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Generate impression based on findings.
90 year-old male with bilateral subdural hematomas. There is redemonstration of bilateral slightly hyperattenuating subdural hematomas causing mass effect bilaterally. There is redemonstration of a slight, stable midline shift towards the right. The ventricles and cisterns are preserved with no evidence of herniation.T...
Grossly stable bilateral subdural hematomas.
Generate impression based on findings.
Right-sided weakness. Unenhanced head CT: There is bilateral patchy hypoattenuation in the subcortical/periventricular white matter most likely relating to chronic small vessel ischemic disease. There is a more focal area of hypoattenuation within the right thalamus that likely represents a prominent vascular space or ...
1.Intracranial sequela of chronic small vessel ischemic disease without CT evidence of acute infarction.2.35% stenosis of the left internal carotid artery origin with mild poststenotic dilatation.3.No thrombus, aneurysm, AVM or hemodynamic significant stenosis elsewhere in the neck/brain.
Generate impression based on findings.
54-year-old male with T4N0 right tonsillar cancer status post chemotherapy and tonsillectomy Interval postoperative changes of the right palatine tonsil are present in the location previously demonstrating a right palatine tonsillar mass. Although enhancement can see about the surgical borders, there are no discrete ma...
Interval postoperative changes of the right palatine tonsil are present in the location previously demonstrating a right palatine tonsillar mass. Although enhancement can see about the surgical borders, there are no discrete masses. There has also been interval resection of a reference right level 2 necrotic lymph node...
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69-year-old male with history of right tonsillar carcinoma status post therapy. HEAD CT: There is no abnormal intracranial enhancement, mass effect or edema to suggest intracranial metastases. No intra-or extra-axial fluid collection identified. The gray white matter differentiation is preserved. There is no hydrocepha...
1.Stable postoperative changes without evidence of residual or recurrent tumor. No evidence of cervical adenopathy. 2.No evidence for brain metastases.
Generate impression based on findings.
2-year-old patient. Abscess. There are scattered multi-compartmental non-enlarged lymph nodes which are normal for a patient of this age. There are no visualized abnormalities including lymphadenopathy, fluid collections or masses. The C-spine is normally aligned and there are no bony abnormalities. There is no prevert...
No visualized abnormality of the neck.
Generate impression based on findings.
69-year-old male. History of pleomorphic adenoma. Evaluation of tumor extension. There is a large, heterogeneously attenuating and enhancing soft tissue mass which has eroded a portion of the left posterolateral hard palate and adjacent maxillary sinus wall to involve the nasal cavity, maxillary sinus, oral cavity, oro...
Large soft tissue mass involving the hard and soft palate, maxillary sinus, nasal cavity and oral/nasopharynx. No visualized adenopathy, bony or intracranial lesion suspicious for metastasis on this exam.
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59-year-old male status post lung transplant with subsequent left chest talc pleurodesis, readmitted to ICU with shock. Question of sepsis, PE? ABDOMEN:LUNG BASES: Please see PE CT report generated by the radiology chest service.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: This to be surgically absent....
Nonobstructive intussusception proximal jejunum. Diffuse dilatation of small bowel favor ileus without discrete transition zone. Other findings as above. Please refer to separate chest CT report as well.
Generate impression based on findings.
53 year-old female. Fever. Clinical question: Abscess? ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Small hypodense lesion lateral segment left lobe consistent with simple cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant a...
No findings to suggest acute abdominal process or fever. Probable uterine fibroid. Foley catheter coiled in the bladder can be pulled back somewhat.
Generate impression based on findings.
62-year-old male. History sigmoidectomy for perforation after heart transplantation. Evaluate for abnormal fluid collections prior to discontinuing IV antibiotics. The exam is not sensitive for detecting lesions in the solid organs or vessels to the lack of intravenous contrast. Given those limitations, the following o...
Pericardial fluid. Bilateral pleural effusions. No intraperitoneal fluid collections. High density material in gallbladder correlate clinically.Other findings as above including nonobstructive mild jejunal intussusception of doubtful clinical significance.
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60 year-old female. Weight loss, night sweats ascites. Rule out malignancy. The exam is not sensitive for detecting lesions in the solid organs or vasculature due to the lack of intravenous contrast. Given those limitations, the following observations are made:CHEST:LUNGS AND PLEURA: Scattered nonspecific micronodules....
Contrast extravasation. Lack of IV contrast limits sensitivity for the purpose of the exam. Correlate clinically as to the need for repeat attempt after IV access is established. Other findings as above.
Generate impression based on findings.
60 year-old female with headache. Rule out bleed. No intracranial mass, hemorrhage, fluid collection or hydrocephalus. Note is made of a partially empty sella. Gray white differentiation is normal bilaterally and the midline is intact. The left mastoid air cells are underpneumatized. Visualized bones elsewhere and para...
No abnormal findings including intracranial hemorrhage.
Generate impression based on findings.
89-year-old female. No BM. Clinical question: Perforation, progression of stercoral colitis. ABDOMEN: Limited by respiratory motion. Exam is not sensitive for detecting lesions in the solid organs are vasculature due to lack of intravenous contrast. Some not sensitive for detecting lesions in the bowel due to the lack ...
Bibasilar atelectasis or consolidation unchanged. Signs of stercoral colitis unchanged. No evidence of bowel perforation
Generate impression based on findings.
79-year-old female. GI bleed. Drop in hemoglobin adenoma. The exam lack sensitivity for GI bleed to the lack of venous phase. Note is made that the arterial phase is also somewhat early.ABDOMEN: The exam is not sensitive for lesions in the solid organs due to lack of portal venous phase.LUNG BASES: A small to moderate ...
Limited exam not sensitive for GI bleed although no bleeding sites are seen. Cholelithiasis. Renal cyst. Right pleural effusion.If GI bleeding persists consider repeat scan in the portal venous phase to search for GI bleed if renal function permits. Discussed with clinical service.
Generate impression based on findings.
59-year-old male. Status post lung transplant with subsequent left chest talc pleurodesis. Readmitted to ICU with shock. Evaluate for PE. PULMONARY ARTERIES: Technically adequate examination. No pulmonary embolism is identified. Mildly prominent main pulmonary artery measuring 3.8 cm suggestive of pulmonary artery hype...
1. No evidence of pulmonary embolism. Findings suggestive of pulmonary artery hypertension. 2. Loculated moderate to large left pleural effusion with foci of high density suspicious for hemorrhage and foci of air, superimposed infection cannot be excluded. Intraluminal debris in the left mainstem bronchus in addition t...
Generate impression based on findings.
93 year old female. Follow-up intracranial hemorrhage. There has been no significant change in the small foci of intraparenchymal hemorrhage within the left periventricular white matter of the frontal lobe. There is associated hypodensity likely representing intraparenchymal edema. The small focus of subarachnoid blood...
1.No significant interval change in intraparenchymal blood products and associated edema.2.Interval partial resolution of subarachnoid blood products.3.Right facial laceration.4.Fluid-fluid level in the right maxillary sinus without any visualized overlying fracture.These results were communicated to the neurosurgery r...
Generate impression based on findings.
93 year-old female. Currently taking ASA. Fall with subsequent neck pain. Rule out fracture and intracranial hemorrhage. Head: Within the periventricular white matter adjacent the right frontal lobe there are several hyperattenuating foci with surrounding hypodensity most likely represent intraparenchymal hemorrhage. A...
1.Small foci of intraparenchymal and subarachnoid blood within the right hemisphere. No significant mass effect including herniation/shift.2.Laceration over the right orbit and a fluid-fluid level in the right maxillary sinus most likely represents blood products. No visualized fracture on provided images, however desi...
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55-year-old male. Groin pain. Rule out incarcerated inguinal hernia. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: 1.8 x 1.4 cm in nodule probably originating off...
Likely scrotal abscess or infected hematoma. There may be a component of right inguinal hernia as well but I doubt that the entire gas filled structure represents bowel.Discussed with clinical service by myself as well as by radiology resident on call the time of the examination. Possibility of small bowel hernia in ad...
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74-year-old female flank pain. Clinical question: Flank pain, increasing drain output status post radical cystectomy ileal conduit. Please give oral contrast.Additional history per radiology resident on call: Inability to pass catheter through the ostomy. The exam is not sensitive for detecting lesions in the solid org...
Ascites. No obstruction. No evidence of peristomal hernia.
Generate impression based on findings.
71-year-old male with history of non-small cell lung carcinoma with worsening cancer burden, likely intracranial metastases. Hypodensities are present involving the left precentral gyrus, as was seen on the limited MRI from yesterday, and substantially decreased in size when compared to the prior CT, now with very litt...
1.Brain metastases, not substantially changed when compared to yesterday's limited MRI, however substantially decreased in size when compared to the prior CT, now with very little associated vasogenic edema, and no associated mass effect.2.Note that noncontrast head CT is insensitive for detection of metastases.3.No ac...
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22-year-old male with history of hydrocephalus, follow-up shunt revision. Redemonstrated are bilateral posterior approach ventricular catheter shunts which course anteriorly with both catheter tips terminating adjacent to the midline in the middle cranial fossa, with no interval change since prior exam. Both posterior ...
1. No evidence for acute intracranial hemorrhage mass effect or edema.2. Unchanged positioning of multiple ventricular catheter shunts.3. Unchanged configurations and dimensions of CSF spaces.
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32 year old female with intracranial hemorrhage, now comatose. Subcutaneous air tracking laterally from interventricular catheter site has decreased. The right anterior approach intraventricular catheter tip remains in the right frontal horn. A left basal ganglia hemorrhage again measures 60 x 49 mm. There is redemonst...
1.Redemonstration of left basal ganglia hemorrhage extending into the ventricular system causing rightward midline shift and effacement of CSF cisterns, unchanged.2.The right anterior horn continues to be decompressed although the remainder of the ventricular system remains relatively unchanged with the exception of th...
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6-year-old male following trauma. Vertebral body and intervertebral disk heights are normal. There is normal alignment of the cervical spine. There are no visualized fractures or dislocations. The odontoid process has a normal appearance given the patient's age. No prevertebral soft tissue swelling or obvious soft tiss...
Normal examination for the patient's age. No visualized sequelae of trauma.
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65-year-old male. SCC neuroendocrine tumor with hyperglycemia. Restaging CT. CHEST:LUNGS AND PLEURA: Solitary nonspecific micronodule right lung, series 4 image 34, 5.2 mm. No effusions.MEDIASTINUM AND HILA: 1.7 x 1.2 cm left thyroid nodule series 2 image #1. Associated punctate calcification.Atherosclerotic calcificat...
Diffuse hepatic metastases. Soft tissue lesion midline cardiophrenic area and enhancing subcutaneous nodules likely represent metastasis.Micronodule right lung. Left thyroid nodule.
Generate impression based on findings.
Automobile versus pedestrian accident. ABDOMEN:LUNG BASES: No focal opacities present. A pleural effusion is not seen.LIVER, BILIARY TRACT: Normal enhancement. No laceration is identified. Gallbladder is incompletely distended.SPLEEN: Intact and normal in appearance.PANCREAS: Normal in appearance.ADRENAL GLANDS: No sig...
No evidence of solid or hollow viscus trauma.
Generate impression based on findings.
10-year-old female. Cervical spine tenderness. Vertebral body and intervertebral disk heights are normal. There is no visualized fracture-dislocation or abnormality of alignment. There is no prevertebral soft tissue swelling. The odontoid is intact.
No C-spine abnormality demonstrated.
Generate impression based on findings.
Female, 83 years old, history of head and neck cancer (supraglottic) status post CRT. Head CT:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. Periventricular hypoattenuation redemonstrated consistent with age indeterminant small vessel ischemic disease. A r...
1.Post treatment change in the neck with no evidence of progressive disease or pathologic adenopathy. There does appear to be interval increase in supraglottic mucosal edema.2.Redemonstrated is a right supraclinoid ICA aneurysm.3.No intracranial metastatic disease.
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71-year-old female. Evaluate for breast cancer. Treated breast cancer. CHEST:LUNGS AND PLEURA: Micronodular or intrapulmonary lymph node right lung series 5 image 36, unchanged. No effusions.MEDIASTINUM AND HILA: Redemonstration of calcified lymph nodes cardiomegaly, prominent main pulmonary artery and aneurysmal dilat...
No definite evidence of metastatic disease. Stable micronodular right lung. Mediastinal findings as above, unchanged.
Generate impression based on findings.
50 year-old female with altered mental status. There is intra-and extra-axial blood products including a 2.4 x 2.3 x 2.0 cm hyperattenuating interparietal collection within the central portion of the left cerebellar hemisphere. Blood products extend extra-axially and are visualized throughout the cisterna magnum and an...
Intraparenchymal hemorrhage within the left cerebellar hemisphere with blood products extending into the extra-axial space in the posterior fossa and brain stem without significant mass effect or herniation.
Generate impression based on findings.
Patient with documented intracranial hemorrhage and neck pain. For follow-up of intracranial hemorrhage and assessment of the cervical spine. Head: This been no change in dimensions or configuration of the hyperattenuating intraparenchymal blood collection within the left cerebellar hemisphere. This measures 2.5 x 2.5 ...
1.No significant change in dimensions or configuration of the intraparenchymal left cerebellar hemorrhage with extra-axial extension. No significant mass effect and no hydrocephalus. Findings on a previous CT angiogram suggest the possibility of a posterior fossa developmental venous abnormality, a lesion which is infr...
Generate impression based on findings.
32-year-old male reporting pain to left jaw/face the past few days. Assess for fracture. There is extensive dental and periodontal disease including maxillary and mandibular dental caries with erosion of teeth and, in certain locations, the alveolar process of the maxilla (coronal series 80412 image 38) with soft tissu...
Diffuse dental disease including caries and periapaical cyst associated with osseaous erosions and extension to involve the maxillary sinuses and cause cellulitis within the subcutaneous tissues overlying the left maxilla which are stranded and swollen. No obvious deep or intraorbital extension at this time. No drainab...
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46-year-old female left lower quadrant pain x 9 days. Left CVA tenderness. Rule out left-sided stone. The exam is not sensitive for detecting lesions in the bowel or solid organs or vessels due to lack of oral or intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No s...
No specific findings to explain patient's symptoms. No evidence of nephrolithiasis. Right ovarian cyst as measured. Gastric lap band in place with a somewhat horizontal lie of the band. Scattered colonic diverticulosis without evidence of diverticulitis.
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48-year-old male. Right upper lobe nodule/mass seen on CXR. No old films. History of smoking LUNGS AND PLEURA: 5.7 x 4 cm right upper lobe subpleural mass containing a small central cavitation and air bronchograms (series 5, image 27) suspicious for a primary lung neoplasm, less likely possibility is a cavitating infec...
1. Right upper lobe mass with irregular margins and central cavitation has features suspicious for a primary lung neoplasm. Other less likely differential possibility is a cavitating infection (e.g. TB, fungal). Correlation with core biopsy is suggested. 2. Nodular interstitial thickening adjacent to the aforementioned...
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57-year-old male status post laparoscopic distal pancreatectomy for insulinoma on 7/24, now with increased WBC, SOB PULMONARY ARTERIES: No central or lobar pulmonary embolism. Evaluation of the subsegmental pulmonary arteries is limited.LUNGS AND PLEURA: Small bilateral pleural effusions and overlying compressive atele...
1.No evidence of central or lobar pulmonary embolism.2.Small bilateral pleural effusions and overlying compressive atelectasis.3.Postsurgical changes and fluid collections in the upper abdomen are better evaluated on CT abdomen dated 7/28/2013.
Generate impression based on findings.
63-year-old male with hypoxia and right lower extremity edema, evaluate for pulmonary embolism, history of lung cancer PULMONARY ARTERIES: Technically adequate exam. No evidence of pulmonary embolism.LUNGS AND PLEURA: Upper lobe centrilobular emphysema with bullae are unchanged. Increasing left lower lobe airspace opac...
1.No evidence of pulmonary embolism.2.Redemonstration of left hilar mass with attenuation of the left upper lobe bronchus and accompanying pulmonary artery.3.Increasing pericardial effusion compatible with radiation changes.4.Increasing left lower lobe opacity, likely representing radiation pneumonitis or possibly infe...
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Right upper lobe mass, assess for worsening and metastatic disease. LUNGS AND PLEURA: Interval increase in reference right upper lobe mass with extensive postobstructive atelectasis of the right upper lobe. The mass measures 82 x 55 mm on image 38/104. There is extensive central low density presumably necrosis. On prio...
1. Interval increase in right upper lobe mass with extensive post obstructive atelectasis.2. Increased pericardial effusion with pericardial metastases.3. Interval increase in pulmonary nodules, presumed metastases.
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Female, 72 years old, altered mental status and history of ovarian cancer. Periventricular hypoattenuation is a nonspecific finding, likely representing age indeterminate small vessel ischemic disease, not significantly changed. Focal lucency within the left caudate head is consistent with an age indeterminate lacunar ...
No acute intracranial abnormality.
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70 year-old male with altered mental status, found down. Evaluate for CVA versus bleed, fracture. CT head:No intracranial hemorrhage, mass lesion or edema is identified within the brain parenchyma. Normal gray-white matter differentiation. No CT evidence for acute territorial ischemia. Note that CT is insensitive for t...
1.No evidence for cervical spine fracture.2.No evidence for acute intracranial hemorrhage mass effect or edema.3.Degenerative changes of the spine with multilevel spinal canal and neural foraminal narrowing.4.Small vessel ischemic disease of indeterminate age.
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Female, 54 years old, headache. Extensive periventricular and subcortical hypoattenuation is demonstrated in a symmetric and bilateral distribution. Statistically, this most likely represents age indeterminate small vessel ischemic disease, though other processes may produce similar imaging findings.No evidence of mass...
1. Extensive white matter hypoattenuation which most likely represents age indeterminate small vessel ischemic disease. However, other processes may produce a similar appearance. If clinical concern persists, follow-up imaging with MRI may be helpful.2. No evidence of mass effect, intracranial hemorrhage or other defin...
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Tonsil ca s/p CRT. CHEST:LUNGS AND PLEURA: Scattered punctate micronodules, some of which are calcified, are stable and presumably benign. No new pulmonary nodules.MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal nodes are unchanged. Coronary calcification. Atherosclerotic calcification of the aorta and its br...
No evidence of metastatic disease.
Generate impression based on findings.
51 year old female. Elevated WBC post heart transplant. Also, no bowel movement after cholecystectomy. Evaluate for abnormal fluid collection, abscess or signs of obstruction. CHEST:LUNGS AND PLEURA: Small to moderate right pleural effusion, decreased from prior exam. Small left pleural effusion is decreased in size fr...
1.Interval decrease in size of anterior mediastinal fluid collection, now with new foci of gas. Infection cannot be excluded.2.Left inguinal fluid collection.3.Small to moderate right, and small left pleural effusions, decreased from prior exam.4.Interval decrease in ascites.
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58 year old female with hypoxemia and tachycardia, rule out pulmonary embolism PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Moderate right pleural effusion and small left pleural effusion. Overlying compressive atelectasis. Nonspecific 3-mm pulmonary nodule in the right middle lobe (series 7,...
No pulmonary embolism.1.Bilateral pleural effusions, right greater than left with overlying compressive atelectasis.2.Nonspecific 3 mm nodule in the right middle lobe.3.Postsurgical changes in the abdomen.
Generate impression based on findings.
Pleural effusion. Rib pain, pleurisy. LUNGS AND PLEURA: New small -- moderate right pleural effusion. Persistent bibasilar consolidation, atelectasis, and interstitial thickening. Calcified granuloma in posterior left upper lobe.MEDIASTINUM AND HILA: New relatively high density small pericardial effusion. The high dens...
1. New small -- moderate right pleural effusion. Persistent bibasilar consolidation, atelectasis, and interstitial thickening. This is likely due to a combination of chronic changes due to sickle cell disease with superimposed infection, aspirate, and/or edema.2. No evidence of rib fracture.3. New relatively high densi...
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Female, 12 years old, status post fall with head trauma. 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 ar...
No acute intracranial abnormality.
Generate impression based on findings.
84 year old female with shortness of breath and new onset CHF, atrial fibrillation, and recent proximal humerus fracture, evaluate for pulmonary embolism PULMONARY ARTERIES: Technically adequate exam. No evidence of pulmonary embolism. Main pulmonary artery is dilated measuring 4.2 cm in diameter compatible with pulmon...
1.No evidence of pulmonary embolism.2.Pulmonary arterial hypertension.3.Cardiomegaly.4. Stable nonspecfic bilateral pulmonary nodules.
Generate impression based on findings.
53 year-old male with left sided weakness. There is no interval change in ventricular sizes. Bifrontal bone burr holes are present. Redemonstrated is effacement of the fourth ventricle secondary to a left cerebellar parenchymal hemorrhage with surrounding low density vasogenic edema. The hematoma appears smaller when c...
1.Partial resolution of the left cerebellar hematoma.2.No interval change in ventricular sizes.3.Stable confluent cerebral white matter and thalamic hypodensity.
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Left tonsil cancer, rule out lung mets. LUNGS AND PLEURA: Minimal dependent edema or atelectasis but no evidence of metastatic disease. Calcified granuloma right lower lobe.MEDIASTINUM AND HILA: Nonspecific hypodense thyroid nodules. Coronary calcification. Trace pericardial fluid. No pathologically enlarged mediastina...
No evidence of pulmonary metastases.
Generate impression based on findings.
70-year-old male. Found down, multiple abrasions/ecchymoses all over body. Evaluate for acute process/trauma. CHEST:LUNGS AND PLEURA: Moderate right and trace left pleural effusion. Right middle lobe subsegmental atelectasis. Right middle lobe tree in bud opacities, which likely represents aspiration bronchiolitis. Lef...
Moderate right and trace left pleural effusion.1.Bilateral renal lesions, which are suspicious for solid renal masses, but are incompletely characterized without intravenous contrast.2.Contracted gallbladder containing gallstones, could represent chronic cholecystitis.3.Thickened, dilated esophagus containing fluid. As...
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Question pleural effusion with consolidation. Question pneumonia, atelectasis, nodule. CXR with left lower lobe opacity and pleural effusion. LUNGS AND PLEURA: Elevation of left hemidiaphragm with left lower lobe scarring and atelectasis. No evidence of mass or pneumonia. Trace left pleural effusion versus pleural thic...
Elevation of left hemidiaphragm with left lower lobe scarring and atelectasis. No evidence of mass or pneumonia. Trace left pleural effusion versus pleural thickening.
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63 year-old male. Evaluate for retroperitoneal bleed. ABDOMEN:LUNG BASES: Bilateral pleural effusions. There are right lower lobe airspace opacities and pulmonary nodules. One right middle lobe nodule measures 10 mm (seen on image 1 of series 4). There is pleural thickening and calcification on the left. LVAD device in...
1. No evidence of a retroperitoneal bleed.2. Multiple pulmonary and osseous lesions suspicious for metastatic disease.
Generate impression based on findings.
Female, 86 years old, status post fall, hit head. Mild periventricular hypoattenuation, a nonspecific finding likely representing age indeterminate small vessel ischemic disease.No evidence of focal edema, mass effect or midline shift. No intracranial hemorrhage or abnormal extra-axial fluid collection. The ventricular...
No acute intracranial abnormality.
Generate impression based on findings.
AML on chemo now with neutropenic fever and opacity on CXR. LUNGS AND PLEURA: Versus the prior CT there is new/increased basilar predominant bronchial thickening with fine centrilobular nodular opacity and tree in bud opacity suggestive of infectious bronchiolitis. No consolidation or pleural effusion.MEDIASTINUM AND H...
Findings suggestive of infectious bronchiolitis. Atypical infections including mycobacterial infections are considered. The imaging appearance can also be the result of follicular bronchiolitis in the appropriate clinical setting.
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34 years old female with headache. Right frontal approach ventricular shunt catheter in stable position, tip adjacent to the left caudothalamic groove. The visualized radiopaque portions of the catheter are intact.The supratentorial ventricular system remains decompressed, similar to the prior examination. Fourth ventr...
No significant interval change or evidence of an acute intracranial abnormality. Stable ventricular size.
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59 year old female. History of abdominal pain, C. difficile, recurrent fevers. Rule out abdominal abscess ABDOMEN:LUNG BASES: Trace bibasilar atelectasis. Minimal right pleural effusion.LIVER, BILIARY TRACT: Left hepatic lobe hypoattenuation, suggestive of cyst, is unchanged. Right, indeterminate hepatic lobe hypoatten...
Colitis.
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Male 45 years old; Reason: r/o obstruction History: abd pain and fullness, decreased out ABDOMEN:LUNGS BASES: Stable skin thickening in the right inferior thoracic subcutaneous tissues. No nodule or mass detected.LIVER, BILIARY TRACT: The liver contour is normal, without focal lesion. There is no biliary ductal dilatat...
1.No evidence of bowel obstruction. Stable left lower quadrant ostomy.2.Cholelithiasis without cholecystitis3.chronic osteomyelitis and neuropathic changes in the sacrum and hips, stable since previous exam
Generate impression based on findings.
50 year-old female with cerebellar hemorrhage. Redemonstrated are intra-and extra-axial blood products including a 2.4 x 2.3 x 2.0 cm hyperattenuating intraparenchymal collection within the left cerebellar hemisphere. Blood products extend extra-axially and are visualized throughout the cisterna magnum and anteriorly i...
Stable hemorrhage within the left cerebellar hemisphere with blood products extending into the extra-axial space in the posterior fossa and brain stem without significant mass effect or herniation. Blood products layering within the occipital horns are now evident, although there has been no change in ventricular sizes...
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18 year-old male with history of assault, tenderness along angle of left mandible. MAX/FACIAL: There is an oblique fracture extending through the left mandibular ramus to the third left mandibular molar, involving the alveolar fossa and mandibular canal. No dental fracture is noted. Adjacent soft tissue swelling and ed...
1. Left mandibular fracture with adjacent soft tissue edema/swelling as described above.2. Left maxillary sinus disease as described above.3. No acute intracranial abnormality.
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67 year-old male with altered mental status. There is redemonstration of bilateral patchy hypoattenuation in the subcortical/periventricular white matter most likely relating to chronic small vessel ischemic disease. There are more focal areas of hypoattenuation within the right and left thalami that likely represents ...
1. No acute interval change or hemorrhage. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Stable small vessel ischemic disease and thalamic lacunar infarcts. 3. Stable mild ventriculomegaly, which is slightly out of portion to sulcal prominent. This may ...
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Female, 15 years old, headache. Evaluate for bleed. Within the left sylvian fissure, there is a 1.3 x 0.9 cm focus of fat attenuation tissue. On review of the outside MRI, and in conjunction with the present study, lesion most likely represents a small dermoid cyst or a lipoma. The lesion produces that most mild local ...
1. Small lipoma or dermoid cyst within the left sylvian fissure.2. No acute intracranial abnormalities.
Generate impression based on findings.
Chest tube stopped draining. Question evidence of left pleural effusion. LUNGS AND PLEURA: Moderate to large left pleural effusion. The left pigtail drain has been retracted and is no longer in the pleural space. The tip is in the soft tissues (image 54/105). Punctate subpleural perifissural nodule on the left is presu...
Moderate to large left pleural effusion. The left pigtail drain has been retracted and is no longer in the pleural space.
Generate impression based on findings.
81 year old male. History of cholangitis. Status post ERCP and stent placement. Now with new leukocytosis, and right upper quadrant pain. ABDOMEN:LUNG BASES: Small to moderate bilateral pleural effusions and bibasilar atelectasis. Reference right lower lobe lung nodule has increased in size, now measuring 2.5 x 2.2 cm ...
1.Interval ERCP with pancreatic and biliary stent placement, and associated pneumobilia.2.New complete portal vein thrombosis, with interval development of ascites.3.Increased size of peritoneal nodules compatible with carcinomatosis.4.Increased size of pulmonary nodules.
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Male 57 years old; Reason: s/p lap distal pancreatectomy for insulinoma 7.24 now with increased WBC count History: wbc ABDOMEN:LUNGS BASES: Bilateral pleural effusions, left greater than right. There is bilateral compressive atelectasis.LIVER, BILIARY TRACT: The liver is normal in morphology. There is no lesion detecte...
1.Fluid collection in the left upper quadrant with foci of gas likely representing a hematoma. Superinfection cannot entirely be ruled out.2.Splenic infarction, as above. 3.Lack of enteric contrast limits evaluation of possible bowel injury.
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44-year-old female. Rule out intra-abdominal abscess. History of hysterectomy one week ago. ABDOMEN:LUNG BASES: Minimal subsegmental linear atelectasis bilaterally.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No s...
1. Anterior abdominal wall wound with developing body wall abscess.2. Pelvic ascites.
Generate impression based on findings.
Male 45 years old; Reason: 45 year old man with follicular NHL on observation and lung nodule. Compare to prior scan. H/O alpha-1 anti-trypsin deficiency History: none CHEST:LUNGS AND PLEURA: Severe emphysematous changes. The right upper lobe pulmonary nodule measures 7 x 6 mm (image 24/series 5), unchanged. The pleura...
1.Decrease in the size of the reference lymph nodes.
Generate impression based on findings.
Male, 43 years old, sore throat, very tender to palpation in the left submandibular region, temperature of 100.2. Evaluate for soft tissue infection or peritonsillar abscess. The adenoids, palatine and lingual tonsils and soft palate are thickened and edematous. Within the adenoidal tissues, there is at least one small...
1. Markedly enlarged adenoidal and tonsillar tissues consistent with adenitis/pharyngitis. There may be a small region of phlegmonous change or early abscess formation within the adenoidal tissues, though this could also simply represent entrapped secretions.2. Swelling of the left submandibular gland as well as surrou...
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36-year-old male. Evaluate for abscess. History of Crohn's. Right lower quadrant pain, rebound tenderness, obstructive symptoms. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenic cyst, unchanged.PANCREAS: No significant abnormality notedADRENAL GLA...
1.Inflammation involving the terminal ileum, the cecum, and the ascending colon. 2.Small bowel obstruction.3.Linear areas of inflammation from the terminal ileum, which may represent blind ending fistulas, or small abscesses.
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Female 55 years old; Reason: assess for chronic pancreatitis History: abdominal pain ABDOMEN: The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made: LUNG BASES: No significant abnormality notedLIVER, BILIARY TR...
Status post pancreatic duct stent in with pneumobilia, likely iatrogenic. No definite CT evidence of pancreatitis.
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Mesothelioma status post 4 cycles of chemo. CHEST:LUNGS AND PLEURA: Nodular right pleural thickening is again seen consistent with given diagnosis of mesothelioma. A loculated right pleural effusion extends to the right major fissure and has slightly increased from the prior study.The majority of the tumor mass is exte...
1. Right pleural thickening with chest wall invasion is consistent with given diagnosis of mesothelioma. The reference measurements are stable to slightly increased as detailed above.2. New small left pleural effusion.
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Metastatic colon carcinoma CHEST:LUNGS AND PLEURA: Slight interval increase in size of several of the numerous bilateral pulmonary nodules. The reference left lower lobe peripheral nodule best seen on image is 5 now measures 1.6 x 1.4 cm; this is in comparison to 1.3 x 1.1 cm on 5/22/2013.Left pleural thickening, relat...
Slight interval increase in size of several of the numerous bilateral pulmonary nodules.
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52 year-old male with non-Hodgkin's lymphoma. Re-evaluate and compare to previous study. CHEST:LUNGS AND PLEURA: Small, calcified pulmonary nodule in right upper lobe unchanged from prior study. MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Index right axillary node appears stable and measures 10 mm...
Increased size of index lymph nodes compared to prior study on 9/6/2012.
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History of laryngeal cancer status post completed "FHX 5/4/2012" CHEST:LUNGS AND PLEURA: Stable pleural based calcification suggest prior asbestos exposure. Mild bibasilar subsegmental atelectasis, right greater than left. Right middle lobe is now better aerated. Right apical scarring, possibly related to radiation tre...
1.No evidence of pulmonary metastatic disease.2.Stable compression deformities of the T4 and T5 vertebral bodies, possibly pathologic in nature. 3.Healed left scapular fracture unchanged.4. Right middle lobe is now better aerated.
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Female 41 years old; Reason: r/o renal injury, contusion, retroperitoneal bleed from blunt object History: flank injury, cva ttp ABDOMEN:LUNGS BASES: Bibasilar atelectasis. No mass or nodule detected.LIVER, BILIARY TRACT: No significant abnormality noted. The gallbladder is contracted.SPLEEN: No significant abnormality...
1.L1-4 right transverse process fractures with possible wedge compression fracture of L1. MRI recommended for full characterization and evaluate for possible ligamentous injury.
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Lung cancer status post CRT. Please re-eval for surgery. CHEST:LUNGS AND PLEURA: Reference spiculated left upper lobe nodule measures 14 x 10 mm on image 42/106 (14 x 12 mm on prior). No new pulmonary nodules. Apical scarring with paraseptal emphysema. Faint centrilobular nodular opacity again noted with mild bronchial...
1. Stable to marginally decreased pulmonary nodule.2. Decrease in mediastinal lymphadenopathy.3. New segmental right-sided PE with extension into subsegmental branches.Findings discussed with Dr. Hoffman at the time of report.
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80 year-old male with back pain. Evaluate for abscess. Thoracic spine:Alignment is anatomic. Vertebral body heights and intervertebral disk spaces are preserved. Please see below regarding spinal fusion hardware and associated findings. Mild multilevel degenerative changes with no significant compromise of the spinal c...
Stable findings involving the T12-L2 levels with no obvious enhancing paraspinal or intraspinal collection to suggest abscess formation.
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Evaluate for pulmonary edema, evidence of VTE History of pulmonary hypertension starting Flolan. Develops inspiratory crackles with increased Flolan dose. LUNGS AND PLEURA: Thin-walled cyst right lung base unchanged. Fine diffuse centrilobular nodular abnormality with bronchial wall and septal thickening unchanged. Dep...
1. No evidence of lobar or segmental PE. Subsegmental braches are not adequately opacified for diagnostic evaluation.2. Right sided cardiac enlargement consistent with known pulmonary HTN.3. Mild dependent pulmonary edema.4. Nonspecific centrilobular nodular opacity with bronchial wall thickening and interstitial thick...
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89 year-old male with history of stroke. There is a focus of hypoattenuation with mild adjacent sulcal effacement in the right middle frontal gyrus. There is patchy hypoattenuation in the periventricular white matter. A small calcified lesion is seen in the right frontal region. The ventricles, sulci, and cisterns are ...
1. No acute intracranial hemorrhage. 2. Likely right middle frontal subacute infarct. 3. Small vessel ischemic disease of indeterminate age. 4. Probable right frontal meningioma.
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52-year-old male with history of Burkitt leukemia/lymphoma. Assess disease status. CHEST:LUNGS AND PLEURA: Interval improvement of the centrilobular nodules noted on prior exam. Interval decrease in size of right pleural effusion. Resolved left apical pulmonary nodule compared to prior exam.MEDIASTINUM AND HILA: There ...
1. Interval decrease in size of mediastinal lymph nodes.2. Enhancing left upper pole renal mass with features on imaging consistent with renal call cancer.
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Male, 26 years old, status post assault, altered mental status. Brain parenchymal morphology is within normal limits. No focal edema, mass effect or midline shift is seen. No evidence of intracranial hemorrhage or abnormal extra-axial fluid collection. The ventricular system is patent and normal in size.Irregularity of...
1. Findings consistent with a gunshot wound involving the left preauricular and parotid spaces as well as the left masticator space.2. There is a comminuted fracture of the left mandibular condyle with numerous surrounding bony and metallic fragments. The subjacent parapharyngeal and pharyngeal spaces are edematous whi...
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83 year-old male with history of SDH. Examination shows predominantly hyperdense collections in the bilateral cerebral subdural spaces, right more than left. The maximum thickness of the right and left subdurals measures 20 mm and 14 mm, respectively. There is resultant sulcal effacement and 7-mm leftward midline shift...
Bilateral cerebral subdural acute hematomas, right greater than left, with resultant sulcal effacement, 7-mm leftward midline shift and mild subfalcine herniation.
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History of head and neck cancer. CHEST:LUNGS AND PLEURA: Apical scarring or fibrosis unchanged. No evidence of pulmonary metastases. MEDIASTINUM AND HILA: Cardiomegaly and ectasia of aortic root is unchanged. There is circumferential narrowing of the brachiocephalic and left common carotid arteries at their origins, un...
No evidence of metastatic disease.
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26 year old female. Recurrent UTI. Evaluate for nephrolithiasis. 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: P...
Punctate, non obstructing left renal stone.
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Female 47 years old; Reason: ro renal recurrence History: Hx of ovarian CA and Renal cell ca ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in nephrology. Well marginated fluid attenuating lesions representing cysts are unchanged. Right hepatic lobe hemangiomata are unchange...
1.Stable exam without recurrent lymphadenopathy.2.Status post partial right nephrectomy without suspicious lesion.
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Metastatic ER positive breast cancer. Cough, stable back pain. CHEST:LUNGS AND PLEURA: New irregularly marginated subpleural airspace opacity in the right upper lobe (image 41/100) at the site of previous radiation therapy. Stable nonspecific pleural thickening at the right apex. No new pulmonary nodules. Scattered pun...
1. New airspace opacity in right upper lobe which is more typical of infection or aspiration than metastatic disease though continued follow up is recommended.2. Interval decrease in reference hepatic mass and upper abdominal lymph node.3. No change in appearance of spine. The osseous metastases were better demonstrate...
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48-year-old male. Right upper quadrant pain, outside CT shows peripherally enhancing lesion at the right inferior liver lobe, but no arterial phase. Please characterize with cirrhosis protocol. Lower lung fields abnormal on CT. LUNGS AND PLEURA: Moderate, apical predominant centrilobular emphysema.Necrotic, spiculated ...
1.Necrotic, spiculated right hilar mass which is suspicious for primary lung neoplasm.2.Hypoattenuating right hepatic lobe lesion with peripheral enhancement. In the context of the right hilar mass this is suspicious for metastatic disease.3.Heterogeneous left adrenal mass.
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41 year old female with lumbar transverse fracture L1 -- L4. Evaluate fracture seen on CT abdomen. Five lumbar type vertebral bodies are presumed to be present. There is slight anterior wedging of L1. There is disk protrusion at L1-L2 with no significant compromise to the spinal canal or neural foramina. No CT evidence...
1.Mildly displaced vertical fractures through the transverse processes of L1-L4. Possible small right paraspinal muscle hematoma. 2.Slight anterior wedging of L1 with L1-L2 disk protrusion, age indeterminate, although could be acute given relative lack of significant degenerative disk disease elsewhere in the lumbar sp...
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93 year-old female with history of fall and fluid level in the right maxillary sinus. Motion degraded exam. There has been no significant change in the small foci of intraparenchymal hemorrhage within the right periventricular white matter of the frontal lobe. There are no new hemorrhage or intraventricular blood produ...
1. Stable right frontal periventricular hemorrhage. No new hemorrhage. Motion degraded exam. 2. Probable right orbital floor fracture. 3. Right facial and periorbital soft tissue swelling. Small amount of blood products in the right maxillary, ethmoid and sphenoid sinuses.
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Right lower quadrant pain ABDOMEN:LUNG BASES: Small to moderate pericardial effusionLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRE...
Mild to moderate pericardial effusion. Prominent soft tissue anal rectal junction; favor rectal prolapse over mass. Recommend correlation with physical examination.
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Reason: Is there any obstruction of the SVC causing SVC syndrome? Pt has subQ emphysema and newly diagnosed thrombus around R PICC History: facial plethora, known DVT around R PICC, facial swelling (however has known subQ emphysema). LUNGS AND PLEURA: Left-sided chest tube is in place with its tip near the apex.Minimal...
1.Persistent severe subcutaneous emphysema involving the entire chest wall, shoulders, and supraclavicular region, and extending throughout the neck to at least the level of the maxilla.2.Small amount of loculated pneumothorax on the left with a left-sided chest tube in place and its tip directed at the apex. Pneumomed...
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Male 75 years old; Reason: s/p EVAR with bilateral renal stents, 1 year surveillance History: see above ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left ad...
1.Decrease in the size of the aortic aneurysm following stent placement.2.Areas of cortical ischemia involving the left lower pole of the kidney.
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Male, 91 years old, headache, question of blood thinners. Prominence of the sulci and ventricles is consistent with parenchymal volume loss. Extensive periventricular hypoattenuation likely represents age indeterminate small vessel ischemic disease. There is the suggestion of parenchymal thinning in additional areas, f...
1. Extensive age indeterminant small vessel ischemic disease. Evidence of possible chronic territorial ischemia as well.2. No evidence of intracranial hemorrhage or other definite acute intracranial abnormalities.
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50 year-old female with severe uncontrolled asthma presents with shortness of breath and chest tightness LUNGS AND PLEURA: Patchy very faint minimal ground glass opacity at both lung bases, which is nonspecific but can be seen with asthma. No significant bronchial wall thickening.MEDIASTINUM AND HILA: Small subcentimet...
Patchy very faint minimal ground glass opacity at both lung bases, which is nonspecific but can be seen with asthma. No significant bronchial wall thickening.
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ILD. evaluate for progression. SOB. LUNGS AND PLEURA: Bilateral subpleural predominant reticulation with traction bronchiectasis has increased in severity and distribution. Small areas of honeycombing are unchanged. No groundglass opacity. No new pulmonary nodules.MEDIASTINUM AND HILA: Scattered small subcentimeter nod...
Interval increase in distribution and severity of interstitial disease.
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75-year-old female with stage IV non-small cell lung cancer, cancer surveillance CHEST:LUNGS AND PLEURA: Bronchiectasis and fibrotic changes in the right upper lobe compatible with post radiation change. Scattered pulmonary micronodules are unchanged. No new pulmonary masses or nodules. Interval resolution of right ple...
1.Fibrotic change, traction bronchiectasis, and consolidation in the right upper lobe compatible with postradiation change. No new suspicious pulmonary nodules or masses. Resolved right pleural effusion.2.No evidence of metastatic disease.
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Metastatic breast cancer. CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary metastases are stable. The previously referenced left lower lobe subpleural nodule measures 8 mm (image 37, series 5), previously 8 mm. The previously referenced right lower lobe nodule measures 4 mm (image 50), previously 4 mm. MEDIASTINUM ...
Stable pulmonary, hepatic and osseous metastases.
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15 year-old female with headache. NONCONTRAST CT HEADExamination again shows a fat containing mass within the left sylvian fissure, which is unchanged since prior. The lesion produces that most mild local mass effect with displacement of adjacent gyri. No evidence of significant generalized mass effect is seenThe ventr...
1. Stable fat containing mass within the left Sylvian fissure, which likely represents a lipoma or dermoid cyst. 2. Unremarkable CTA brain.
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Reason: History of lung mets and synovial sarcoma, with recent onset of coughing and weakness. Evaluate for extent of disease History: History of lung mets and synovial sarcoma, with recent onset of coughing and weakness. Evaluate for extent of disease LUNGS AND PLEURA: Multiple pulmonary nodules have slightly decrease...
Mild interval decrease in size of multiple pulmonary nodules. No new sites of disease identified.
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Hodgkin's lymphoma with no active disease. Found to have right upper lobe cavitary lesion. Now being treated with voriconazole. Monitoring for resolution. LUNGS AND PLEURA: Interval decrease in right upper lobe cavitary mass now measuring 36 x 31 mm on image 19/107 (53 x 41 mm on prior). Interval significant decrease i...
Interval decrease in right sided cavitary mass, wall thickening and perilesional /infectious inflammatory changes.
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Male 58 years old; Reason: met melanoma on vemurafinib please assess disease status and compare to previous imaging History: metastatic melanoma CHEST:LUNGS AND PLEURA: Right upper lobe pulmonary right nodule is less solid measures 1.0 x 0.8 cm (image 38/series 4) previously, 1.2 x 1.2 cm.The pleural spaces are clear. ...
1.Near stable exam with no significant interval change in the size of the reference lesions.
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Female, 62 years old, with headache. Evaluate for hemorrhage. No evidence of focal parenchymal edema, mass effect or midline shift. No CT evidence of acute territorial ischemia.No intracranial hemorrhage or abnormal extra-axial fluid collections detected. Ventricular system is patent and normal in size.Emphysema noted ...
1. No significant vascular stenosis or occlusion within the neck.2. Two or perhaps three tiny outpouchings of the left cavernous ICA are identified, each measuring no more than 1 mm in size. These are suspicious for tiny aneurysms. Although less likely, these may also represent minimally calcified plaques.3. Elsewhere,...
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Metastatic breast cancer CHEST:LUNGS AND PLEURA: Bronchus intermedius is occluded by tumor at its origin. The airway is of the middle and lower lobe are dilated and filled with debris. Postobstructive consolidation of the lower lobe is unchanged. Postradiation fibrosis is unchanged.Right middle lobe reference nodule is...
Metastatic breast cancer with stable reference measurements.
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Male 69 years old; Reason: 69 yr old male with h/o AML, s/p MUD SCT, \R\day 80 History: elevated EBV, evaluate for PTLD CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Coronary artery calcifications. No mediastina...
1.Large right subcapsular hematoma.2.No evident lymphadenopathy in the chest, abdomen or pelvis.3.Cholelithiasis.4.Diverticulosis.