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portable frontal chest radiograph shows low lung volumes, which results in crowding of bronchovascular structures. a left retrocardiac opacity is presumably atelectasis, however, pneumonia could be considered in the appropriate clinical setting. there is no pleural effusion or pneumothorax. the heart is normal size and the mediastinal contours are unremarkable. no pulmonary edema.
status post resection and ileocolonic stricture, now with cough and shortness of breath. evaluate for an acute process.
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right-sided port-a-cath tip terminates in the svc. the cardiac, mediastinal and hilar contours are within normal limits. the pulmonary vascularity is normal. lungs are clear. no pleural effusion or pneumothorax is present. multiple clips are seen within the right axilla. there is mild gaseous distention of the stomach. no acute osseous abnormalities are detected.
altered mental status, lymphoma.
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cardiac silhouette size is borderline enlarged. mediastinal and hilar contours are normal. pulmonary vasculature is normal. subsegmental atelectasis is demonstrated within the right mid lung field. no focal consolidation, pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>f with <num> seizures-like episodes today. // ?pneumonia
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chest pa and lateral radiograph demonstrates decreased right upper lobe opacifications as well as decreased central lucent cavity. however, there has been interval increase in size of the right middle lobe opacification with greater lateral expansion of consolidation and with a greater area of central lucency. no pneumothorax evident. blunting of the right costophrenic angle likely represents a new small pleural effusion. cardiac size is not enlarged.
patient with pneumonia, abscesses, new acute chest pain, please evaluate for pneumothorax.
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the cardiomediastinal and hilar contours are within normal limits. there are small bilateral pleural effusions. the lungs are otherwise clear with no focal consolidations or pneumothorax. a left subclavian central venous catheter line terminates in the mid svc, unchanged in position from prior examination. right clavicular fracture is unchanged.
<unk>-year-old male patient with aml and sweet's syndrome with increased o<num> sats. study requested to rule out pneumonia.
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there is a mildly tortuous thoracic aorta. otherwise, the cardiomediastinal silhouettes are normal. the bilateral hila are normal. projecting over the left upper lung, there is a <num> mm circular possibly calcified opacity, which may represent bony island or left upper lobe lung nodule, possibly an old calcified granuloma ; specific localization is limited given lack of alternative views. it is recommended to obtain any old chest x-rays if this is not a known finding, or to obtain apical lordotic views if there are no prior films. otherwise, there are no focal lung consolidations. there is no evidence of pulmonary vascular congestion. there is no pneumothorax or effusion.
<unk> year old man with hemoptysis, right chest pain, and weight loss // mass lesion or other cause of hemoptysis
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et tube terminates approximately <num> cm above the carina. right-sided pic line terminates in the right atrium. there is an enteric tube which extends below the diaphragm with the tip out of view of this film. on a background of severe emphysema, as well as biapical bulla and fibrotic changes including bronchiectasis, ground-glass reticular opacification in the lower lungs bilaterally are unchanged. the cardiomediastinal contours are stable. the visualized osseous structures are unremarkable. there may be small bilateral pleural effusions.
history of respiratory failure, intubation. please evaluate et tube placement.
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the heart size is top-normal. the hilar and mediastinal contours are unremarkable. no focal consolidations concerning for pneumonia identified. there is no pleural effusion, or pneumothorax. the visualized osseous structures are unremarkable.
history: <unk>f with chest pain // acute process
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen.
<unk>f with chest pain // ? pna, pneumothorax
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initial images demonstrate a dobbhoff tube curled in the esophagus with its tip terminating at the level of the aortic knob. subsequent images show a dobhoff tube coursing below the diaphragm with its tip terminating in the gastric fundus. a left subclavian central venous catheter is in unchanged position. lung volumes remain low with accentuation of the cardiac silhouette and bronchovascular structures. left retroardiac opacity persists and may reflect volume loss. there is no definite pneumothorax.
<unk>-year-old man, status post dobbhoff placement. please check for placement.
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frontal and lateral chest x-rays demonstrates a tunneled right ij port, the tip of which is in the lower svc. the lungs are clear. there is no effusion, or pneumothorax. the cardiac silhouette and mediastinal contours are normal.
<unk>-year-old male with pneumothorax.
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compared to the study from the prior day there is no significant interval change.
new hc ap.
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current study is somewhat lordotic in projection. until does not fit changed positioning of pericardial drain. better, but incomplete aeration at the left lung base.
<unk> year old man with concern for recent pneumothorax // r/o pneumothorax, moreso on the left
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the lungs are clear.the cardiac, hilar and mediastinal contours are normal.no pleural abnormality is seen. calcified granuloma at the right lung base is noted.
history: <unk>m with chest pain // r/o pna
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right internal jugular central venous catheter tip terminates in the region of the confluence of the brachiocephalic veins. no large pneumothorax is identified on this supine exam. hazy opacification of the right hemithorax likely reflects a large layering right pleural effusion. moderate to severe cardiomegaly is re- demonstrated. mediastinal and hilar contours are relatively unchanged. no focal consolidation or overt pulmonary edema is clearly evident. rotary dextroscoliosis of the thoracic spine is again noted.
history: <unk>m with central venous line in place
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a bilateral pleural effusions and overlying atelectasis are increased since <unk>. an enteric catheter projects over the stomach. cardiac and mediastinal contours are unremarkable.
<unk>-year-old woman with presbyesophagus, presenting with increased dysphagia. rule out pneumonia.
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frontal and lateral chest radiographdemonstrates hypoinflated lungs. bilateral lower lobe heterogeneous opacities are present. no pleural effusion or pneumothorax. on lateral view there is mild compression of the distal trachea from likely central lymphadenopathy. heart size and hila are unremarkable.
<unk>-year-old female with o<num> saturations in <num>%. assess cause of hypoxemia.
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the lungs are clear without focal consolidation, pulmonary edema, pleural effusion or pneumothorax. the cardiac and mediastinal contours are stable. there is no free air beneath the right hemidiaphragm.
<unk>-year-old woman with multiple episodes of vomiting.
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the picc line tip is at the cavoatrial junction, in improved location compared to the prior study. the appearance of the lungs are unchanged
<unk> year old man with picc // confirm picc
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. heart size is normal.
<unk>m with vomiting, chest pain, hematemesis // eval for free air
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frontal and lateral views of the chest demonstrate normal lung volumes. there is no pleural effusion is present. mild interstitial pulmonary edema and cardiomegaly. heart is mildly enlarged. mild pulmonary edema is new since prior exam. there is no focal consolidation. post-surgical changes related to cabg are noted. sternotomy wires are intact.
patient with multiple falls, on coumadin.
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cardiac silhouette size remains mildly enlarged. mediastinal contour is similar with post radiation fibrotic changes noted involving the medial aspects of both upper lobes with associated bronchiectasis. hilar contours are unchanged. no pulmonary edema is present. remainder of the lungs are clear without focal consolidation, pleural effusion or pneumothorax. no acute osseous abnormality is detected.
history: <unk>m with chest pain
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there is interval placement of a right internal jugular central venous catheter with tip traceable at least to the right atrium. a left pectoral dual-channel pacemaker aicd has leads in the right atrium and right ventricle. patient is status post median sternotomy and cabg. thereis cardionegaly, but likely accentuated by low lung volumes and ap technique. the mediastinal and hilar contours are within normal limits. there is improvement of known pulmonary edema. there is persistent bibasilar collapse and/or consolidation, probably with small effusions.
<unk>-year-old male with dyspnea and central line placement.
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pa and lateral views of the chest were provided. midline sternotomy wires and mediastinal clips are again noted. hyperinflated lungs appear clear bilaterally without focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. the imaged bony structures are intact. no free air is seen below the right hemidiaphragm.
<unk>-year-old female with abdominal pain, mild distension, lower extremity edema, question chf.
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the lungs are clear. there is no pneumothorax. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with l sided cp // pneumothorax
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there is an increased opacity in the retrocardiac region as well as increased opacity in the right lower lobe. otherwise, the remainder of the lungs are clear. cardiomediastinal silhouette is normal. no acute fractures are identified.
cough.
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mild pulmonary edema is new. no substantial pleural effusions. mild cardiomegaly unchanged. pulmonary artery enlargement again demonstrated. prior median sternotomy and cabg.
<unk> year old man with wt loss and left base rales // r/o ca, chf
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lung volumes are low, similar in appearance when compared to the prior study. the tracheostomy and a left picc are unchanged in appearance compared to the prior study. the heart remains enlarged. there is persistent enlargement of the bilateral hila with prominent pulmonary vasculature and bilateral perihilar airspace opacities. the appearances are most consistent with pulmonary edema but infection cannot be excluded. no pneumothorax seen.
<unk> year old woman with stroke, trach, s/p bronch // interval change after bronch
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the heart size is normal. the cardiomediastinal silhouette and hilar contours are normal. the lungs are clear. there is no pleural effusion or pneumothorax. the visualized osseous structures are grossly unremarkable.
chest pain.
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in comparison with chest radiograph from <unk>, there is no relevant change. left-sided cardiac pacing device with dual leads following their expected courses to the right atrium and ventricle. there is no focal consolidation, effusion, or pneumothorax. mediastinal and hilar contours are stable. heart size is normal.
<unk> year old man with tectal glioma, cardiac pacer // check placement of pacer leads
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as compared to prior chest radiograph, there is increased density of the right lower lobe which is likely related to a moderate amount of pleural fluid with a subpulmonic component, in combination with known abdominal ascites. there is a small left pleural effusion. there is a dense paratracheal opacity which likely relates to partial right upper lobe collapse. there are worsening opacities at the lung bases bilaterally which could represent atelectasis, aspiration or pnuemonia. there is no pneumothorax.
<unk>-year-old female patient with hypoxia, recently diagnosed with portal vein thrombosis. study requested for evaluation of interval change.
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left-sided pacer device is stable in position.no focal consolidation is seen. no pleural effusion or pneumothorax is seen. the cardiac silhouette is top-normal to mildly enlarged. mediastinal contours are stable. no pulmonary edema is seen.
history: <unk>m with dyspnea // acute process
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the patient is intubated. the endotracheal tube terminates about <num> cm above the carina. a right internal jugular introducer catheter terminates in the lower superior vena cava. an orogastric tube terminates in the stomach. endovascular aortic valve prosthesis is noted. the cardiac, mediastinal and hilar contours appear unchanged. there is probably a small pleural effusion with atelectasis on the left. small right-sided pleural effusion is no longer conspicuous. although a right upper lobe opacity is substantially less than distinct than before, there is moderate, somewhat increased diffuse predominantly central opacification suggesting worsening pulmonary edema. the bones appear demineralized with multiple incompletely characterized compression deformities since sites of prior vertebroplasty.
status post endotracheal intubation.
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the cardiac, mediastinal and hilar contours appear stable. the right hemidiaphragm is mild to moderately elevated, probably with a small subpulmonic effusion but likely decreased substantially. there is persistent patchy right posterior basilar opacity overlying the diaphragm although atelectasis may be suspected in the early post-operative course as the likely cause.
fever, chills, abdominal pain, shortness of breath and chest pain. recent resection of left hepatic hemangioma.
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lung volumes remain low. right pleural effusion is overall unchanged. persistent rightward shift of the mediastinum suggest component of right lung volume loss. the left lung is clear. although the right heart border is obscured mild cardiomegaly is likely unchanged. there is no evidence of pulmonary edema. there is no pneumothorax.
<unk> year old man with pleural effusion and volume overload, increased o<num> requirement. // worsening pulmonary edema? worsening pleural effusion? new areas of consolidation?
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bilateral predominantly perihilar and basilar opacities likely reflect new mild pulmonary edema since <unk>, likely due to acute chf. small amount of perifissural fluid is seen in the right lung. the heart size is unchanged. no pneumothorax.
<unk> year old woman with heroin abuse, cad p/w exertional dyspnea. // please evaluate for etiology
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tracheostomy tube appears to be in unchanged position. lung volumes are low. mild cardiomegaly with left ventricular predominance is re- demonstrated. mediastinal and hilar contours are similar. there is crowding of bronchovascular structures with mild pulmonary vascular congestion, improved in the interval, without overt pulmonary edema. patchy opacities in lung bases may reflect areas of atelectasis however infection or aspiration cannot be completely excluded. previously noted small left pleural effusion appears decreased or nearly resolved. no pneumothorax is demonstrated. a right-sided vp shunt catheter is again noted.
history: <unk>m with hemoptysis
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lung volumes are low. this accentuates the size of the cardiac silhouette which is mildly enlarged. mediastinal and hilar contours are unchanged. there is crowding of bronchovascular structures without overt pulmonary edema. increased opacity within the retrocardiac region likely reflects atelectasis. no pleural effusion or pneumothorax is present. there are moderate multilevel degenerative changes in the thoracic spine.
history: <unk>f with nausea, chest pain
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the patient remains intubated. an orogastric tube courses into the stomach. a single-lead pacemaker, inserted via the inferior vena cava, terminates in the right ventricle, as before, and there is also a right internal jugular central venous catheter terminating at the cavoatrial junction. an aortic balloon pump has been removed. the cardiac, mediastinal and hilar contours appear unchanged. although a right perihilar opacity referring either to the right middle or lower lobe has substantially improved, there is an increased interstitial prominence suggesting mild vascular congestion, in addition to suspicion for a layering pleural effusion on the right, probably small to small-to-moderate in size. a retrocardiac opacity has increased, which is most commonly due to atelectasis.
hypoxia. question pulmonary edema.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with dyspnea that awoke from sleep this am // eval for pna or ptx
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linear left basilar opacity is most suggestive of atelectasis. elsewhere the lungs are clear where not obscured by the left chest wall pacing device. cardiomediastinal silhouette is within normal limits. chronic deformity of the left humeral head is only partially visualized.
<unk>f with chest pain // ? pna
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streaky bibasilar opacities are seen, most suggestive of atelectasis. the lungs are otherwise clear. the cardiomediastinal silhouette is within normal limits noting a slightly tortuous descending thoracic aorta.
<unk>m with stroke // infiltrate?
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the lung volumes are slightly low, with elevation of the right hemidiaphragm. there is mild peribronchial cuffing and engorgement of the pulmonary vasculature. blunting of the costophrenic angles may represent small bilateral pleural effusions. there is no pneumothorax or consolidation concerning for pneumonia. the heart size is top-normal.
history: <unk>f with shortness of breath // ?chf
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pa and lateral views of the chest: the lungs are clear. there is no pleural effusion, pneumothorax or focal airspace consolidation to suggest pneumonia. the heart size is normal and the mediastinal contours are unremarkable. again, multiple wedge-shaped deformities of the mid thoracic and upper lumbar spine are noted and are unchanged.
palpitations left arm pain, evaluate for acute cardiopulmonary process.
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an et tube tip lies approximately is <num> cm above the carina, below the level of the clavicular heads. . an ng tube is present, tip overlying the stomach. no pneumothorax is detected. there is moderate cardiomegaly. prominence of the mediastinal silhouette is noted, but could relate to vascular structures and supine positioning. upper zone redistribution and diffuse vascular blurring is compatible chf and inter, stitial edema. hazy opacity at the right base could represent a small to moderate layering pleural effusion with underlying collapse and/or consolidation. there is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. the left costophrenic sulcus is grossly clear.
<unk> year old woman newly tranfered from osh s/p pea arrest with hypoxemic respiratory failure, ?chf, liver and renal failure, intubated with r l central access // please evaluate for acute process
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new left perihilar opacity, infiltrate versus edema. heart size, pulmonary vascularity within normal limits. no pleural effusion.
<unk> year old man with chest pain and sob // acute thoracic pathology.
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cardiac silhouette size is normal. mediastinal and hilar contours are unremarkable. pulmonary vasculature is not engorged. clips and chain sutures are seen within the left mid and lower lung fields. no focal consolidation, pleural effusion or pneumothorax is present. cervical spinal fusion hardware is incompletely assessed.
history: <unk>f with shortness of breath
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left chest tube projects over the left lung base. small left pneumothorax is stable. previously seen small left pleural effusion has resolved. apical component of the pneumothorax is stable and the pleural space previously occupied by pleural effusion is now replaced with basilar pneumothorax. bilateral lungs are clear. cardiomediastinal silhouette is normal size. right coronary artery stent is in unchanged position.
<unk> year old woman with pleurex catheter. // ? ptx
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the cardiomediastinal and hilar contours are within normal limits. the lung fields are clear. there is no pneumothorax, fracture or dislocation. limited assessment of the abdomen is unremarkable.
history: <unk>m with cp*** warning *** multiple patients with same last name! // eval for cp
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an approximately <num>-mm opacity in the right apex is new compared to the prior radiograph in <unk>, but appears to correspond to a nodule with solid component on ct in <unk>. otherwise, the lungs are clear. the heart is normal in size. the mediastinum is not widened. the hila are unremarkable. no pleural effusion or pneumothorax. bilateral apical pleural thickening is probable. surgical clips projecting over the region of the hiatus. calcifications in the uterus number are overall unchanged.
<unk> year old woman with copd and worsening dyspnea // ?infiltrate
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single upright view of the chest was obtained. small biapical pneumothoraces are newly visualized since the prior exam. there is no evidence for tension. bilateral pleural tubes are in similar position to prior. comparison of the size of bilateral pleural effusions is difficult due to positional differences, however the left effusion appears slightly increased, now moderate in size, and the right effusion appears slightly decreased. the cardiomediastinal silhouette is similar to the study <num> hours prior.
<unk>-year-old female with b-cell lymphoma status post right and left thoracentesis. evaluate for re-expansion pulmonary edema or pneumothorax.
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there is mild bibasilar atelectasis. the heart size is top normal, overall stable compared to the prior exams. the hilar and mediastinal contours are normal. the lungs are clear without evidence of focal consolidations concerning for pneumonia. there is no pleural effusion or pneumothorax. the visualized osseous structures are unremarkable.
history of chest pain. please evaluate.
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heart size is normal. mediastinal and hilar contours are unchanged. the patient is status post right upper lobectomy with multiple clips again noted within the right hemithorax and evidence of volume loss in the right lung. loculated right apical fluid is re- demonstrated. pulmonary vasculature is not engorged. streaky scarring is noted within the right lower lobe. left lung remains hyperinflated but without focal consolidation. no pneumothorax is demonstrated. no acute osseous abnormalities are present.
history: <unk>m with poorly controlled hiv, presents with subjective fever and cough
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there is an accessed right chest wall infusion port with its catheter terminating at the cavoatrial junction. the lungs are clear. the hilar and cardiomediastinal contours are normal. there is no pneumothorax. there is no pleural effusion. pulmonary vascularity is normal.
<unk>-year-old woman with advanced ovarian adenocarcinoma, and renal transplant, presenting with dyspnea and generalized abdominal pain.
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pa and lateral radiographs of the chest demonstrate clear lungs. the left hilar lymphadenopathy appears to have subtly increased in bulk when compared to the <unk> study. enlarged lymph nodes can also be seen in the aorticopulmonary window. the heart size is normal. there is no pneumothorax or pleural effusion. pulmonary vascularity is normal.
cough in patient with non-hodgkin's lymphoma and neutropenia.
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moderate enlargement of the cardiac silhouette is unchanged. the aorta is tortuous. mild pulmonary vascular congestion is present. patchy opacities in the lung bases may reflect atelectasis, but infection is not excluded in the correct clinical setting. no large pleural effusion or pneumothorax is identified. no acute osseous abnormality is detected.
history: <unk>f with chest pain, dyspnea, and weakness
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compared to the prior radiograph, there is slight enlargement of cardiac silhouette with pulmonary vascular congestion and interstitial opacities consistent with pulmonary edema. this is overall similar in appearance to the radiograph from <unk>. there is a larger patchy opacity in the right lower lobe which may represent a pneumonia. no pneumothorax is seen. no pleural effusion is seen.
hypoxia. evaluate for pulmonary edema.
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the tip of the right picc line extends to the cavoatrial junction. there has been interval removal of the feeding tube. unchanged retrocardiac opacity as well as an opacity in the left mid lung zone. there are small bilateral pleural effusions. no pneumothorax identified. the size and appearance of the cardiomediastinal silhouette is unchanged.
<unk> year old woman s/p lle fasciotomy c/b ischemic colitis. t<num> // assess for focus of infection
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the lungs are well inflated. obscuration of the right heart border by a hazy opacity is concerning for right middle lobe pneumonia. there is no pneumothorax, pleural effusion, or overt pulmonary edema. mild pulmonary vascular congestion is present.
history: <unk>f with cough // eval for consolidation
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the lungs are well inflated. left pleural effusion has slightly decreased in size. it is considered small to moderate. there is also minimal blunting of the right costophrenic sulcus. in innominate vein stent is noted. the heart size is enlarged. the osseous structures are normal for age.
<unk> year old woman with pleural effusion // eval
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the cardiomediastinal and hilar contours are within normal limits. lungs are well expanded and clear. there is no focal consolidation, pleural effusion or pneumothorax.
history: <unk>f with cough, fever // evidence of pneumia evidence of pneumia
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rotated positioning. an enteric type tube is present, with radiopaque tip overlying the distal stomach. a left subclavian central line is present, tip overlying distal svc. there is probably an et tube present. the et tube tip is poorly visualized due to overlying structures, but it appears to lie at the level of the lower clavicular heads, approximately <num> cm above the carina, similar to the prior film. compared with the prior film, there is new hazy opacity at the right base, which appears to represent a small to moderate size pleural effusion. underlying collapse and/or consolidation cannot be excluded. there is also increased retrocardiac opacification, with new obscuration of the left hemidiaphragm. there is upper zone redistribution, without overt chf.
<unk> year old man with intubated, pna, incr secretions // interval change
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the aorta is tortuous. the heart is enlarged. the hilar contours are within normal limits. linear opacity at the left lung base, likely reflects scarring. there is mild atelectasis at the right lung base. lungs are hyperinflated suggesting underlying emphysema but are otherwise clear. there is no focal consolidation, pleural effusion or pneumothorax.
history: <unk>f with recent pna, with cough/sob // eval pna eval pna
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pa and lateral views of the chest provided. midline sternotomy wires and mediastinal clips are noted. there is a nodular opacity projecting over the right lung base measuring <num> x <num> cm. there was a small nodule seen in this site on the prior pet-ct and findings are concerning for enlarging pulmonary nodule. otherwise, the lungs appear clear without evidence of pneumoni, edema, effusion, or pneumothorax. cardiomediastinal silhouette appears grossly unremarkable. the imaged bony structures are intact. no free air below the right hemidiaphragm.
<unk>m with history of clear cell renal cell cancer with metastatic disease to the chest, new shortness of breath, assess for metastatic burden versus acute abnormality.
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the lungs are well inflated and clear. no pleural effusion or pneumothorax. heart size, mediastinal contour, and hila are unremarkable. limited assessment of the osseous structures are unremarkable. no displaced rib fracture.
<unk>m with cp, assess etiology.
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pa and lateral chest radiographs demonstrate a right port-a-cath terminating in the mid svc. surgical clips are noted over the right breast. there is no focal consolidation, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is within normal limits.
currently on remicade with cough.
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pa and lateral chest radiographs demonstrate of focal consolidation, pleural effusion, or pneumothorax. the heart size is normal. the cardiac, hilar, and mediastinal contours are unremarkable.
chest pain.
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cardiomediastinal silhouette and hilar contours are unchanged from prior exam. incidental note is made of an azygos fissure. architecture at the base of the azygos fissure is somewhat complicated; however, there has been no change in appearance since <unk>. lungs are otherwise clear. there is no pleural effusion or pneumothorax.
smoking history with prolonged cough.
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the lungs are clear and well expanded. no focal consolidation, mass, pleural effusion, pneumothorax, or pulmonary edema. the heart size is normal. the mediastinum is not widened. the hila are within normal limits. visualized thoracic spine is unremarkable.
<unk> year old woman with indeterminate quant gold preparing to start anti-tnf. no tb risk factors or symptoms presently. // assess for evidence of active or old tb.
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left lower lung opacity seen laterally. elsewhere, lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>f with cough, tachypneic // consolidation, effusion ptx
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single frontal view of the chest was obtained. heart size is normal and cardiomediastinal contours are stable. the lungs are clear without focal consolidation, pleural effusion, or pneumothorax. peg tube overlying the upper abdomen midline is in unchanged position.
<unk>-year-old male with fever and cough.
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ap chest radiograph. left-sided pigtail drain has been removed. moderate layering left pleural effusion with adjacent atelectasis is stable to slightly improved. trace right pleural effusion is noted. there is no pneumothorax. moderate cardiomegaly is stable.
malignant left pleural effusion from small cell carcinoma. left pleural drain removed. evaluation for interval change.
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the patient is status post coronary artery bypass graft surgery. a dual-lead pacemaker/icd device appears unchanged with leads again terminating in the right atrium and ventricle, respectively. surgical clips are also again present in the left axilla. the heart is mildly enlarged. the mediastinal and hilar contours appear unchanged including stable widening of the right upper mediastinal contour. an area of right apical pleural thickening is improved suggesting continued decrease in a suspected loculated pleural effusion, although patchy right mid lung opacities and pleural thickening appear unchanged. fissures remained thickened. overall, since <unk>, however, there is less opacification in the right lung. the left lung remains clear. there is no pneumothorax. the bones appear demineralized with similar multilevel compression deformities along the mid to lower thoracic spine, which are incompletely characterized.
flank pain and crackles at the bases; history of congestive heart failure and coronary disease.
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support devices including et tube, enteric tube and right subclavian central venous line have been removed. lung volumes are low and the view is somewhat lordotic. however, there is a new airspace opacity projecting over the right heart border, and increased retrocardiac opacification, which may be due to aspiration or infection. small right pleural effusion is unchanged. there is no pneumothorax. nodular opacity projecting over the left sixth interspace likely represents a nipple shadow. the heart and mediastinum are within normal limits despite the projection.
<unk> year old woman with iph. now with dry cough, febrile // febrile, dry cough in altered pt with stroke.
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single ap portable view of the chest. the lungs are clear of consolidation, effusion or pulmonary vascular congestion. calcified granuloma seen at the left lung apex. cardiomediastinal silhouette is within normal limits. deformity of the proximal right femur suggesting prior fracture is again seen. there is no visualized acute osseous abnormality.
<unk>-year-old female with hypertension and altered mental status. question pneumonia.
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the lungs are clear. there is no pneumothorax or pleural effusion. the heart size is normal. the cardiomediastinal silhouette is unremarkable.
cough.
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heart size appears mildly enlarged but similar. mediastinal and hilar contours are unremarkable. pulmonary vasculature is normal. minimal patchy opacities are noted in the lung bases. no focal consolidation, pleural effusion or pneumothorax is evident. there are mild degenerative changes in the upper lumbar spine. no acute osseous abnormality is visualized.
history: <unk>m with hiv, malaise
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there is increasing opacification of the right hemithorax which suggests primarily an increase in a pleural effusion with associated atelectasis. there is neutral to perhaps mild rightward shift. the left lung remains clear. there is no pleural effusion on the left. a port-a-cath terminates in the superior vena cava.
cough and shortness of breath.
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no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. the heart size is normal. mediastinal contours are normal. no bony abnormality is detected.
cough.
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low lung volumes are noted with secondary bibasilar atelectasis, more so on the left. the lungs are otherwise grossly clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with diffuse body pain, s/p fall // r/o acute process
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there has been interval removal of the left port catheter. there remains a right internal jugular line with tip not well visualized but likely in the mid svc. there are low lung volumes with worsened pulmonary vascular congestion. additionally, the mediastinal caliber is increased and there is bibasilar atelectasis. there is no pneumothorax.
<unk>-year-old with sepsis secondary to port dehiscence. evaluate interval change.
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allowing for rotation, cardiomediastinal contours are within normal limits, and lungs and pleural surfaces are clear except for a questionable <num> cm nodular opacity at the left apex and a small linear focus of scar or atelectasis at the right lung base. scoliosis is noted.
<unk> year old woman with acute diverticulitis and mild hypoxia. // please eval for e/o pneumonia vs. atelectasis.
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the lungs are well expanded and clear. there is no pleural or pneumothorax. cardiomediastinal silhouette is unremarkable.
history: <unk>m with fever. // pneumonia?
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the heart appears mildly enlarged even allowing for the projection. this is unchanged compared to the prior study. a left-sided picc has been removed. prominence of the main pulmonary arteries is similar when compared to the prior study and consistent with pulmonary arterial hypertension. no consolidation, pneumothorax or pleural effusion seen. the visualized bony structures are unremarkable in appearance, bone island noted in the right scapula.
history: <unk>f with fever, hypotn // ? pna
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thoracic aorta is mildly tortuous, otherwise the cardiomediastinal silhouettes are within normal limits. the bilateral hila are unremarkable. the lungs are clear. there is no pulmonary vascular congestion. there is no pneumothorax or pleural effusion.
<unk>m with chest pain shortness of breath, evaluate for pneumonia.
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a right ij catheter terminates at the lower svc. an endotracheal tube terminates <num> cm above the carina. an orogastric tube extends to at least the level of the stomach, beyond the scope of this examination. the heart size remains normal. the hilar and mediastinal contours are unchanged. an ill-defined right basilar opacity appears slightly improved since the <unk> radiograph. no new consolidation, pneumothorax, or effusion is detected.
right basilar opacity.
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the lungs are clear without focal consolidation or effusion. the cardiomediastinal silhouette is normal. no acute osseous abnormalities identified.
<unk> year old woman with presyncope, lupus // evaluate for acute process
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the heart size, mediastinal, and hilar contours are normal. the lungs are clear without pleural effusion, focal consolidation, or pneumothorax.
<unk>f with chest pain and shortness of breath. evaluate for pneumonia.
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there is subtle opacification within the retrosternal clear space on the lateral, which may represent a subtle pneumonia. linear opacities at the left lung base likely reflect atelectasis. no additional focal consolidations. no pulmonary edema. normal appearance of the cardiomediastinal silhouette. no pneumothorax. no pleural effusion.
history: <unk>f with hypoxia // ?pneumonia
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portable ap chest radiograph. surgical clips are now present over the left lateral aspect of the thorax from wound debridement and thoracotomy. surgical drain is present in the soft tissues of the chest wall. a left pleural drain is now seen with decreased effusion relative to yesterday's ct. pulmonary vascular congestion within the left lung likely represents a component of reexpansion pulmonary edema. the effusion layerings superior to the aortic know, also better seen on prior ct. there is no pneumothorax. the heart size is normal. the right lung is clear.
thoracic aortic aneurysm with endovascular repair. presented with suspected wound infection and was taken to the or for left thoracotomy and debridement. evaluation for postoperative complications.
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single ap portable radiograph of the chest. left-sided aicd with lead in appropriate position. median sternotomy wires are intact. there is stable moderate cardiomegaly. small bilateral pleural effusions are unchanged. no new consolidation concerning for pneumonia is identified. there is no pneumothorax.
patient with shortness of breath, eval new pulmonary process.
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cardiomediastinal contours are within normal limits and without change. there is no definitive evidence of pneumomediastinum or pneumothorax. lung volumes remain slightly low, and lungs and pleural surfaces are clear.
<unk> year old man with recent hx choking on toothpick with negative egd but with evidence possible pneumomediastinum on cxr (likely artifact). // interval resolution of pneumomediastinum?
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in comparison to the most recent chest radiograph from <unk>, there is <unk> increased opacity <unk> the left lung base with silhouetting of the left hemidiaphragm. otherwise, the right hemithorax demonstrates atelectatic changes, but without focal <unk>consolidation. cardiomediastinal silhouette remains moderately enlarged. atherosclerotic disease is again noted <unk> the aortic arch. no acute fractures are identified.
evaluation of patient with weakness.
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single frontal chest radiograph demonstrates right-sided chest tube with interval worsening of predominantly apical pneumothorax, now small to moderate in size. asymmetrically increased left lower lung opacification. no pleural effusion evident. remainder of the examination is unchanged.
pneumothorax and chest tube placed at outside hospital. please evaluate pneumothorax.
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frontal and lateral radiographs of the chest demonstrate stable-appearing bibasilar opacifications, right worse than left, likely representing atelectasis, however, superimposed infection cannot be excluded. there are multiple nodules seen in the right lung, concerning for metastatic disease. again seen are tiny bibasilar pleural effusions. cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax.
<unk>-year-old female with small cell lung cancer and neutropenic fever. evaluate for pneumonia.
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pa and lateral views of the chest are compared to previous exam from <unk>. the lungs are clear on the frontal view. there is increased opacity projecting over the lower lungs anteriorly and posteriorly on the lateral, which is likely due to extremely low lung volumes on this projection. costophrenic angles are sharp. cardiomediastinal silhouette is normal. osseous and soft tissue structures are unremarkable.
<unk>-year-old female with chest pain radiating to left shoulder. also with lower back pain. question infiltrate.
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there is no focal consolidation, pleural effusion or pneumothorax. the cardiomediastinal and hilar contours are normal.
history: <unk>f with cp,sob // pna?
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compared with the prior radiographs, there is bilateral basilar subsegmental atelectasis. no large focal consolidation or pneumothorax identified. there may be a trace right pleural effusion. heart size is normal. a right picc line terminates in the mid svc, as seen on the prior study.
<unk>m with right flank pain and ?consolidation on ctu. eval for pneumonia.
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lungs are well inflated and clear. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. there is no pleural effusion or pneumothorax. visualized upper abdomen is unremarkable. osseous structures are grossly intact.
status post assault with right lower chest pain, evaluate for rib fracture.
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ap single view of the chest has been obtained with patient in semi-upright position. comparison is made with the next preceding similar study dated <unk>. there is no significant interval change in comparison with the previous study. the mostly loculated pleural effusions persists in the right hemithorax. general volume loss on the right side, but no increased mediastinal shift. no remaining apical pneumothorax can be seen. a small loculated pneumothorax exists on the right base in alignment with the draining chest tube. no new abnormalities in the left hemithorax. no pulmonary vascular congestion in the accessible areas.
<unk>-year-old female patient with stage iv breast carcinoma, now with recurrent right-sided effusion status post chest tube placement, evaluate for interval changes.