkable. There appears minimally asymmetric enhancement of the right tentorium. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear except for mild mucosal thickening in the left sphenoid sinus.
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Minimally asymmetric enhancement of the right tentorium, which could be due to prominent veinous enhancement. Neoplastic infiltration is felt less likely. Unremarkable contrast enhanced CT head otherwise.
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Generate impression based on findings.
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26 year-old female 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. Nonunion of the C1 posterior arch.
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No acute intracranial abnormality.
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Generate impression based on findings.
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3 year-old male with ataxia and vomiting. 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 paranasal sinuses are clear. There is opacification of the mastoids and middle ear cavities. Clinical correlation for infection. The calvarium appears thickened due to marrow hyperplasia.
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1. No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Opacification of the mastoids and middle ear cavities. Clinical correlation for infection.
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Generate impression based on findings.
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84 year old female with confusion. The ventricles, sulci, and cisterns are symmetric and prominent, representing volume loss. Confluent periventricular and subcortical hypodensities are suggestive of small vessel ischemic disease. Left caudate and right basal ganglia hypodensities are consistent with prior lacunar infarcts. The gray-white matter differentiation is preserved. There is no mass effect, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The bones are unremarkable. Limited view of the paranasal sinuses and mastoid air cells are normally pneumatized. Lens prostheses.
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1. No acute intracranial abnormalities. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Moderate small vessel ischemic disease of indeterminate age. Prior lacunar infarcts.
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Generate impression based on findings.
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30 year-old male with seizures. 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. Nonunion of posterior C1 arch.
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No acute intracranial abnormality.
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Generate impression based on findings.
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35 year-old male with acute leukemia and functional neutropenic fever. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There are mild mucosal thickening and small retention cyst in the maxillary sinuses. The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, and sphenoid 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. Mild maxillary sinus inflammatory disease.
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Generate impression based on findings.
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Male 74 years old; Reason: Eval for colitis History: abdominal pain, bloody diarrhea ABDOMEN:LUNGS BASES: Pacer wire. Scarring or atelectasis right middle lobe and left lower lobe. No discrete nodules or effusions.LIVER, BILIARY TRACT: Two numerous to count hypodense masses throughout all lobes of the liver consistent with diffuse metastatic disease from the patient's pancreatic neoplasm. For baseline purposes lesion in the lateral segment of the left lobe is measured on series 3 image 35, 1.5 x 1.5 cm second index lesion is measured in the right lobe of the liver on series 2 image 40, 2 x 1.7 cm.Gallstones. No biliary dilatation. No evidence of hepatic or portal venous thrombus although the hepatic veins are poorly opacified.SPLEEN: No significant abnormality noted.PANCREAS: 3.6 x 2 .8 cm. hypoattenuating mass in the body the pancreas exerting some mass effect on the dorsal splenic vasculature and inferiorly on the stomach with dilatation of the pancreatic duct in the tail. The dorsal aspect of the mass abuts the superior mesenteric artery on series 2 image 47 for approximately 180 degrees.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease no evidence of aneurysm. No pathologic size lymph nodes.BOWEL, MESENTERY: Valuation limited by lack of oral contrast for the no evidence of ascites or carcinomatosis.BONES, SOFT TISSUES: Marked dextroscoliosis and degenerative changes.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: Extremely large left inguinal hernia containing loops of small intestine and sigmoid colon and mesentery. It is nonobstructive although there may be some fluid in the hernia sac. No intramural air or free air. This could be a sign of a low-grade ischemia and correlate clinically for pain.No evidence of intraperitoneal ascites outside of the hernia sac or carcinomatosisGreater than average stool burden throughout the colon and rectum.BONES, SOFT TISSUES: Scoliosis and degenerative changes.OTHER: No significant abnormality noted.
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1.Pancreatic mass with diffuse hepatic metastases.2.Large left inguinal hernia with some fluid in the hernia sac correlate clinically to rule out ischemia although no bowel wall thickening is seen.
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Generate impression based on findings.
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Female 46 years old Reason: eval for obstruction, abscess, hernia History: post operative LLQ pain at scar 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: Small distal periaortic nodesBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes are thought, L5, S1.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: As seen in the coronal plane, 2.5 x 3.3 cm hypoattenuating lesion in the left adnexa likely cysts. Correlate with ultrasoundBLADDER: Deformity anterior laterally on the right possibly related to prior surgery or represent a large broad-based bladder diverticulum see coronal and 61/98LYMPH NODES: Surgical clips and a fat stranding in the left common iliac and external iliac distribution.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: 1.2 x 3 cm soft tissue focus with component of gas seen in the subcutaneous fat of the left anterior abdominal wall series 2 image 66. Probably postsurgical change. Infection cannot be excluded. There is stranding in the subcutaneous fat diffusely on the left side of the body particularly laterally consistent with recent surgery. Well-demarcated lytic focus in the left iliac crest. Bilateral degenerative changes ligamentous and muscular calcificationOTHER: No significant abnormality noted
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Postsurgical changes left anterior lateral abdominal pelvic wall. One focus of gas may be postsurgical or may be related to infection correlate clinically.Left adnexal cyst (>3cm longest dimension) correlate with ultrasound.Lucent focus left iliac crest may be postsurgical or posttraumatic correlate clinically. Other findings as above.
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Generate impression based on findings.
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81 year-old male status post fall. The ventricles, sulci, and cisterns are symmetric and prominent compatible with volume loss. The gray-white matter differentiation is normal. Moderate hypoattenuation in the periventricular white matter suggestive of chronic ischemic small vessel disease. Foci of low-attenuation focus in the left thalamus and cerebellum may represent lacunar infarcts, unchanged. There is no mass effect, 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 small mucous retention cyst or polyp in the right sphenoid sinus.No calvarial fracture is noted. There is normal cervical lordosis. The vertebral bodies, dens, lateral masses, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. Calcification of the transverse ligament is seen. Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no significant spinal canal stenosis. Multilevel degenerative disk disease is noted in the cervical spine consisting of anterior/posterior disk osteophyte complexes, uncovertebral and facet hypertrophy with associated loss of disk height at C6 and C7 and C7-T1 and resulting in bilateral foraminal narrowing from C3-C4 to C6-C7. There is endplate degeneration of C5 and C6. The paraspinal and prevertebral soft tissues are unremarkable. Vascular calcifications. Paraseptal emphysema.
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1. No acute intracranial abnormality. 2. Moderate age indeterminate small vessel ischemic disease and brain volume loss. Multiple chronic appearing lacunar infarcts. 3. No evidence of cervical spine fracture or subluxation, if spinal cord or ligamentous injury is suspected MRI is recommended.4. Degenerative changes of the cervical spine.
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Generate impression based on findings.
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Female 56 years old Reason: r/o obstruction History: abd pain, nausea Exam is not sensitive detecting lesions in the solid organs of vasculature due to the lack of intravenous contrast. Given that is limitation, the following observations are made:ABDOMEN:LUNG BASES: 1.5 x 0.8 cm right middle lobe nodule series 4 image 12. This is increased in size from 10/21/10 where I measured it as 0.9 x 0.6 cm.LIVER, BILIARY TRACT: Cholecystectomy clips. No obvious biliary dilatation. No focal lesions given limitation of no IV contrast.SPLEEN: No significant abnormality notedPANCREAS: Mild fatty replacement diffusely.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcifications aorta. No evidence of aneurysm.BOWEL, MESENTERY: Surgical clip medial to the left kidney may represent intraperitoneal drop surgical clip. This is of no clinical significance. Some mild distortion of bowel probably related to adhesions but nonobstructive. No bowel wall thickening. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Expected postsurgical changes. Right lower quadrant there is a parastomal hernia containing small bowel without evidence of bowel wall thickening, dilatation or fluid in the hernia sac. No intramural air or free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Increasing size right middle lobe solid nodule compared to 2010. Note that is not seen in the field of view of the one the older CT scans from 2004 and 2008.Nonobstructive parastomal hernia.
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Generate impression based on findings.
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Chest pain and right lower extremity edema, assess for pulmonary embolism. PULMONARY ARTERIES: Technically adequate exam. No evidence of pulmonary embolism.The main pulmonary artery is normal in size.LUNGS AND PLEURA: Mild subsegmental dependent atelectasis.No pneumothorax or pleural effusions.Several scattered calcified and noncalcified micronodules are present. The largest of these, in the right upper lobe, measures 4 mm and likely represents a subpleural lymph node.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.Aortic and coronary artery calcifications are present.No hilar or mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Non-specific subcentimeter hepatic hypodensities are present; statistically, likely represent benign hepatic cysts.Subcentimeter hypodensity within the partially visualized upper pole of the left kidney too small to characterize but likely represents a cyst.
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1.No evidence of pulmonary embolism. 2.Subcentimeter hepatic and renal hypodensities likely representing benign cysts.
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Generate impression based on findings.
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Female 62 years old Reason: eval for diverticulitis, colitis History: abdominal pain, diarrhea ABDOMEN:LUNG BASES: Pacer wires.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: Postsurgical changes consistent with laparoscopic hernia repair with corkscrewed tacs seen in the anterior abdominal wall. No evidence of bowel wall thickening or dilatation. No free or loculated intraperitoneal fluid or fat stranding.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Bowel thickening or dilatation. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: Sclerotic changes and trabecular thickening in the left iliac wing. Correlate clinically. Could represent Paget's disease although the bone does not appear enlarged.OTHER: No significant abnormality noted
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No findings to explain the patient's symptoms.
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Generate impression based on findings.
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Male 53 years old; Reason: eval for pyelo, stent function History: fever, b/l flank pain, recent neobladder, b/l stents ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Subcentimeter too small to characterize segment for a likely cyst.SPLEEN: No significant abnormality noted..PANCREAS: No significant abnormality noted..ADRENAL GLANDS: No significant abnormality noted..KIDNEYS, URETERS: Nephroureterostomy stent in place. Multiple filling defects seen in the collecting system on the left consistent with a clot given the history. There may be a few on the right as well. There is mild hydronephrosis and hydroureter. Correlate for stent patency..RETROPERITONEUM, LYMPH NODES: No significant abnormality noted..BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall..OTHER: No significant abnormality noted..PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted..BLADDER: Surgically absent. Neobladder.. Mushroom catheter in place in the neobladder.LYMPH NODES: No significant abnormality noted..BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall..OTHER: Right and left pelvic sidewall fluid collections consistent with lymphocele, seroma or hematoma. Largest on the left series 9 image 124 measures 4.7 x 4.3 cm. the collection along the right obturator area is compressing the right external iliac vein although no definite thrombus is seen in the iliac or femoral veins..
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Postsurgical changes with filling defects consistent with blood clots in the collecting system left greater than right with mild bilateral hydronephrosis and hydroureter.Bilateral pelvic fluid collections consistent with postsurgical lymphocele, seroma or hematoma. Compression of the right external iliac vein.
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Generate impression based on findings.
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Reason: 66 year old with DLBCL s/p chemotherapy and now has new O2 requirement. ? etoposide pneumonitis. History: dyspnea LUNGS AND PLEURA: New (from 8/16/2013) bilateral upper lobe predominant ground glass opacities and nodules which spare the periphery are present. These are likely due to a drug reaction or hypersensitivity pneumonitis. If the patient is neutropenic, atypical infection should also be considered. Multiple nonspecific pulmonary micronodules are present.There are bilateral small pleural effusions. MEDIASTINUM AND HILA: Heart is normal in size. No pericardial effusion.Aortic and coronary artery calcifications are present.Prominent mediastinal lymph nodes measuring up to 1.4 cm in the short axis (image 33, series 3), similar to prior. Right central venous catheter with tip in the SVC.CHEST WALL: Right central venous port.Degenerative changes are present within the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small amount of perisplenic ascites. Hypoattenuation along the inferior aspect of the spleen may be secondary to infarction or tumor. Partially visualized slightly prominent extrahepatic bile duct similar to prior.
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1.New bilateral upper lobe predominant ground glass opacities which are likely due to a drug reaction or hypersensitivity pneumonitis. If the patient is neutropenic, atypical infection should also be considered.2.Small bilateral pleural effusions. 3.Prominent mediastinal lymph nodes, similar to prior. 4.Splenic hypoattenuation which may represent infarction or tumor.
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Generate impression based on findings.
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Male 57 years old Reason: s/p ileoanal pouch for ulcerative colitis c/b ischemic gut. now bowel in discontinuity. Fever/leukocytosis. pls eval for fluid collection/pneumonia History: fever, leukocytosis CHEST:LUNGS AND PLEURA: Small to moderate bilateral pleural effusions. Extensive patchy geographic air space opacities persist on the left and improved on the right but persistent right upper lobe. Some groundglass opacities. Differential diagnosis as per chest CT report 12/13.MEDIASTINUM AND HILA: Small mediastinal nodes unchanged. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Diffuse thrombosis of the portal venous system confluence, splenic vein and proximal superior mesenteric vein. These findings were related to the clinical service and discussed with Dr. Kenneth Chakour, pager 3865 by Dr. Trilisky the radiology resident on call.No focal liver lesions. No biliary dilatation. Hepatic veins enhance normally.SPLEEN: Splenic parenchyma enhances normally while the splenic vein is not well seen and is likely thrombosed.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Expected postsurgical changes with absent colon and short length of small intestine. Right and left-sided ostomies. Moderate amount of intraperitoneal fluid which is free and may be partially loculated. Remaining that is not dilated and there is no intramural air or free air.BONES, SOFT TISSUES: Surgical changes anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in place.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colon and much of the small bowel is surgically absent. Rectal pouch.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality noted
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Portal, splenic and superior mesenteric vein thrombosis.These findings were related to the clinical service and discussed with Dr. Kenneth Chakour, pager 3865 by Dr. Trilisky the radiology resident on call. Moderate volume ascites.Persistent but improving lung findings as above.
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Generate impression based on findings.
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Female 83 years old Reason: assess left sided hydronephrosis and to exclude pelvic fx History: as above Exam is not sensitive for detecting lesions in the bowel or solid organs are vasculature due to the lack of oral or intravenous contrast. Given those limitations, following observations are made:ABDOMEN:LUNG BASES: Small right pleural effusion. Trace left pleural effusion.LIVER, BILIARY TRACT: Cholelithiasis based on comparison to MR and obvious biliary dilatation or definite focal liver lesions given limitation of no IV contrast.SPLEEN: 5.4 x 5.2 cm well-defined mass in the spleen series 2 image 31 with more profoundly hypoattenuating central portion. The differential diagnostic considerations include lymphoma given the left para-aortic mass, hemangioma, metastasis much less likely given lack of liver lesions, hamartoma.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Severe left-sided hydronephrosis and hydroureter to the level retroperitoneal mass.Right upper pole probable cyst.RETROPERITONEUM, LYMPH NODES: Hypodense mass 32 Hounsfield units in the left periaortic area compresses left ureter. The mass measures 3.8 x 3.5 cm on series 3 image 55. Atherosclerotic disease aorta and iliac arteries no evidence of aneurysm.BOWEL, MESENTERY: Evaluation due to lack of oral contrast. Specifically there is no contrast seen in the duodenum and relationship of the left para-aortic mass to the bowel is uncertain. The distal third portion and proximal fourth portion of the duodenum are compressed by the retroperitoneal mass.No evidence of bowel obstruction. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: Small nonobstructive umbilical hernia.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Calcifications probably in uterus likely a fibroid.BLADDER: No significant abnormality notedLYMPH NODES: Small bilateral external iliac and obturator nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes. No evidence of fracture.OTHER: Atherosclerotic calcifications.
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Left periaortic retroperitoneal mass consistent with adenopathy. Less likely exophytic mass off of the duodenum. Splenic mass. Rule out lymphoma, metastatic disease, less likely stromal tumor. Other findings as above.Findings discussed with Dr. Rajesh Jain pager 3457.
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Generate impression based on findings.
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Acute respiratory failure, assess for PE PULMONARY ARTERIES: Exam is limited by motion artifact, body habitus, and contrast bolus timing. No large pulmonary emboli are identified in limited examination; exam not diagnostic for small pulmonary emboli. The main pulmonary artery is dilated which can be seen in right heart strain. LUNGS AND PLEURA: Bilateral severe air space opacities and small bilateral pleural effusions with compressive atelectasis are compatible of CHF. Cannot exclude concomitant aspiration.MEDIASTINUM AND HILA: An endotracheal tube is present with tip approximately 1cm above carina. Right sided central venous catheter with tip in SVC. Enteric feeding tube with tip at or slightly above gastroesophageal junction. Marked cardiomegaly. No significant hilar or mediastinal lymphadenopathy. CHEST WALL: Left chest wall soft tissue asymmetry suggestive of prior mastectomy. Degenerative changes are present within the thoracolumbar spine. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.No large pulmonary emboli are identified in limited examination; exam not diagnostic for small pulmonary emboli. Dilated main pulmonary artery which can be seen in right heart strain. 2.Severe bilateral airspace opacities, cardiomegaly, and small bilateral pleural effusions compatible with CHF. Cannot exclude concomitant aspiration.3.Enteric tube with tip at or slightly above GE junction; recommend advancement.
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Generate impression based on findings.
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43 year-old female with dysphagia and vocal changes. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. Examination shows a circumferential, necrotic, enhancing mass at the posterior aspect of the supraglottis. The mass measures 30 x 24 x 27 mm (TR x AP x CC). It extends into the paraglottic space, false vocal cords, posterior cricoid space, and aryepiglottic folds. The epiglottic fold and Waldeyer's ring appear thickened. There is airway narrowing and effacement of the piriform sinuses. The adjacent cartilages appear grossly intact. There are multiple enlarged lymph nodes bilaterally at levels II and III. A left level II node measures 25 x 16 mm. A right level III node measures 15 x 11 mm. The oral cavity, oro/nasopharynx, larynx and subglottic airways are unremarkable/patent. The parotid, submandibular, and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. Limited view of the chest is unremarkable.
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Supraglottic mass, extending into the paraglottic space, false vocal cords, posterior cricoid space, and aryepiglottic folds, and causing airway narrowing as described above. Cervical lymphadenopathy as above.
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Generate impression based on findings.
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Female 60 years old Reason: 60F short bowel syndrome 2/2 extensive SB resection, total abd colectomy, chronic EC fistula close to jejunostomy site, w increased pain, drainage, poor healing around fistula site History: abdominal pain, EC fistula ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Large laminated gallstone. Marked gallbladder wall thickening. Gallbladder is not hydropic however. No intrahepatic or extrahepatic biliary dilatation. Small hypoattenuating foci likely cysts unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Probable cysts kidneys.RETROPERITONEUM, LYMPH NODES: No pathologic size nodes. Atherosclerotic calcification without evidence of aneurysm.BOWEL, MESENTERY: Prominent elongated stomach. Short small bowel remnant without dilatation. No sinus tracts or fistula seen. No loculated fluid collections to suggest abscess.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall. Left-sided abdominal ostomy. No subcutaneous fluid collections to suggest abscess in the abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Hyposthenic, elongaed stomach extends into the pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Large laminated gallstone with thickened gallbladder without biliary dilatation. Postsurgical changes as described above.
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Generate impression based on findings.
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Female 54 years old Reason: cholecystitis on bedside ultrasound History: RUQ pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Gallbladder and biliary tract. Normal liver. No CT evidence of cholecystitis or cholelithiasis despite reported bedside ultrasound findings.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral nonobstructive nephrolithiasis in the right lower pole and left upper pole. Kidney contour is normal there is no perinephric fat stranding, hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Minimal atherosclerotic change aorta and iliac arteries without evidence of aneurysm. No pathologic sized retroperitoneal nodes.BOWEL, MESENTERY: Marked submucosal edema involving the distal half of the stomach. The stomach lateral is thickened up to 1.4 cm in some places as measured on series 2 image 44. This is consistent with gastritis. There are some scattered perigastric nodes.BONES, SOFT TISSUES: No significant abnormality notedOTHER: 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: No significant abnormality notedOTHER: No significant abnormality noted
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Marked submucosal edema distal half of the stomach with perigastric nodes likely gastritis.
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Generate impression based on findings.
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Male 23 years old Reason: please evaluate for lad History: 23M with history of Burkitt's lymphoma, now relapsed, presents for staging CHEST:LUNGS AND PLEURA: Small right pleural effusion. Right basilar atelectasis or consolidation. Small patchy slightly nodular opacities in the left lower lobe. This was not seen on the prior examMEDIASTINUM AND HILA: Small pericardial effusion. Small nonpathologic sized nodes. Probable small right internal mammary node 1.2 by 0.7-cm series image 32. Port-A-Cath tip SVC RA junction.CHEST WALL: Port-A-Cath right chest wall. Minimal gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: Several Ill-defined hypodense lesions in the liver series 2 image 98, 100 and 121. These and additional lesions was seen on the 10/19/13 study.SPLEEN: No significant abnormality noted. Normal size.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: Fat stranding with some nodularity consistent with carcinomatosis, increased compared to the prior exam. No evidence of bowel wall thickening or dilatation. See pelvis report.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: Poorly marginated solid right lower quadrant mass with hypodense irregular central portion may represent necrotic tumor inseparable from right colon and ileum with poorly defined margins. Mass size estimated at 8.7 x 7.9 cm as measured on series 3 image 158 is increased in size compared to the prior exam where it measured 6.4 x 5 cm on series 3 image 92. Right colon circumferentially thickened. All the small bowel is extrinsically compressed there is no evidence of mechanical obstruction.Extensive fat stranding and nodularity in the mesentery and omentum consistent with carcinomatosis increased compared to the prior exam. Small areas of loculated fluid in the leaves of the mesentery and some free fluid.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Large right lower quadrant mass with signs of carcinomatosis. Progression of disease. Patchy airspace disease lung bases right pleural effusion.Several ill-defined hypodense lesions in the liver may represent hepatic involvement with lymphoma.
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Generate impression based on findings.
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Male 48 years old Reason: assess for stone/clot/R hydro History: R abd pain, s/p R pcnl ABDOMEN:LUNG BASES: Bilateral small to moderate pleural effusion and associated atelectasis or consolidation, right greater than left. Correlate clinically.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: A communication between the right renal collecting system along a tract extending to the right posterior pararenal space the large extravasation of contrast consistent with urinoma and persistent urine leak from the collecting system. Postsurgical changes right kidney; air in and around the upper pole is probably related to prior surgery. Small punctate calcifications in the renal collecting system and renal pelvis on the right are nonobstructive. Mild right hydroureter.Left kidney demonstrate some scarring but no hydronephrosis or perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Vasectomy clips. Bilateral pleural effusions and bibasilar atelectasis or consolidation.BLADDER: Foley catheter in urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: A small amount of free intraperitoneal fluid in the dependent portion of the pelvis.BONES, SOFT TISSUES: Mild anasarca.OTHER: The fluid from the right posterior pararenal space tracks caudally along the psoas and iliac is muscle.
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Postsurgical changes right kidney with tract communicating between collecting system and right posterior pararenal space with continued air leak. Previously seen large left kidney stones fungal no longer seen small fragments are still present in the collecting system on the right. Mild right hydroureter.Ascites.
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Generate impression based on findings.
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Male 48 years old Reason: eval for progression History: metastatic RCC CHEST:LUNGS AND PLEURA: 4 millimeter micronodule right middle lobe series 5 image 65. Previously measured left lower lobe nodule series 5 image 64, 8 x 7 mm previously 11 x 7mm. Left lower lobe nodule or lymph node along the fissure measures 4 x 4 mm series 5 image 72. 3-mm micronodules left base since 5 image 80. No effusions.No new nodules.MEDIASTINUM AND HILA: Stable left hilar lymph node.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. No focal liver lesions. Periportal cuffing consistent with hepatic lymphedema probably due to compression of lymphatic drainage by the lymphadenopathy.SPLEEN: No significant abnormality notedPANCREAS: Intrinsically normal. Peripancreatic lymphadenopathy.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right kidney is surgically absent. Segmental surgical defect dorsal aspect left kidney.RETROPERITONEUM, LYMPH NODES: Increase in retroperitoneal adenopathy with increase in size and number of lymph nodes. Index lymph nodes as follows:Portacaval node series 2 image 106/229 measures 5.6 x 3.9 cm. Previously 5.1 x 3.5 cm.Left periaortic node series 2 image 130 measure 3.3 x 3.2 cm previously 2.1 x 2.1 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes lumbar spine.OTHER: No significant abnormality noted
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Increase in size and number of retroperitoneal lymph nodes consistent with progression of disease. Stable lung nodules.
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Generate impression based on findings.
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Female 64 years old Reason: 64 year old female with metastatic ovarian cancer. Staging. History: abdominal pain CHEST:LUNGS AND PLEURA: This well-defined micronodules and some discrete nodules. Some patchy ground glass opacities are improved compared to the prior exam. There is a persistent small to moderate size right pleural effusion.MEDIASTINUM AND HILA: Small nonpathologic sized nodes. Port-A-Cath tip in the SVC RA junction.CHEST WALL: Some distortion is seen in one of the right posterior ribs. This may be posttraumatic. There is some associated calcifications in the soft tissues adjacent to the to surround see series 3 image 69 -- 71. These findings are unchanged from the prior exam.Multifocal calcifications versus clips in the right breast, unchanged. Some nodular soft tissue densities are seen in the left breast unchanged. Port-A-Cath right chest wall.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Surgical clips consistent with lymph node dissection. Small shotty nodes. See pelvis report.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Postsurgical changes consistent with lymph node dissection. A few small lymph nodes are seen but slightly increased compared to the prior exam. Largest is in the left common iliac distributions increased image 119/192 measuring 1.2 x 0.9 cm. On the 2/9/13, series 2 image 72 it measured 0.8 x 0.6 cm. A second baseline node is measured at the bifurcation of the right internal/external iliac artery series 10 image 148 measuring 1 x 0.8 cm. this is only punctate on the prior exam of 2/line/13, series 2 image 88. BOWEL, MESENTERY: Scattered colonic diverticulosis. No evidence of ascites a discrete measurable carcinomatosis although the fat in the mesentery is somewhat dirtier in appearance compared to the prior exam. Continued follow-up advised.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Small lymph nodes but increasing in size. Haziness of the mesenteric fat concerning for carcinomatosis but without discrete measurable solid lesion. Micronodules lung and some small patchy ground glass areas improving compared to the prior exam. Other findings as above.
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Generate impression based on findings.
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Male 50 years old Reason: Metastatic adenocarcinoma please compare to previous scan and provide index lesion measurements to determine response to therapy History: As above CHEST:LUNGS AND PLEURA: Stable micronodules.MEDIASTINUM AND HILA: Index mediastinal and retrocrural nodes measure as follows: subcarinal node series 2 image 45 1.1 x 1 cm. Previously 1.2 x 1 cm. (not 1.3cm as in prior report)Para-aortic lymph nodes series 2 image 52 1.3 x 1 cm. Previously 1.3 x 1.1 cm.The Port-A-Cath and junction of SVC right atrium.CHEST WALL: Port-A-Cath right chest wall.ABDOMEN:LIVER, BILIARY TRACT: Ill-defined lesion in the posterior segment of the right lobe, series image 110, measures 2.3 x 1.8 cm. Previously 1.4 x 1 cm. no new lesions. Focal thickening and neck of the gallbladder unchanged.SPLEEN: Size. Focal calcification consistent with granuloma.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No focal. Diffuse retroperitoneal nodes including peripancreatic retrocrural porta distribution.Reference nodes as follows:Peripancreatic node series 2 image 104, 2.6 x 2.1 cm. Previously 2.5 x 2.2 cm.Aortocaval node series 3 image 140 measures 1.3 x 1.3 cm. Previously 1.7 x 1.3 cm.BOWEL, MESENTERY: Scattered nodes throughout the mesenteric root. No evidence bowel wall thickening or dilatation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Scattered small nodes. Reference pelvic nodes as follows:Right internal iliac node series 2 image 167, 1 0.3 x 1.3 cm. Previously 1.6 x 1.2 cm.Cluster of left external iliac nodes series and image 179, 2 x 1.6 cm. Previously 2.5 x 1.4 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No new sites of disease. Index lymph nodes measured as above.
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Generate impression based on findings.
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Female 53 years old Reason: eval for mets, tumor, typhilitis History: abd pain, on chemo, off/on neutropenia 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: Small shotty retroperitoneal nodes.3BOWEL, MESENTERY: Postsurgical changes right lower quadrant. Long segment of thickening of the neoterminal ileum is seen in the abdomen and extending into the pelvis. A wall thickening is somewhat hypodense suggesting submucosal edema with some of the loops having a wall thickened to nearly 1 cm. No intramural air or free air. Mesenteric vasculature enhances normally. Long segment submucosal edema may be infectious inflammatory or ischemic in nature. Patent ileocolic anastomosis. No free or loculated intraperitoneal fluid. No evidence of mechanical obstruction .BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Markedly edematous neoterminal ileum and distal ileum extends from the abdomen into the pelvis as described above concerning for a ischemia, inflammation or infection. No intramural or free air. Minimal free fluid. No loculated intraperitoneal fluid collections. Mild fat stranding in the mesentery consistent with postsurgical change.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal.OTHER: No significant abnormality noted
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Long segment markedly edematous distally in the neoterminal ileum as discussed above. Minimal free fluid in the pelvis.
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Generate impression based on findings.
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Female 18 years old Reason: appy History: abd pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is visualized. No free or loculated intraperitoneal fluid. No bowel wall thickening or dilatation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No findings to explain patient's symptoms. No CT evidence of appendicitis
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Generate impression based on findings.
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Male 52 years old; Reason: RUQ pain History: pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Pericholecystic fluid and no gallbladder wall submucosal edema. Extensive fat stranding and fluid extends from the region of the gallbladder around the hepatic flexure and in the right paracolic gutter. Differential diagnostic considerations include clinical acute cholecystitis. Disease in the colon less likely.No evidence of intrahepatic biliary dilatation. No focal liver lesions. Portal and hepatic venous enhance normally.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Cortical thinning and small probable cysts consistent with chronic medical renal disease. Punctate calcifications.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild thickening antrum. This may be secondary to the process described above in the pericholecystic area. Gastritis less likely but possible. Fluid in the pericholecystic area is seen around the omentum and mesentery of the hepatic flexure and extending into the right paracolic gutter.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Likely normal renal allograft in right iliac fossa.
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Fat stranding and fluid right upper quadrant as detailed above. Favor gallbladder etiology.
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Generate impression based on findings.
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2 year-old male with 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. There is opacification of paranasal sinuses and mastoid air cells/middle ear cavities.
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No acute intracranial abnormality.
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Generate impression based on findings.
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4 year-old female with vomiting but no fever. 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 is mild paranasal sinus inflammatory disease.
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No acute intracranial abnormality.
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Generate impression based on findings.
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14 year-old male with syncope. 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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82 year-old female with AML, to rule out baseline sinusitis. The orbits are unremarkable except for lens prostheses. The mastoids are clear. Limited view of the intracranial structure is unremarkable apart from mild arterial calcification. There is leftward nasal septal deviation with spurring. 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 are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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No evidence of sinusitis. Leftward nasal septal deviation with spurring.
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Generate impression based on findings.
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Male; 44 years old. Reason: Pls give delayed contrast for visual of the ureters (CT Urogram) History: abdominal pain, hematuria ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left nephroureterostomy in place with tip in neobladder. Moderate bilateral hydronephrosis. New right non-obstructing calyceal calculus measuring 8 mm. Metastatic soft tissue mass encasing the distal left ureter, best seen on image 101 of series 6, is similar in size measuring 4.2 x 2.5 cm, previously 4.2 x 2.5 cm. Foci of gas within both collecting systems slightly represents reflux from neobladder.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Infrarenal IVC filter in expected location.PELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy and creation of neobladder.BLADDER: No significant abnormality notedLYMPH NODES: Soft tissue mass in the left lower pelvis, best seen on image 120 series 6, which is relatively stable measuring 3.3 x 7.2 cm, previously 3.5 x 6.2 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Bilateral moderate hydronephrosis without evidence of stent dysfunction.2.Non-obstructing right renal calculus.3.Stable metastatic disease and postsurgical changes.
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Generate impression based on findings.
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Male 58 years old; Reason: pt with metastatic melanoma s/p seveal cycles of DTIC chemotherapy - please assess response to therapy History: melanoma CHEST:LUNGS AND PLEURA: Bilateral pulmonary metastatic deposits are again seen, relatively stable in size. For example, Right lower lobe pulmonary lesion measures 1.0 x 1.0 cm (image 83/series 5) previously, 1.0 x 0.9 cm.Left lung base lesion measures 1.4 x 1.0 cm (image 86/series 5) previously, 1.2 x 0.9 cm.The previously reference lesions are stable. For example, a right lower lobe lesion measures 1.2 x 1.1 Cm, previously 1.2 x 1.0 cm (image 85 series 5). The left lower lobe nodule measuring 6 x 6 mm, previously 6 x 6 mm (series 5 image 72).Pleural spaces are clear. Interval resolution of the right-sided ground glass opacities in the upper lobes. No definite new solid lesions.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Chronic right rib fractures. Small left axillary lymph nodes.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Reference segment 7 lesion measures 1.4 x 0 .9 cm, previously 1.2 x 0.8 cm (image 101/series 3).Reference segment 3 lesion measures 2.0 x 1.6 cm (image 134/series 3) previously, 2.0 x 1.4 cm.Other hepatic lesions are unchanged.The hepatic and portal veins are patent. No biliary ductal dilatation.SPLEEN: Hypervascular splenic lesion is unchanged.PANCREAS: 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: Small umbilical hernia containing fat.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Pelvic lymph nodes are unchanged. Index left distal external iliac lymph node measures 1.7 x 0.8 cm (image 189/series 3) previously, 1.6 x 0.9 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Near stable size measurements of the reference lesions. No definite new lesions.
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Generate impression based on findings.
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Male, 63 years old, relapsed AML with ongoing neutropenic fevers. Very mild mucosal thickening is evident through the ethmoid air cells. The paranasal sinuses are otherwise free of significant mucosal thickening and debris. There is mild soft tissue opacification at the level of the left frontoethmoidal recess. The major sinus ostia are otherwise unobstructed. Incidental note is made of bilateral accessory maxillary ostia.The nasal cavity is clear. The nasal septum is intact. The turbinates are morphologically within normal limits.Minimal opacification of the right mastoid air cells is seen. Otherwise, mastoid air cells and middle ear cavities are clear.
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No evidence of active sinusitis.
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Generate impression based on findings.
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82-year-old female with chest pain. Rule out PE. PULMONARY ARTERIES: Technically adequate for evaluation of pulmonary embolism although there is respiratory motion artifact in the lung bases. No pulmonary embolus identified.LUNGS AND PLEURA: Respiratory motion artifact limits evaluation of the lower lobes. A 6-mm nodule in the right lower lobe (series 11, image 82) has grown slightly in size, previously 4 mm, but most likely an intrapulmonary lymph node. No new nodules identified. Scattered micronodules, some calcified, are unchanged. A right upper lobe groundglass nodule is stable since 2004.MEDIASTINUM AND HILA: An enlarged right paratracheal node is not significantly changed, measuring 11 mm (series 8, image 20), previously in 10 mm.Normal heart size. No pericardial effusion. Atherosclerotic calcifications in the coronary and thoracic aorta are moderate and unchanged.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple hypodense liver lesions, some too small to characterize, though grossly unchanged and favor benign etiology.Large exophytic superior pole cyst in the left kidney is partially imaged, though is grossly stable and suggestive of a simple cyst.
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No evidence of pulmonary embolism as clinically questioned.Slight interval growth of right lower lobe pulmonary nodule. A follow-up in 12 months is suggested.
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Generate impression based on findings.
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Male, 57 years old, history of diffuse large B-cell lymphoma involving the tonsil and neck. The left palatine tonsil is markedly enlarged measuring approximately 3.5 x 3.0 cm (image 28 series 7). On the prior examination, the left palatine tonsil was normal in size and without evidence of discretely measurable tumor. The oropharyngeal airway is partly effaced, but the airway does remain patent.The left aspect of the soft palate is mildly thickened as well. It is unclear if this reflects reactive edema or involvement by tumor. Elsewhere the aerodigestive mucosa is within normal limits.The appearance of left level 2 adenopathy has changed since the prior examination in that the dominant node or aggregate of nodes has developed central cystic change whereas previously it was heterogeneously enhancing. This lesion measures 4.2 x 3.4 cm in maximal transaxial dimension (image 34 series 7), previously 3.8 x 2.8 cm. Smaller though still pathologic nodes are present adjacent to this dominant lesion both at levels 2 and 3. No pathologic adenopathy is detected in the right neck by size criteria.The salivary glands and thyroid are free of focal lesions. The cervical vessels remain patent with the exception of the left internal jugular vein which is effaced through the region of bulky left neck adenopathy. No concerning osseous lesions are seen. Degenerative disease is present through the cervical region with posterior disk-osteophyte complex formation at lower levels and posterior element hypertrophy.
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1. Interval development of marked thickening of the left palatine tonsil. This results in partial effacement of the oropharyngeal airway. The airway does, however, remain patent.2. Bulky left level 2 adenopathy is redemonstrated. Since the prior examination, a dominant node or aggregate of nodes has increased in size while also developing a central cystic change.
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Generate impression based on findings.
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Male; 63 years old. Reason: relapsed AML w/ ongoing neutropenic fevers, eval for intraabd infection History: ongoing neutropenic fevers 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:LUNGS AND PLEURA: Nonspecific micronodules are similar to prior.MEDIASTINUM AND HILA: Central venous catheter tip at the cavoatrial junction. Nonpathologic sized mediastinal lymph nodes are present.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: Hypodense round lesion in the posterior midpole, best seen on image 131 of series 3, measures 2.7 x 2.9 cm. Probable left non-obstructing calyceal calculus measuring 5 mm. Probable simple cyst arising from the inferior pole of the right kidney. No hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse wall thickening of the distal duodenum and proximal jejunum which, given the patient's history of relapsed AML and fever, may represent infection.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No evidence of abnormal fluid collection or inflammatory changes.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Left fat-containing inguinal hernia. No evidence of abnormal fluid collection or inflammatory changes.
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1.Diffuse wall thickening of the distal duodenum and proximal jejunum which, given the patient's history of relapse AML and neutropenic fever, may represent gastroenteritis.2.Right kidney lesion as described above cannot be accurately characterized without contrast enhancement. If patient care warrants further imaging, an ultrasound may be obtained.These results were discussed with Dr. Cohen by Dr. Masse on 12/23/13 at 1020.
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Generate impression based on findings.
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92 year-old female status post MVA and new onset hearing loss and fatigue. There is patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and prominent, representing volume loss. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. Intracranial arterial calcification. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. Lens prostheses.
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No acute intracranial abnormality. Moderate 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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Male 57 years old; Reason: 57 year old man with DLBCL of the neck and tonsil. Initial staging exam. History: Neck swelling and sore throat. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, some of which are calcified. No discrete masses or nodules detected. Paragraph the pleural spaces are clear.MEDIASTINUM AND HILA: Borderline adenopathy is noted with reference para-aortic node measuring 0.9 x 1.4 cm (series 3 image 30).CHEST WALL: No significant abnormality notedOTHER: Patient has a dual lead pacemaker with cardiomegaly.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Few too small to characterize lesions in the kidneys is mild perinephric edema. No discrete masses or hydronephrosis detected.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small bilateral inguinal hernias which contain omental fat.
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1.No pathologically enlarged adenopathy detected.
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Generate impression based on findings.
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37-year-old male. Nasopharyngeal cancer and PEs as well as chronic aspiration. Evaluate for aspiration pneumonia versus PE. PULMONARY ARTERIES: Technically adequate exam for evaluating pulmonary embolism. No acute pulmonary emboli identified.LUNGS AND PLEURA: Debris in the right mainstem bronchus and trachea. Extensive bilateral lower lobe bronchial wall thickening and mucus impaction. Lower lung zone tree-in-bud opacities and basilar dependent consolidation consistent with aspiration bronchiolitis/infection. MEDIASTINUM AND HILA: 14-mm reference right hilar lymph node measures 14 mm on series 8, image 110, unchanged. Extensive collateral vessels are noted in the mediastinum likely related to attenuation of the brachiocephalic veins near their confluence with the SVC. Left Port-A-Cath tip is in the SVC.CHEST WALL: Tracheostomy and neck surgery are again noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No evidence of acute pulmonary embolism.2. Findings consistent with aspiration bronchiolitis/infection.
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Generate impression based on findings.
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26 year-old female with swallowed fish bone. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. No radiopaque foreign body is detected. 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 parotid, submandibular, and thyroid glands are unremarkable. The osseous structures are unremarkable. Limited view of the chest is unremarkable.
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Unremarkable contrast enhanced CT soft tissue neck with no evidence of radiopaque foreign body, lymphadenopathy or mass.
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Generate impression based on findings.
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History provided states 77-year-old male with Crohn's disease. Status post colectomy with worsening abdominal pain, nausea, vomiting, slightly elevated lactate. Concern for obstruction. Prior CT imaging states patient has history of ulcerative colitis ABDOMEN:LUNG BASES: Right pericardial 2.5-cm diameter lesion, unchanged dating back to March, 2013 of uncertain significance. No other significant abnormalities.LIVER, BILIARY TRACT: Benign. Liver cysts, unchanged without other abnormality. Gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign liver cyst, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post prior colectomy with right lower quadrant ileostomy. Apparent slight thickening of the wall of several distal jejunal loops is seen, but I would favor this being lack of bowel distention and collapsed bowel, rather than active inflammatory bowel disease, particularly if the patient's history is indeed ulcerative colitis. Although slight dilatation of distal small bowel loops are again seen no evidence of bowel obstruction seen with rapid progression of orally administered contrast through the small bowel to the ileostomy. No free fluid is seen in the mesentery. 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: Status post prior colectomy with right lower quadrant ileostomy. Apparent slight thickening of the wall of several distal jejunal loops is seen, but I would favor this being lack of bowel distention and collapsed bowel, rather than active inflammatory bowel disease, particularly if the patient's history is indeed ulcerative colitis. Although slight dilatation of distal small bowel loops are again seen no evidence of bowel obstruction seen with rapid progression of orally administered contrast through the small bowel to the ileostomy. No free fluid is seen in the mesentery. BONES, SOFT TISSUES: No change appear to penile prosthesis with reservoir.OTHER: No significant abnormality noted
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1. Status post colectomy with right lower quadrant ileostomy, unchanged in appearance since 11/30/13. 2. No evidence of significant bowel obstruction. 3. No change soft tissue density adjacent to right pericardium.
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Generate impression based on findings.
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Wrist fracture, evaluate for fracture Comminuted intra-articular fracture of the distal radius is seen with the fracture fragments in near anatomic alignment. The fracture involves primarily the dorsal aspect of the radius. There is associated soft tissue swelling. The visualized tendons appear intact and there is no evidence of tendon entrapment.
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Comminuted intra-articular distal radius fracture.
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Generate impression based on findings.
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Female; 75 years old. Reason: r/o diverticulosis History: abdominal pain, rectal bleeding ABDOMEN:LUNG BASES: Left hilar granuloma incompletely visualized.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: Diffuse atherosclerotic calcifications and aneurysmal dilatation of the abdominal aorta extending into the common iliac arteries.BOWEL, MESENTERY: No evidence of obstruction, pneumatosis, or pneumoperitoneum. Extensive chronic-appearing colonic diverticulosis without evidence of acute diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Cardiomegaly.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Extensive chronic-appearing sigmoid diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Chronic diverticulosis without evidence of acute diverticulitis.2.Diffuse atherosclerotic disease of the abdominal aorta and its branches.
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Generate impression based on findings.
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65 or old male. Hospitalized two weeks status post stem cell transplant, acutely SOB and hypoxic, known chronic DVTs. PULMONARY ARTERIES: Diagnostic exam for pulmonary embolism to the segmental level. Motion degradation the upper lobes limits evaluation. No acute pulmonary pulmonary emboli seen.LUNGS AND PLEURA: Moderate bilateral pleural effusions, left greater than right, with associated atelectasis, increased from prior exam. Motion degradation in upper lobes limits evaluation.MEDIASTINUM AND HILA: Small pericardial effusion. Right jugular venous catheter tip terminates in the SVC. Mediastinal lipomatosis. Mild enlarged mediastinal lymph nodes are again seen, likely reactive.CHEST WALL: Degenerative changes of the thoracic spine. Multiple compression fractures status post vertebroplasty. Deformity of the sternum, related to a remote fracture. Right sided old healed rib fracture. Anasarca, increased.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small amount of ascites.
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1. Limited evaluation of the upper lobes due to motion degradation. No acute pulmonary embolism seen to the segmental level.2. Moderate bilateral pleural effusions, left greater than right, with small amount of ascites, increased from prior exam. No specific evidence of pulmonary edema.
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Generate impression based on findings.
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58 old female with shortness of breath, chest pain, abnormal chest x-ray. Evaluate for PE and consolidation of left lower lobe. PULMONARY ARTERIES: Technically adequate examination for evaluation of pulmonary embolus. No pulmonary embolus identified.LUNGS AND PLEURA: Moderate bilateral pleural effusions with associated compressive atelectasis, most prominent in the lower lobes. Multifocal ground glass opacities and interlobular septal thickening suggest mild pulmonary edema.MEDIASTINUM AND HILA: Moderate cardiomegaly. Dense coronary calcifications. Previously noted enlarged paratracheal node is similar in size, measuring 9 mm in short axis (series #6, image 48). Other borderline-enlarged mediastinal nodes are unchanged.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Densely calcified splenic artery. Atherosclerotic calcifications of the abdominal aorta and its branches.
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No evidence of pulmonary embolism.Cardiomegaly with mild pulmonary edema and bilateral effusions suggestive of heart failure.
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Generate impression based on findings.
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Male; 55 years old. Reason: POD 10 s/p liver transplant with recent post op hct drop, now with tachycardia, ileus, elevated WBC, please look for pseudoaneurysm, hematoma, ileus, SBO History: POD 10 s/p liver transplant with recent post op hct drop, now with tachycardia, ileus, elevated WBC, please look for pseudoaneurysm, hematoma, ileus, SBO ABDOMEN:LUNG BASES: Patchy multifocal airspace opacities with small bilateral pleural effusions favoring pneumonia.LIVER, BILIARY TRACT: Postsurgical changes consistent with liver transplant. Focal dilatation of the common hepatic artery at the area of the surgical anastomosis, best seen on image 77 of the coronal reconstruction and image 61 of series 8, measures 1.0 x 0.8 cm represents a pseudoaneurysm. Surrounding the pseudoaneurysm, a large hematoma measuring 8.8 x 5.0 cm with blush of hyperattenuation immediately posterior representing active contrast extravasation. Moderate perihepatic ascites. Minimal intrahepatic ductal dilatation. Multiple perihepatic surgical drains.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: The bowel is moderately distended with discrete transition point in the right lower quadrant consistent with high-grade partial small bowel obstruction. Additionally, there is diffuse wall thickening of the proximal colon BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of pneumoperitoneum is likely postsurgical in nature. Surgical skin staples. NG tube in stomach.VASCULATURE: The celiac axis is patent. Pseudoaneurysmal dilatation of the common hepatic artery as described above. The SMA, renal arteries, and IMA are patent.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate free pelvic fluid.
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1.Pseudoaneurysm of the common hepatic artery at the site of surgical anastomosis with surrounding hematoma and active contrast extravasation.2.High-grade partial small bowel obstruction with transition point in the right lower quadrant.3.Bilateral multifocal airspace opacities consistent with bilateral pneumonia.4.Diffuse wall thickening involving proximal colon; cannot exclude acute infectious or ischemic etiology.5.Postsurgical changes as described above.These findings were discussed with Dr. Sur by the radiology resident on call, Dr. Funaki and Dr. Masse.
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Generate impression based on findings.
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35 year old male. New acute leukemia with functional neutropenic fever. LUNGS AND PLEURA: Bibasilar linear atelectasis/scar. A few scattered calcified and noncalcified micronodules. No focal airspace consolidation or pleural effusion.MEDIASTINUM AND HILA: No definite mediastinal or hilar lymphadenopathy within limits of noncontrast exam. Normal heart size without significant pericardial effusion.CHEST WALL: No focal osseous lesion identified.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Mildly enlarged peripancreatic lymph nodes.
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No specific evidence of infection.
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Generate impression based on findings.
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62-year-old female with refractory abdominal pain. Evaluate for mesenteric ischemia. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No abnormality seen in liver, however, arterial phase imaging does not fully evaluate liver parenchyma. Gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No lymphadenopathy or abnormal masses.CT ANGIOGRAM: Aorta shows minor atherosclerotic calcifications without evidence of aneurysmal dilatation or dissection. The aorta bifurcates normally into the normal. Bilateral common iliac arteries, which bifurcate to patent internal and external iliac arteries. The origins of the celiac axis and its branches appear normal. Origin of superior mesenteric artery appears normal. Bilateral renal arteries show normal origins. Inferior mesenteric artery origin is normal and patent.BOWEL, MESENTERY: No significant abnormality noted. Lack of abnormality seen in the small bowel makes ischemic disease unlikely.BONES, SOFT TISSUES: Diffuse bony degenerative changes.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy. No other abnormalities.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse bony degenerative changes. No change sclerotic changes in the left iliac wing with slight trabecular thickening dating back to 2008. Postsurgical changes in anterior abdominal wall.OTHER: No significant abnormality noted
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1. Mild atherosclerotic changes throughout the abdominal aorta and without significant narrowing or evidence of decreased flow to intestines. 2. No abnormality seen in the intestinal tract to suggest ischemia.
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Generate impression based on findings.
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52-year-old male.Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules identified. Mild bronchial wall thickening is present, as well as subsegmental atelectasis in the right lower lobe. Calcified left lingular micronodule suggestive of prior granulomatous disease.MEDIASTINUM AND HILA: Calcified mediastinal and left hilar lymph nodes suggestive of prior granulomatous disease. A left-sided port catheter tip lies in the right atrium.CHEST WALL: Severe degenerative changes of the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The right kidney is low riding in the right flank and facing anteriorly. The left kidney is normal.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.Contrast-filled balloon type PEG tube is noted.BONES, SOFT TISSUES: Severe degenerative changes of the thoracolumbar spine. Fractured osteophyte inferior to inferior margin of L2, unchanged.OTHER: No significant abnormality noted.
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No evidence of metastatic disease. Findings are present suggesting chronic aspiration.
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Generate impression based on findings.
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80 year-old female. Evaluate for connective tissue disease. LUNGS AND PLEURA: Large right and small left pleural effusions with associated atelectasis. Patchy basilar predominant ground-glass opacities with septal thickening suggestive of edema. Nonspecific nodular opacities are superimposed on this background of ground glass. Evaluation for underlying lung pathology is limited by the aforementioned findings.MEDIASTINUM AND HILA: ETT tip 3 cm of the carina. Cardiomegaly without significant pericardial effusion. ICD. Right jugular Swan-Ganz catheter tip terminates in the right main pulmonary artery. Enlarged mediastinal lymph nodes. Ectatic ascending aorta measuring 3.8 cm in diameter.Severe coronary artery calcifications.CHEST WALL: Degenerative arthritic changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. NG tube tip terminates in the stomach.
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Bilateral pleural effusions and basilar predominant ground-glass opacities with septal thickening, most consistent with CHF pattern. There are superimposed nodular opacities on the background of edema, of uncertain etiology.
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Generate impression based on findings.
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Female 37 years old; Reason: please assess for possivle infection, pt septic, possible UTI History: fever, tachycardia, RLQ tenderness ABDOMEN:LUNGS BASES: Bibasilar atelectasis with a small left pleural effusion. Opacity in the left lung base is incompletely characterized, correlate for infectious etiology.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable appearance of the IVC filterBOWEL, MESENTERY: Rim enhancing fluid collection with foci of gas measuring 5.7 x 5.4 cm (series 80960 image 49) is seen, which has decreased in sizesince the previous exam. The fluid collection has become more organized, and now contains foci of gas suggesting the possibility of superinfection of the previously seen hematoma in this region. Extensive inflammatory reaction is noted in the mesentery, although decreased since previous exam. No definite contrast extravasation is seen.PEG tube is noted in the stomach, which does not appear to be positioned properly against the wall, correlate clinically.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: IUD in place with physiologic uterus and adnexaBLADDER: Foley catheter collapses the bladder limiting evaluation.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Decrease in amount of the pelvic hemoperitoneum and ascites.
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1.Slight interval decrease in size of the perigastric fluid collection with more organization and containing foci of gas, with enhancement of the wall concerning for superinfection.2.Decrease in the amount of hemoperitoneum without frank contrast extravasation3.Malposition of the PEG tube as described above
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Generate impression based on findings.
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64 year old female with ovarian cancer receiving chemotherapy. CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules. The reference left lower lobe nodule is not significantly changed and measures 6 x 5 mm, previously measured 6 x 5 mm (series 6, image 62). A non-reference right middle lobe nodule appears mildly increased in size and measures 8 mm, previously measured 6 mm (series 6, image 45). No consolidation or pleural effusions.MEDIASTINUM AND HILA: Reference right paratracheal node is unchanged, measuring 1.5 x 1 .0 cm, previously measured 1.4 x 1.1 cm (series 4, image 32). Reference paraesophageal node measures 8 x 8 mm, previously measured 8 x 8 mm (series 4, image 74).Heart is normal in size without pericardial effusion. Right chest wall port tip in distal SVC.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Reference hepatic dome lesion is not significantly changed, measuring 2.3 x 2.4 cm, previously measured 2.6 x 2.5 cm (series 4, image 74).A more inferiorly located non-reference segment 7 lesion is significantly increased in size, measuring 1.7 x 1.7 cm, previously measured 1.0 x 0.8 cm (series 4, image 82). Additional non-reference lesion located in the hepatic dome adjacent to IVC is also significantly increased in size, currently measuring 1.5 x 1.3 cm, previously measured 0.6 x 0.6 cm (series 4, image 73 (series 4, image 73).Left lobe lesion not significantly changed (series 4, image 90).Status post cholecystectomy.SPLEEN: Thrombosed splenic artery aneurysm unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic left kidney. Left nephroureteral stent in place.RETROPERITONEUM, LYMPH NODES: A small reference gastrohepatic node measures 8 x 7 mm, previously measured 9 x 7 mm (series 4, image 86).Reference periaortic node measures 1.0 x 0.6 cm, previously measured 1.0 x 0.5 cm (series 4, image 118).The reference soft tissue density adjacent to left common iliac artery is difficult to accurately measure but appears unchanged and measures approximately 1.6 x 1.1 cm, previously measured 1.5 x 1.2 cm (series 4, image 140).Reference soft tissue adjacent to right psoas not significantly changed and measures 1.6 x 0.8 cm, previously measured 1.4 x 0.7 cm (series 4, image 139).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Significant interval increase in size non-reference hepatic lesions.2.Stable to slightly increased size of lung nodules. 3.Stable reference lymph nodes.
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Generate impression based on findings.
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82 year-old female with AML. Evaluate for baseline infiltrate. LUNGS AND PLEURA: Clustered micronodules and nodular opacities in the left lower lobe and related post-surgical changes consistent with history of benign granulomatous disease. 12 x 13 mm spiculated nodule in the right middle lobe best seen on the coronals is of uncertain etiology, may be infectious or neoplastic (series 80232, image 57). MEDIASTINUM AND HILA: Main pulmonary artery diameter of 3.7 cm suggestive of pulmonary artery hypertension. Mildly enlarged precarinal lymph node measures 14 mm. Cardiomegaly without significant pericardial effusion.CHEST WALL: Degenerative arthritic changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. Moderate hiatal hernia. Lobular contour of the left kidney with mild cortical thinning. Left adrenal adenoma. Probable left peripelvic cysts, incompletely visualized.
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1. Clustered micronodules and nodular opacities in left lower lobe most consistent with biopsy proven benign granulomatous disease.2. Spiculated nodule in the right middle lobe of uncertain etiology, may be infectious or neoplastic. Recommend retrieval of prior studies for comparison. 3. Findings suggestive of pulmonary artery hypertension.
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Generate impression based on findings.
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89-year-old female with abnormal brain lesion, elevated liver function test. Rule-out signs of malignancy. CHEST:LUNGS AND PLEURA: No parenchymal lung nodules or masses. Dependent atelectasis.. No pleural disease.MEDIASTINUM AND HILA: Markedly enlarged left thyroid lobe with heterogeneous appearance, measuring 6.1 x 5.8 cm. Right thyroid lobe appears normal. Enlarged pretracheal lymph node (series 4, image 34) measuring 1.5 x 2.2 cm. No other enlarged lymph nodes seen. Coronary artery calcification 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: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Stomach is collapsed with minimal distention. There is apparent thickening of the fundus of the stomach, but this may relate to lack of distention. Small bowel, and colon show no diagnostic abnormalities with no evidence of obstruction. No free mesenteric fluid is seen. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple calcified masses in uterus, representing fibroid tumors. No other abnormalities.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bony degenerative changes without evidence of metastatic disease.OTHER: No significant abnormality noted.
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1. Left lobe thyroid mass. 2. Small bowel, and colon appear normal -- stomach is nondistended and cannot be evaluated, although wall thickening present mat relate to lack of distention. 3. No other significant abnormality seen.
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Generate impression based on findings.
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Male; 64 years old. Reason: r/o obstruction vs diverticulitis History: LLQ Pain Lack of intravenous contrast enhancement limits the evaluation of solid organ parenchyma and vascular structures. Given these limitations, the following observations can be made:ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: Small hypodense lesion in hepatic dome cannot be accurately characterized without contrast enhancement. No evidence of intrahepatic ductal dilatation. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate descending colon diverticulosis with minimal mesenteric fat stranding, best seen on image 129 of Series 3, which may represent early diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Infrarenal IVC filter in expected location. Multiple fat-containing ventral hernias.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Early diverticulitis of the distal descending colon.
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Generate impression based on findings.
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54-year-old male. Reason: Patient with recent gingival biopsy positive for invasive squamous cell carcinoma. Please evaluate for metastasis. History: As above. LUNGS AND PLEURA: Multiple scattered bilateral micronodules, some calcified. Noncalcified 6-mm right upper lobe nodule (series #4, image 82) and 7-mm left lingular nodule (series #4, image 134) are identified. Mild subpleural reticulation in the left upper and lower lobes and right lung base, raising the question of early fibrosis.No pleural effusions.MEDIASTINUM AND HILA: A borderline enlarged pretracheal lymph node measures 10 mm in its short axis (series #3, image 26). Other scattered nonenlarged mediastinal lymph nodes are noted. A calcified right hilar lymph node compatible with prior granulomatous disease.CHEST WALL: Partial collapse of T11 vertebral body of indeterminate age.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Punctate splenic calcification is consistent with prior granulomatous disease. Left kidney not visualized.
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1.Scattered calcified and noncalcified micronodules, most likely representing prior granulomatous disease. However, metastatic disease cannot be definitively excluded. Continued surveillance is recommended.2.Mild subpleural reticulation could represent early fibrosis.3.No definite evidence of metastatic disease.
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Generate impression based on findings.
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70-year-old male. AML, persistent neutropenic fevers. Evaluate for infiltrate. LUNGS AND PLEURA: Moderate right and small left pleural effusions, new from prior exam, with associated atelectasis. Patchy upper lobe predominant ground-glass opacities likely related to expiratory phase of scan and associated edema given presence of septal thickening. No specific evidence of infection.Calcified granulomas.MEDIASTINUM AND HILA: Left PICC tip in the SVC. Mild atherosclerotic calcification of the thoracic aorta. Low attenuation blood pool consistent with anemia.CHEST WALL: Degenerative arthritic changes involving the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Splenic granulomas.
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1. No specific evidence of infection.2. Interval development of moderate right and small left pleural effusions and pulmonary edema.
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Generate impression based on findings.
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Female, 64 years old, with altered mental status, nausea vomiting after fall last week. Minimal infiltration of the right parietal scalp has improved from the prior exam. The bones of the calvarium are intact.The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
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1. Resolving right parietal scalp injury.2. No acute intracranial abnormalities.
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Generate impression based on findings.
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49 year-old female. History of AML and Hodgkin's lymphoma in 1985. Cough. Evaluate for infection. LUNGS AND PLEURA: Bilateral paramediastinal radiation fibrosis with bronchiectasis, unchanged. Moderate bilateral pleural effusions, not significantly changed.Mild patchy groundglass opaciites in lower lung zones with septal thickening consistent with edema. Two nodular opacities in the right lower lobe with halo of ground-glass attenuation, possibly represents atypical infection.MEDIASTINUM AND HILA: Large calcified mediastinal lymph nodes. Right jugular catheter tip in the SVC. Low attenuation blood pool consistent with anemia. Moderate pericardial effusion/thickening, similar to prior exam.CHEST WALL: Axillary lymphadenopathy, new from prior exam. Reference left axillary node measures 11 mm (series 3, image 20).UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Nodular opacities in the right lower lobe possibly represent atypical infection.2. Persistent pleural effusions and mild pulmonary edema.3. Axillary lymphadenopathy, new from prior exam.
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Generate impression based on findings.
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34-year-old male with Hodgkin's lymphoma. CHEST:LUNGS AND PLEURA: No significant change in peripheral nodular opacity in the right lower lobe, which may represent scarring (series 5, image 62). No consolidation or pleural effusions.MEDIASTINUM AND HILA: Calcified lesion adjacent to inferior left heart border unchanged, likely representing treated tumor.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensity in segment 4A unchanged and too small to characterize but likely cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Interval appendectomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No evidence of lymphadenopathy.2.Calcified lesion adjacent to left heart border is unchanged, likely representing treated tumor.3.Stable subcentimeter liver hypodensity, which most likely represents cyst.
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Generate impression based on findings.
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66 year-old female. Acute SOB. Evaluate for pneumonia versus effusion. LUNGS AND PLEURA: Patchy right lower lobe consolidation consistent with pneumonia. Small right pleural effusion. Left lower lobe ill-defined centrilobular nodules and mild bronchial thickening, consistent with aspiration/small airways disease. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Severe coronary calcifications. Main pulmonary artery diameter is 3.6 cm suggestive of pulmonary artery hypertension. Hypoattenuating blood pool compatible with anemia.CHEST WALL: Heterogeneous appearance of the visualized skeleton consistent with history of MDS.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Mild splenomegaly.
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Right lower lobe consolidation consistent with pneumonia. Small right pleural effusion.
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Generate impression based on findings.
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68 year-old male with prostate cancer under active surveillance. Equivocal findings on cytology and CT scan in 5/2013. Gross hematuria. ABDOMEN:LUNG BASES: Right basilar scarring.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Simple left renal sinus cyst is unchanged and measures 3.5 x 2.4 cm (series 9, image 50). No significant change in the focal dilation of left upper pole calix, which may be caused by cyst. No suspicious lesions. No hydroureter or filling defects on delayed images. 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: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Unchanged sclerosis of L5 and S1, likely degenerative in nature. Spinal canal stenosis noted at L5-S1.OTHER: No significant abnormality noted
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1.No suspicious renal or collecting system lesions.2.Stable left renal sinus cyst, which is likely cause of dilation of left upper pole calix.
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Generate impression based on findings.
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16-year-old female with right lower quadrant abdominal pain -- rule-out appendicitis. 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: Orally administered contrast rapidly progresses to normal. Stomach, and small bowel to the right lower quadrant. Colon is feces filled and without abnormality. Appendix is well-visualized and normal without any signs of inflammation or periappendiceal abnormalities. No free mesenteric fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Normal uterus. Unilocular 4.5-cm benign-appearing cyst in left adnexa, most likely physiologic.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Orally administered contrast rapidly progresses to normal. Stomach, and small bowel to the right lower quadrant. Colon is feces filled and without abnormality. Appendix is well-visualized and normal without any signs of inflammation or periappendiceal abnormalities. No free mesenteric fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. No signs of appendicitis -- no abnormality seen to account for right lower quadrant pain. 2. Left ovarian cyst.
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Generate impression based on findings.
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Reason: high res ct requested History: hypoxia, possible hx of sarcoida 3/30/08 LUNGS AND PLEURA: Mild mosaic attenuation abnormality demonstrating air trapping on the expiratory images. No evidence of interstitial lung disease.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: There is cardiomegaly with small pericardial effusion.Mild coronary calcifications and extensive aortic valvular calcification.Enlargement of pulmonary artery compatible pulmonary arterial hypertension.ICD leads in the right atrial appendage and right ventricle.No evidence of mediastinal or hilar lymphadenopathy.CHEST WALL: Extensive degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Incompletely evaluated hepatic in renal hypodensities.
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1.Mosaic attenuation pattern and evidence of air trapping on the expiration images.2.No evidence of interstitial lung disease. Specifically, no evidence of sarcoidosis.3.Cardiomegaly and small pericardial effusion.4.Enlargement of the pulmonary artery compatible with pulmonary arterial hypertension.
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Generate impression based on findings.
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31 year-old female with right lower quadrant pain, nausea and vomiting x 1 week -- assess for appendicitis or any source of abdominal infection or cause of pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Orally administered contrast is predominantly in the stomach, duodenum, and proximal jejunum. There is no evidence of obstruction with collapsed small bowel, and this most likely relates to timing of administration of contrast that no contrast is seen more distally. No abnormalities are seen in the small bowel. Right colon, descending colon, sigmoid colon and rectum appear normal. The transverse colon shows mild wall thickening, which may be accentuated by lack of distention, but appears different from the remainder of colon and raises question of colitis. No free mesenteric fluid is seen.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: Orally administered contrast is predominantly in the stomach, duodenum, and proximal jejunum. There is no evidence of obstruction with collapsed small bowel, and this most likely relates to timing of administration of contrast that no contrast is seen more distally. No abnormalities are seen in the small bowel. Right colon, descending colon, sigmoid colon and rectum appear normal. The transverse colon shows mild wall thickening, which may be accentuated by lack of distention, but appears different from the remainder of colon and raises question of colitis. No free mesenteric fluid is seen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Mild thickening of transverse colon, raising question of colitis. 2. No other abnormalities seen.
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Generate impression based on findings.
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71-year-old male who suffered mechanical fall, now with inner left thigh and left pelvic pain (inguinal region.) Was hypotensive overnight with dropping hemoglobin. Please rule out bleed Within limits of a non-IV contrast enhanced examination which limits evaluate for solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: Coronary artery calcification. Evidence of prior granulomatous disease. Right basilar atelectasis.LIVER, BILIARY TRACT: Several partially 1 cm hypodense lesions which have an appearance most likely to be cysts, but without IV contrast cannot completely characterize. Punctate calcification from prior granulomatous disease. No biliary tract abnormality seen.SPLEEN: No significant abnormality noted. There is punctate calcification from prior granulomatous disease.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Homogeneously dense appearance to the renal cortex with an appearance most consistent with having received IV contrast at sometime in the near recent past with persistent nephrogram suggesting acute tubular injury. Clinical correlation for contrast administration as no evidence of that is present in the radiology department. Clinical correlation for renal function could assist in evaluating the significance of this finding.. Benign appearing cortical cysts are seen bilaterally without other renal mass seen. No hydronephrosis or perinephric fluid collections. RETROPERITONEUM, LYMPH NODES: No, adenopathy, masses, or evidence of hematoma. Diffuse aortic calcifications are seen.BOWEL, MESENTERY: No significant abnormality noted. No free mesenteric fluid or evidence of bleeding.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 bowel. Abnormality seen. No free mesenteric fluid or evidence of bleeding.BONES, SOFT TISSUES: Degenerative changes seen about the hips bilaterally.OTHER: No significant abnormality noted
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1. No evidence abdominal/pelvic bleeding. 2. Abnormal renal appearance with enhancement of the cortex diffusely most consistent with prior contrast administration and acute tubular injury.
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Generate impression based on findings.
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52 year-old male status post fall. 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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59 year-old female with headache. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. The osseous structures are unremarkable. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No intracranial abnormality on this pre- and post-contrast CT head.
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Generate impression based on findings.
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54-year-old male with history of upper tract TCC. Surveillance CT urogram. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse decrease in attenuation consistent with fatty infiltration, with focal sparing in segment 4.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post right nephrectomy. Stable subcentimeter hypodensities in the left kidney, likely cysts. No new or suspicious abnormalities.The right ureter is completely opacified on delayed images, without evidence of filling defects or lesions.RETROPERITONEUM, LYMPH NODES: Multiple small retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Eccentric thickening along the right bladder wall appears to have decreased, which may be partially due to greater bladder distension on current exam.LYMPH NODES: Stable prominent pelvic lymph nodes. BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Apparent decrease in thickening of right bladder wall, consistent with known TCC. 2.Stable small retroperitoneal and pelvic lymph nodes.
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Generate impression based on findings.
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54-year-old male. Reason: Evaluate known R sided malignant pleural effusion for possible catheter placement. H/o NSCLC History: Dec breath sounds on R, known effusion. LUNGS AND PLEURA: Large loculated right-sided pleural effusion extends inferiorly to the level of T11 in its posteriolateral aspect (sagittal image 35). Atelectasis/dense consolidation and bronchiectasis in the right middle and lower lobes, obscuring a mass identified on the outside exam dated 11/2/2013 from Little Company of Mary Hospital in the right middle lobe. Increased septal thickening and groundglass opacities in the right lung is compatible with edema, though alternatively, may represent neoplastic extension. Areas of pleural thickening are redemonstrated, seen on outside exam. New scattered ground glass opacities may be inflammatory in origin.Stable postsurgical changes of a wedge resection.MEDIASTINUM AND HILA: A low right paratracheal lymph node measures 16 mm in its short axis (series #3, image 35), stable to minimally increased in size from previous exam. Other paratracheal, AP window, and subcarinal lymphadenopathy is grossly unchanged.Normal heart size. No pericardial effusion.CHEST WALL: Moderate degenerative changes of thoracolumbar spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Punctate right upper pole nonobstructing nephrolith.
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1.Loculated right-sided pleural effusion, as above.2.Dense consolidation of the right middle and lower lobes, obscuring previously seen mass on outside CT.3.Mediastinal lymphadenopathy grossly unchanged.
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Generate impression based on findings.
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14-year-old female with left ankle fracture, evaluate for articular surface involvementEXAMINATION: CT left ankle with 3-D reconstructions 12/23/13 Oblique fracture through the distal tibial metaphysis extends to the physis with widening of the physis. The fracture extends into the epiphysis anteromedially. The fracture line does not extend to the tibiotalar tibiotalar joint. The tibial metaphyseal fracture fragment is posteriorly displaced up to 4 mm. The fibula appears normal. Ankle mortise is intact. Mild soft tissue edema is present along the medial aspect of the ankle. A joint effusion is present. Sclerotic focus in the calcaneus likely represents a benign bone island. A splint is present.
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Type IV Salter-Harris fracture of the tibia without articular surface involvement.
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Generate impression based on findings.
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Female; 43 years old. Reason: assess for stone History: hx stone, 3 days dysuria/frequency b/l low back \T\ low abd pain, hematuria Lack of intravenous contrast enhancement limits the evaluation of solid organ parenchyma and vascular structures. Given these limitations, the following observations can be made: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: Large multilobulated calculus centered in the left renal pelvis extending into the lower calyces associated with mild hydronephrosis. Additionally, there is fat stranding about the inferior aspect of the left perirenal space which is suggestive of inflammatory changes. No evidence of right hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: IUD in the uterus.PELVIS: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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Large left renal calculus which has the appearance of a developing staghorn, associated with mild hydronephrosis and perirenal inflammatory changes.
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Generate impression based on findings.
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76 year old male with history of T-cell lymphoma status post Gemzar Navelbine therapy. CHEST:LUNGS AND PLEURA: Increased moderate left pleural effusion with overlying subsegmental left basilar atelectasis.MEDIASTINUM AND HILA: Increased mediastinal adenopathy. Reference prevascular conglomerate of lymph nodes measures 2.4 x 7.2 cm, previously measured 2.6 x 5.0 cm (series 4, image 34).CHEST WALL: Stable enlarged right axillary lymph node (series 4, image 19). Gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Stable mild splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Multiple enlarged retroperitoneal lymph nodes are increased in size.Reference aortocaval node measures 4.3 x 1.9 cm, previously measured 3.3 x 1.5 cm (series 4, image 106). Preaortic upper retroperitoneal node measures 2.1 x 2.3 cm, previously measured 1.9 x 2.2 cm (series 4, image 104).BOWEL, MESENTERY: New small amount of free fluid is noted in the left lower quadrant. Diverticulosis without evidence of diverticulitis.New enlarged mediastinal lymph nodes; for reference, inferior mesenteric node measures 1.0 cm in short axis (series 4, image 146).BONES, SOFT TISSUES: Bilateral fat containing inguinal hernias, with retracted testicle on the right. Compression fracture of L1 again noted.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis. New small amount of free fluid in the upper pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Increased size of mediastinal, retroperitoneal, and mesenteric lymphadenopathy.2.Increased moderate left pleural effusion.
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Generate impression based on findings.
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Female; 66 years old. Reason: evaluate lung/liver masses History: lung/liver masses CHEST:LUNGS AND PLEURA: Innumerable pulmonary nodules have increased when compared to prior with reference pleural based nodule in the right lower lobe, best seen on image 50 of series 80964, measuring 2.1 to 1.7 cm, previously 1.0 x 0.8 cm. Bibasilar atelectasis.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Innumerable hepatic hypodensities are relatively when compared to prior with reference lesion, best seen on image 27 of series 80856, has increased in size now measuring 2.9 x 2.1 cm. Additionally, there is been interval increase in the amount of perihepatic ascites. No intrahepatic ductal dilatation.SPLEEN: Innumerable splenic hypodensities.PANCREAS: In the body of the pancreas there is a discrete mass, best seen on image 95 of series 80784, which has increased in size now measuring 2.8 x 2.9 cm. This mass obliterates the splenic vein and encases the superior mesenteric artery approximately 180 degrees. Additionally, the pancreatic duct is dilated distal to the mass measuring up to 8 mm. Regional lymphadenopathy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right mid-pole simple cyst unchanged.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate ascites.PELVIS:UTERUS, ADNEXA: Stable uterine fibroids.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.Pancreatic body mass which has obliterated the splenic vein and partially encases the SMA.2.Widespread metastatic disease including interval increase in size and number of pulmonary nodules and relatively stable hepatic lesions.3.Increased ascites.
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Generate impression based on findings.
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Male 66 years old; Reason: NHL, re-eval and compare to previous History: increasing jaw mass, NHL. Redemonstrated is a soft tissue mass lateral to the right mandible involving the buccal/gingival spaces which has increased in size compared to last exam, now measuring 24 x 56 x 25 mm (axial series 7, image 29, series 80342, image 64), whereas previously it measured 16 x 47 x 17 mm. This mass elevates the platysma as well as the other overlying muscles of facial expression.The tumor is again seen infiltrating the right hemimandible. The mandibular cortex demonstrates thinning and there is a focal deficiency of the buccal cortex. Lysis of the buccal cortex of the mandible at the level of the mental foramen is probably increased slightly by about 3 mm. The proximal mandibular canal is involved with tumor but grossly unchanged.Scattered mildly prominent lymph nodes are reidentified in the neck. A right level 2 reference lymph node is unchanged measuring 1.0 cm in its shortest dimension (series 7, image 34). A second reference lymph node at the left level 4 is also unchanged measuring 1.1 cm in shortest dimension (series 7, image 64). The salivary glands and thyroid are unremarkable. The cervical vessels remain patent. Lung apices are clear. Axillary adenopathy is better assess on separately dictated chest CT.
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1.Interval increase in the size of the soft tissue mass in the right buccal/gingival space by all dimensions. 2.Slight increase in the lysis of the buccal surface of the mandible at the level of the mental foramen secondary to involvement of the mandible by the tumor.3.Stable scattered lymph nodes in the neck without new lesions elsewhere. Axillary adenopathy is better assessed on the separately dictated chest CT.
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Generate impression based on findings.
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Male, 18 years old, history of juvenile nasal angiofibroma. Postsurgical changes are again noted and compatible with resection of the patient's original large angiofibroma. These changes include absence of the inferomedial wall of the right maxillary sinus, right middle nasal turbinate, and several right ethmoid air cells. There is also chronic widening of the right sphenoid sinus and right pterygopalatine fossa, as well as chronic erosion of the right pterygoid plate. The enhancing nodule seen within the right posterior nasopharynx on the prior examination is no longer present and there is a new surgical clip in this region, compatible with resection of tumor at this site. Persistent mild enhancement of the soft tissues surrounding the adjacent soft tissues about the right pterygoid plate is identified and not significantly changed since the prior CT. Left maxillary sinus opacification has resolved but fluid and scattered air bubbles are noted within the right maxillary sinus, mildly improved. Mild mucosal thickening of the right ethmoid air cells is also present. The remaining paranasal sinuses and mastoid air cells are clear. The visualized intracranial and orbital contents are unremarkable.
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1. Resolution of the previously described enhancing nodule within the right posterior nasopharynx presumably status post resection, with stable enhancement of the soft tissues surrounding the right pterygoid plate. Differential considerations include residual/recurrent disease or postsurgical reaction within this region.2. Opacification of the right maxillary sinus with scattered air bubbles, mildly improved. Interval resolution of left maxillary sinus opacification.3. Stable but extensive postsurgical changes from the patient's original angiofibroma resection as described above.
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Generate impression based on findings.
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13-year-old female with history of kidney stones, follow-up ABDOMEN:LUNG BASES: No consolidation or pleural effusions.LIVER, BILIARY TRACT: Normal appearance of the liver without focal lesions or ductal dilatation. The gallbladder appears normal.SPLEEN: Normal in appearance.PANCREAS: Normal in appearance.ADRENAL GLANDS: Normal in appearance.KIDNEYS, URETERS: Interval placement of a right ureteral stent with the pigtails within the right renal pelvis and bladder lumen. Right sided hydronephrosis seen on the prior exam has improved.A 5-mm stone in the right renal pelvis is unchanged. Additional punctate stones in the right renal pelvis are unchanged. A 5-mm stone in the distal right ureter is unchanged.A nonobstructing 6 mm stone in the left renal pelvis is unchanged in size. There is no hydronephrosis on the left.RETROPERITONEUM, LYMPH NODES: No intra-abdominal lymphadenopathy.BOWEL, MESENTERY: No bowel wall thickening or dilatation. Appendix appears normal.BONES, SOFT TISSUES: No osseous abnormality. Increased body mass index.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Ureteral stent with pigtail in bladder lumen.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No bowel wall thickening or dilatation. BONES, SOFT TISSUES: No osseous abnormalityOTHER: Trace pelvic free fluid is likely physiologic.
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Interval placement of a right ureteral stent with improved right-sided hydronephrosis. Nephrolithiasis and a 5 mm right ureteral stone are unchanged.
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Generate impression based on findings.
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Reason: other adenopathy? History: smoking, cervical adenopathy LUNGS AND PLEURA: Severe apical predominant paraseptal and centrilobular emphysema, slightly progressed.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Mild coronary vascular calcifications are present. Very small hiatal hernia.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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Severe apical predominant paraseptal and centrilobular emphysema slightly progressed. No evidence of lymphadenopathy.
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Generate impression based on findings.
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57-year-old male. Tonsillar SCC. Staging prior to chemotherapy. CHEST:LUNGS AND PLEURA: Multiple nodules with angular margins along both fissures are not significantly changed, likely intrapulmonary lymph nodes. Scattered micronodules, similar to prior exam. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy. Mild degenerative arthritic changes of the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic steatosis. No focal liver mass. No biliary ductal dilatation. Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No abdominal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative arthritic changes in lumbar spine. Coarsened trabecular pattern in L4 and L5 vertebrae are likely hemangiomas.OTHER: No significant abnormality noted.
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No definite evidence of metastases in the chest or abdomen.
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Generate impression based on findings.
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Inguinal hernia with left and right groin bulge and pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cystRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Small bilateral fat containing inguinal hernias without bowel involvement.OTHER: No significant abnormality noted
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Small bilateral fat containing inguinal hernias without bowel involvement
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Generate impression based on findings.
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83 year old female patient with history of pain and snapping sound with focal swelling on physical exam. Assess for biceps tendon tendon tear. The biceps tendon cannot be well visualized on CT examination. There are degenerative cysts in the femoral head compatible with mild osteoarthritis. No evidence of fracture or dislocation.Surgical clips are noted in the right axilla.
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Biceps tendon cannot be well visualized on CT examination and an MR shoulder is recommended if there is continued clinical concern for tendon rupture. No evidence of fracture or dislocation about the right shoulder.
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Generate impression based on findings.
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79-year-old male. Right lung mass. LUNGS AND PLEURA: Large partially loculated right pleural effusion with small amount of air in the pleural space. Nodular circumferential pleural thickening. Associated compressive atelectasis/consolidation, most prominent in right lung base. Right chest tube terminates in the posterior inferior mediastinum, next to the aorta.Right perihilar mass invading into mediastinal fat measures 5.5 x 3.9 cm (series 8028, image 48).A few areas of subpleural nodularity are seen on the left, for example on series 4, image 56.Mild upper lobe centrilobular emphysema. MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy. A reference precarinal lymph node measures 19 mm in short axis on series 3, image 48.CHEST WALL: Degenerative disk disease of visualized upper lumbar spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesion in the pancreatic head measures 2.2 x 2.3 cm (series 3, image 122), incompletely characterized. Severe atherosclerotic calcification of abdominal aorta and branch vessels.
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1. Right perihilar mass highly suspicious for a primary lung malignancy. Recommend that future exams be done with intravenous contrast if no contraindications exist. 2. Large right pleural effusion with associated extensive nodular pleural thickening, probably a malignant pleural effusion. Right chest tube terminates in inferior posterior mediastinum.3. Mediastinal and hilar lymphadenopathy. 4. Few areas of pleural nodularity in the left chest, of unclear significance. 5. Hypodense lesion in pancreatic head, incompletely characterized. Recommend MRCP or dedicated pancreas protocol CT for further evaluation.
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Generate impression based on findings.
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46 year old female with microhematuria. 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: 1 cm hypodense lesion in the left kidney is too small to accurately characterize but appears to have minimal internal complexity (series 7, image 63).No evidence of stones, hydronephrosis, or collecting system filling defects on delayed images.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications in the aorta and its branches.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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Hypodense left renal lesion measuring about 1 cm is too small to accurately characterize but appears to have mild internal complexity (Bosniak IIF); this is most likely benign in nature, however, interval follow-up in approximately 6 months is recommended to confirm stability.
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Generate impression based on findings.
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66-year-old male with non-Hodgkin lymphoma -- reevaluation. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Scattered small pretracheal and precarinal lymph nodes are again seen. These have minimally changed in size with the reference lymph node (series 3, image 27) measuring 1.2 x 0 .8 cm, previously 1.3 x 0.7 cm.CHEST WALL: Increasing size of numerous right axillary lymph nodes are seen with the prior referenced. Right axillary lymph node (series 3 count, image 23) measuring 3.0 x 1 .5 cm, previously 2.6 x 1.3 cm. Adjacent right axillary lymph nodes are similarly slightly increased in size. Left axillary lymphadenopathy. Subjectively, is also increased similarly.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: The periaortic adenopathy has increased in size throughout the infrarenal to distal aortic region. Prior referenced lymph node (series 3, image 131) now measures 2.4 x 1 .6 cm, previously 1.8 x 1.3 cm. Other lymph nodes have similarly increased in size. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate -- No other4 significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Bilateral pelvic lymphadenopathy is again seen in slightly increased throughout all regions. The prior referenced lymph node in the external iliac chain (series 3, image 188). This essentially unchanged, measuring 1.4 x 2.3 cm compared with previous 1.5 x 2.4 cm. However, other lymph nodes visualized have mostly increased in size -- for example, left iliac lymph node seen series 3, image 179 measures 2.1 x 2 .6 cm, previously 2.3 x 1.7 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Increasing size of lymph nodes in right axilla, abdomen, and pelvis, as measured above.
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Generate impression based on findings.
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Female 82 years old; Reason: Multiphase CT scan to evaluate for renal lesion or bladder lesion causing hematuria and weight loss. History: Hematuria. Past CT scan with renal lesion (?cyst) and bladder wall thickening ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Several small calcifications are noted within the liver parenchyma, consistent with prior granulomatous disease. There is a normal appearing gallbladder without evidence of intrahepatic or extrahepatic biliary ductal dilation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 2.8 x 2.7 cm cyst noted in the mid pole left kidney. There is no hydronephrosis or hydroureter detected. There is prompt symmetric excretion through the ureters without filling defect. The jets are visualized in the bladder, with normal appearing bladder mucosa.RETROPERITONEUM, LYMPH NODES: Moderate to severe atherosclerotic disease of the aorta and its branch vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate degenerative changes in the spine. Patient is status post pinning of the left hip.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified fibroid uterus.BLADDER: No significant abnormality noted.LYMPH NODES: Calcified Lymph nodes are noted in the pelvis.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate degenerative changes in the spine. Patient is status post pinning of the left hip.OTHER: No significant abnormality noted.
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1.No etiology for patient's hematuria seen. No significant abnormalities in abdomen/pelvis.
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Generate impression based on findings.
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Prostate carcinoma 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: Right renal scar. Left renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence for adenopathy or metastatic process.
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Generate impression based on findings.
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18 year-old female with history of recurrent clear cell sarcoma status post chemotherapy, radiation and resection CHEST:LUNGS AND PLEURA: Biapical scarring is unchanged with postsurgical changes in the left upper lobe. Thickening of the right major fissure is increased from the prior exam. Right anterior paramedian last opacities are unchanged and likely treatment related. Scattered micronodules are unchanged. No new suspicious nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Postsurgical changes of left sided partial thyroidectomy. Small nodules are noted in the right thyroid gland. Surgical clips in the right superior mediastinum from prior resection of metastatic lesion. No residual soft tissue is present in this region. No mediastinal or hilar lymphadenopathy. Stable appearance of surgical clips in the right hilum. Heart size is normal.CHEST WALL: 4.2 x 2.3 cm left breast mass is unchanged in size and compatible with a fibroadenoma on prior biopsy. No axillary lymphadenopathy. Postsurgical changes of right anterior fifth and sixth rib resection with mesh.ABDOMEN:LIVER, BILIARY TRACT: A mildly hypoattenuating lesion in posterior segment of the right hepatic lobe is less conspicuous than the prior exam but unchanged in size measuring 1.5 cm in maximum diameter. No new hepatic lesions or biliary ductal dilatation is evident. The gallbladder appears normal.SPLEEN: Normal in appearancePANCREAS: Normal in appearanceADRENAL GLANDS: Right renal gland is absent. Left adrenal gland is normal in appearance.KIDNEYS, URETERS: The left kidney appears normal. Postsurgical changes of right renal resection. No residual soft tissue lesions are seen within the right nephrectomy bed.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No bowel wall thickening or dilatation. Interval removal of enteric tube.BONES, SOFT TISSUES: A soft tissue mass between the right hepatic lobe and anterior abdominal wall (series 3, image 95) is unchanged in size since 7/11/2012 measuring 2.5 cm. A 2.8 x 1.4 cm soft tissue mass between the left hepatic lobe and left anterior chest wall is surgery changed since 7/11/2012.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As aboveBONES, SOFT TISSUES: Multiple bone islands are unchanged.OTHER: Right iliac wing exostosis are unchanged.
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1.Soft tissue masses between the liver and chest wall are unchanged since 7/11/2012.2.Right hepatic hypodensity is unchanged in size and may represent a resolving hematoma.
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Generate impression based on findings.
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Reason: worsening ILD vs. edema. better characterize infiltrates History: hypoxia, h/o amio induced ILD LUNGS AND PLEURA: Diffuse, predominantly subpleural reticular interstitial opacity with areas of mild architectural distortion and traction bronchiectasis slightly progressed since the prior exam.Minimal honeycombing at the lung bases.No significant airtrapping in the expiratory images.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Considerable fat deposition within the mediastinum.Scattered mildly prominent mediastinal lymph nodes without definite evidence of adenopathy.Cardiac size and is normal without evidence of a pericardial effusion.Marked coronary artery calcification with evidence of a previous CABG.Pacemaker lead within the right ventricle.CHEST WALL: Median sternotomy.Degenerative changes throughout the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Mild interval progression of interstitial fibrosis compatible with history of amiodarone toxicity.
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Generate impression based on findings.
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Male, 57 years old, history of laryngeal cancer, needs staging. No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Enhancing tumor is redemonstrated involving predominantly the right aspect of the larynx. When comparison is made to the prior examination, some degree of progression is suspected, at least at the level of the right aryepiglottic fold which is progressively thickened and now measures 2.8 x 2.3 cm (image 42 series 5), previously 2.7 x 1.7 cm.Superiorly, the tumor extends along the right aryepiglottic fold to the level of the base of the epiglottis. The right piriform sinus is effaced by tumor. The left aryepiglottic fold is also likely involved by tumor though to a lesser degree. Inferiorly, the tumor involves the false and true vocal cords on the right with infiltration of the paraglottic fat and mild extension along the right subglottic airway. There is an asymmetric lytic appearance to the inferior margin of the thyroid cartilage on the right. Furthermore, it appears that abnormal thickened and enhancing tissue extends through this defect and perhaps also beneath the inferior margin of the right thyroid cartilage into the extralaryngeal soft tissues (see image 48 of series 5, and image 86 of series 80253).A borderline right level 2/3 lymph node is slightly smaller measuring 1.1 x 1.0 cm (image 32 series 5), previously 1.3 x 1.1 cm. Additional mildly prominent lymph nodes are present elsewhere in the neck bilaterally demonstrating equivocal interval changes in size. For example, a left level 3 node measures 1.6 x 0.8 cm (image 38 series 5), previously 1.5 x 0.7 cm.The laryngeal tumor described above results in complete airway effacement. A tracheostomy is in place below this level which is new from prior. The salivary glands are within normal limits. A focal hypodense lesion is redemonstrated in the left thyroid lobe unchanged. Cervical vessels remain patent. Emphysema is demonstrated in the lung apices.Extensive degenerative change is seen in the cervical spine with multilevel posterior disk-osteophyte complexes and stepwise spondylolisthesis at most levels. Superimposed on this is extensive sclerosis of the C3 through C7 vertebral bodies which may also be degenerative in etiology.
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1. Progressive thickening of the previously seen laryngeal tumor is seen, at least at the level of the right aryepiglottic fold. Tumor extends superiorly to the base of the epiglottis and inferiorly to the right subglottic mucosa. Findings are present suspicious for extralaryngeal spread through or beneath the inferior margin of the right thyroid cartilage.2. Scattered mildly prominent cervical adenopathy is demonstrated bilaterally. Most of these nodes do not meet imaging criteria for pathologic enlargement while a few barely meet the criteria. Since the prior exam, lymph nodes are stable to equivocally changed in size.3. No evidence of intracranial metastatic disease.
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Generate impression based on findings.
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75-year-old male with left parotid adenoid cystic carcinoma, left parapharyngeal space mass, right upper lobe mass. Redemonstrated are postoperative findings related to left total parotidectomy and lateral temporal bone resection with flap reconstruction. A heterogeneous enhancing mass within the left parapharyngeal space is again noted, lateral to the styloid process and medial to the surgical bed. When measured in the same location as visualized previously, it measures 12 mm AP x 16 mm RL x 18 mm SI (previously13 AP x 17 RL x 22 mm SI) demonstrating interval decrease in size.There remains no significant cervical lymphadenopathy by size criterial. The osseous structures are unremarkable, aside from mild degenerative cervical spondylosises, unchanged. The major cervical vessels are patent. The imaged intracranial structures are grossly unremarkable. There are bilateral maxillary sinus retention cysts. There is a right apical lung nodule that measures up to 8 mm, which has not significantly changed.
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1.Continued decrease in size of the recurrent adenoid cystic carcinoma within the left parapharyngeal space adjacent to the medial surgical margin, which now measures up to 18 mm in maximal dimension. No significant cervical lymphadenopathy.2.A right apical lung nodule that measures up to 8 mm is consistent with metastatic disease, but has not significantly changed. Refer to the separate chest CT report for additional details.
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Generate impression based on findings.
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51-year-old male. Adenocarcinoma of the lung on Carbo/TEM chemo. Restage after C2. CHEST:LUNGS AND PLEURA: Large heterogeneously enhancing right lung mass measures 7 x 5.6 x 6.8 cm (AP x TR x CC), previously 8.8 x 6 x 8.4 cm. It is again seen to abut the pleura.Ipsilateral nodules likely of the metastases, some are unchanged while others are smaller. No new nodules identified.Moderate upper lobe predominant centrilobular and paraseptal emphysema.MEDIASTINUM AND HILA: No significant change in mediastinal lymphadenopathy. Prevascular lymph node measures 9 mm in short axis. The necrotic subcarinal mass splaying the mainstem bronchi measures 4.7 x 5.7 cm, unchanged (series 80256, image 31). Bilateral hilar lymphadenopathy, similar to prior exam.Few hypodense nodules in the thyroid with the largest measuring 19 x 22 mm (series 3, image 9), unchanged. Small unchanged pericardial effusion.CHEST WALL: Mildly prominent axillary nodes, similar to prior exam. Degenerative arthritic changes of the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Two hepatic hypodensities are unchanged, most likely benign cysts. No suspicious hepatic mass. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate calcification of the abdominal aorta. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Large right lung mass consistent with patient's known adenocarcinoma is decreased in size.2. Right lung nodules probably representing metastasis, some are the same in size while others are decreased in size.3. Mediastinal and bilateral hilar lymphadenopathy, not significantly changed.4. No new sites of disease identified.
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Generate impression based on findings.
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Reason: 20 male with newly diagnosed AML, r/o baseline infiltrate History: AML LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Hypoattenuating blood pool compatible with anemia.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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No significant pulmonary or pleural abnormalities.
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Generate impression based on findings.
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74-year-old male. Lung mass. Evaluate for interval change. Possible organized pneumonia. LUNGS AND PLEURA: Left upper lobe extensive bronchiectasis and cavitation with consolidation, fibrosis, and volume loss, with slightly increased consolidation in the left perihilar region.Left lingula nodular small opacities consistent with mucus plugging and associated bronchiectasis unchanged except for new small focus of consolidation along the fissure. Right lower lobe nodular opacities consistent with endobronchial mucus plugging, similar to prior exam. RIght upper lobe scar-like opacity with internal bronchiectasis, not significantly changed. Severe diffuse centrilobular emphysema.MEDIASTINUM AND HILA: Enlarged precarinal lymph node measuring 12 mm in short axis, unchanged (series 3, image 40), likley reactive. Calcified mediastinal and hilar lymph nodes from healed granulomatous disease are reidentified.Severe coronary artery calcifications.CHEST WALL: Degenerative arthritic changes of thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Left renal cyst. Previously seen segment 8 hepatic lobe lesion is not visualized due to noncontrast technique.
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1. Left upper lobe cavitary lesion, bronchiectasis, and nodular opacities consistent with mycobacterial or other chronic bacterial infection. This certainly also could represent developing organizing pneumonia.2. Slight interval increase in lingular and left perihilar areas of consolidation consistent with more acute infection.
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Generate impression based on findings.
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Reason: Evaluate pelvic fluid collection resolution History: pelvic fluid collection post IR drain, Drain currently in place PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Interval decrease in the size of the fluid collection located along right pelvic sidewall which measures 2.4 x 5.2 cm (series 3 image 58) previously 3.0 x 7.0 cm; a percutaneous pigtail catheter is present in this collection. No other fluid collections are identified.OTHER: No significant abnormality noted
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1. Interval decrease in right hemipelvis fluid collection.
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