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Generate impression based on findings. | Evaluate mediastinal and retroperitoneal lymphadenopathy. Outside hospital CT shows diffuse lymphadenopathy and pulmonary nodules. Left supraclavicular lymph node biopsy consistent with sarcoidosis. CHEST:LUNGS AND PLEURA: Scattered, subcentimeter micronodules which can be followed.MEDIASTINUM AND HILA: Extensive adenopathy, both at the base of the neck and within the mediastinum. For reference purposes, a precarinal lymph node measures 2.3 x 1 .5 cm (image 41; series 2).CHEST WALL: Gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Several small hypodense nodules are noted in the spleen. The largest measures 1.4 x 1.5 cm (image 98; series 3).PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Numerous mesenteric and retroperitoneal lymph nodes. For reference purposes, a conglomeration of lymph nodes in the left para-aortic space measures 2.5 x 2.0 cm (image 127; series 3).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Extensive adenopathy, predominating in the chest and abdomen. Nonspecific hypodense splenic nodules. These findings are compatible with clinical diagnosis of sarcoidosis.2. Gynecomastia. |
Generate impression based on findings. | Reason: s/p renal xplant, evaluate for hydronephrosis History: nephrostomy tube fell out now with dysuria and distention ABDOMEN: Within the limitations of a non-IV contrast enhanced examination which limits evaluation of solid organ parenchyma and vascular structures, the following observations can be made:LUNG BASES: Mild emphysematous changes bilaterally. Atherosclerotic calcifications of the coronary arteries.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Severe splenic artery calcification.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral atrophic native kidneys with scattered punctate calcifications which may represent nephrolithiasis or vascular calcifications. Moderate amount of hydronephrosis of the transplant kidney in the right iliac fossa.RETROPERITONEUM, LYMPH NODES: Scattered, subcentimeter lymph nodes. Atherosclerotic calcifications of the aorta and iliac arteries bilaterally. The internal iliac arteries are severely calcified.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder diverticulum arising from the left lateral wall.LYMPH NODES: Scattered pelvic lymph nodes on the right and inguinal lymph nodes bilaterally.BOWEL, MESENTERY: Diverticulosis of the sigmoid and descending colon without complications.BONES, SOFT TISSUES: Severe degenerative joint disease involving L3-L4 and L4-L5 lumbar vertebra. Severe degenerative disk collapse of L4-L5.OTHER: No significant abnormality noted | 1.Mild hydronephrosis of the transplant kidney in the right iliac fossa may be secondary to reflux versus obstruction.2.Bladder diverticulum arising from the left lateral wall.3.Diverticulosis of the sigmoid and descending colon without complications.4.Severe degenerative joint disease involving L3-L4 and L4-L5 lumbar vertebra. |
Generate impression based on findings. | Reason: Etiology of neutropenic fever- typhylitis History: Profuse diarrhea, neutropenic fever, perianal skin tear, CHEST:LUNGS AND PLEURA: Upper lobe predominant centrilobular emphysema and small bilateral pleural effusions.MEDIASTINUM AND HILA: Heart size is normal. No significant pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdominal aorta and its branches.BOWEL, MESENTERY: No evidence of bowel wall thickening. No evidence of bowel obstruction, free air, pneumatosis, or free fluid in the abdomen/pelvis. No drainable fluid collections in the abdomen or pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No CT evidence of infectious source in the chest, abdomen, or pelvis. 2.Small bilateral pleural effusions. |
Generate impression based on findings. | Female, 35 years old, status post catheter placement. Right posterior parietal approach catheter is redemonstrated. Since the prior examination, the catheter tip has been repositioned. It now terminates to the right of midline within the body of the right lateral ventricle. Scalp swelling is redemonstrated. In addition, there is a small amount of fluid around the right parietal catheter reservoir, slightly increased from the prior examination. Minimal intracranial air is also demonstrated.A small amount of hyperdense material, likely blood product, is seen along the corpus callosum at the midline, at the prior site of catheter termination. Elsewhere in the brain, no evidence of intracranial hemorrhage or abnormal extra-axial fluid is seen. No focal parenchymal edema, mass effect or midline shift is detected.Since the prior examination, the caliber of the right lateral ventricle has decreased. It is now completely decompressed. The left lateral ventricle remains similar in caliber to the prior examination. The third and fourth ventricles are within normal limits. | 1. Interval repositioning of the intraventricular catheter. The catheter tip now terminates in the region of the body of the right lateral ventricle. A small amount of blood product is seen at midline along the corpus callosum, at the prior site of catheter termination.2. Since the prior examination, the caliber of the right lateral ventricle has decreased and the ventricle is now completely decompressed.3. Scalp swelling is again seen along the right parietal region with a small amount of fluid surrounding the catheter reservoir, slightly increased when compared to the prior exam. |
Generate impression based on findings. | IVH. There is an unchanged right transfrontal ventriculostomy catheter that terminates in the region of foramen of Monro. There is unchanged hemorrhage within the lateral ventricles, right greater than left. No new intracranial hemorrhage is identified. The lateral ventricles are stable compared in size and configuration. The brain parenchyma appears unchanged. The skull, paranasal sinuses, and extracranial soft tissues are unchanged. | Unchanged hemorrhage within the lateral ventricles, right greater than left, and unchanged ventricular size with ventricular catheter in position. |
Generate impression based on findings. | Reason: renal stone History: renal colic. H/o stone ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No hydronephrosis or nephrolithiasis. |
Generate impression based on findings. | Reason: eval for poss AAA, dissection History: chest pain, AMS CHEST:LUNGS AND PLEURA: Small right pleural effusion.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Mildly prominent mediastinal lymph nodes.VASCULATURE: Mild atherosclerosis of the aortic arch. No evidence of aneurysmal dilatation or dissection.CHEST WALL: Body wall edema.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Moderate ascites.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mildly prominent retroperitoneal lymph nodes.VASCULATURE: No aneurysmal dilatation or dissection of the abdominal aorta. The celiac axis and SMA are patent. There is mild stenosis of the proximal right common iliac artery.BOWEL, MESENTERY: VP shunt catheter terminates in the right hemiabdomen. No evidence of obstruction, free air, or pneumatosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate free fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of aneurysm/dissection of the aorta or its branches. Mild stenosis of the proximal right common iliac artery. 2.Abdominal and pelvic ascites suggest fluid overload or possibly heart failure. |
Generate impression based on findings. | Mental cell lymphoma. Lymph nodes at multiple sites. CHEST:LUNGS AND PLEURA: Left upper lobe pulmonary nodule (image 24; series 7) measures 4-mm, unchanged.Subtle nodularity involving the right lower lobe peripherally as noted previously. No new dominant lesion. The pleural spaces are clear. The central airways are patent. Subpleural articulations in the right lower lobeMEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.Subcarinal node measures 1.8 x 1.1 cm (image 46/series 5), unchanged.CHEST WALL: Soft tissue thickening adjacent to the upper thoracic spine is stable to slightly increased and currently measures 9 mm in thickness (image 39; series 5).ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. The segment 4 hypodense focus is unchanged.SPLEEN: Spleen is normal in size.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Kidneys enhance homogeneously. Left renal cyst; no hydronephrosis. RETROPERITONEUM, LYMPH NODES: Mild calcific arterial sclerotic disease of the aorta. Small retroperitoneal lymph nodes are not enlarged by CT size criteria.BOWEL, MESENTERY: Scattered colonic diverticulosis is noted previously. No surrounding inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the lumbar spine appear similar to previousOTHER: No significant abnormality noted | Stable examination with measurements given above. |
Generate impression based on findings. | Lung cancer, follow-up CHEST:LUNGS AND PLEURA: Multiple bilateral scattered part solid and ground glass nodules are again observed in all lobes. All but two foci appear unchanged and for reference the partially solid lesion in the right lower lobe again measures 2.2 cm (image 48 series 5). Of concern and note are two part solid lesions in the left upper lobe with increased size of the solid component. The larger focus in the left apex demonstrates a nodular focus currently measuring 6 mm from a prior measurement of 4 mm (image 13 series 5). More inferiorly and anteriorly is another more solid nodule currently measuring 6 mm from a prior measurement of 4 mm (image 34 series 5).Stable appearing postsurgical resections involving the upper, middle and lower lungs. No effusionsMEDIASTINUM AND HILA: The borderline right high paratracheal lymph node is unchanged. No new lymphadenopathyModerate coronary calcifications. The cardiac and pericardium are otherwise within limits.CHEST WALL: Stable focal sclerotic lesion in T11, again unchanged since 2010 again likely benign.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Small stable focal right adrenal nodule, measuring 1.4 cm (image 105 series 3). Mild nodularity of the left adrenal unchangedKIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Minimal interval change including mildly different solid components of two mixed semisolid left upper lobe lesions. The numerous additional bilateral pulmonary findings are otherwise unchanged from the immediate prior exam; yet demonstrate overall mild progression since 2010. The overall appearance remains compatible with known adenocarcinoma (AAH) concerning for questionable malignant transformation of two left upper lobe lesions super imposed upon the known indolent foci being tracked. |
Generate impression based on findings. | Male, 62 years old, history of squamous cell carcinoma of the left tongue base. Glottic and supraglottic mucosal edema is redemonstrated compatible with treatment related effects. Also unchanged is a thin retropharyngeal effusion. No mucosal based mass or pathologic enhancing lesion is seen.No pathologic adenopathy is detected in the neck by size criteria. A reference left level 3 lymph node measures 6 x 5 mm (image 56 series 4), not significantly changed.Continued decrease in size of a hypodense right thyroid lesion is noted. The lesion now measures no more than 4 mm in diameter, previously 8 mm. The salivary glands are free of focal lesions.Cervical vessels remain patent with atherosclerotic calcifications of bifurcations, right side worse than left. Lung apices show no significant abnormality. No concerning bony lesions are demonstrated. | Posttreatment findings in the neck with no significant interval changes and no evidence of progressive disease. |
Generate impression based on findings. | Reason: RUQ pain, hyperbilirubinemia, leukocytosis. ? obstruction vs infectious source vs other cause History: see above ABDOMEN:LUNG BASES: Basilar subsegmental atelectasis and consolidation.LIVER, BILIARY TRACT: No intra-or extrahepatic biliary ductal dilatation. No CT evidence of cholelithiasis. No focal hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction, free intraperitoneal air, pneumatosis intestinalis, or free fluid in the abdomen/pelvis. There is minimal left colonic wall thickening. No significant pericolonic fat stranding.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Minimal left colonic wall thickening without surrounding fat stranding suggests possible colitis of unclear etiology, including infectious/inflammatory causes. |
Generate impression based on findings. | Reason: mets lung ca, w/ uterine lesion, ALK+, on Crizotinib, s/p mulitple chemo prior. Pls c/w previous study and evaluate tx response. History: lung ca CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Reference prevascular lymph node measures 1.4 x 0.9 centimeters (series 3, image 22), previously 1.4 x 1.2 cm.CHEST WALL: The right axilla is not entirely visualized. No left axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: Accessory splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mildly prominent mesenteric and retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: Diverticulosis without diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Left adnexal ovarian dermoid measures 8.1 cm, previously 8.4 cm (series 3, image 153).BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Stable to slight decrease in reference prevascular lymph node. 2. Stable left adnexal dermoid.3. No new sites of disease. |
Generate impression based on findings. | 81-year-old female with history of past surgeries, presenting with vomiting ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a very large ventral hernia containing small bowel loops. Proximal small bowel loops entering into the hernia sac and within the hernia demonstrate mild dilatation measuring up to 3-cm. Small amount of fluid is also present in the hernia sac. Distal small bowel loops are decompressed.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Please see discussion aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Small bowel obstruction secondary to ventral hernia. |
Generate impression based on findings. | Thymoma and resection, follow-up CHEST:LUNGS AND PLEURA: Stable left major fissural lymph node (image 68 series 5). Otherwise scattered micronodules are also unchanged, some of which are calcified. No new suspicious nodules or masses. No effusions. Minimal right middle lobe scarring and diffuse central lobular emphysema.MEDIASTINUM AND HILA: Postsurgical changes in the anterior mediastinum with a small pericardial fluid collection unchanged. The cardiac and pericardium are otherwise unremarkable.Stable appearing para-aortic lymph node (image 73 series 3). No interval change or new findings to suggest lymphadenopathy.Small hiatal herniaCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Mild scattered degenerative changes unchanged. Scoliosis suspectedOTHER: No significant abnormality noted. | No suspicious findings to suggest metastatic or recurrent disease. Postsurgical findings as described. |
Generate impression based on findings. | Reason: Hx of Follicular NHL History: s/p 4 cycles of chemotherapy CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Reference precarinal lymph node measures 2.1 x 1.4 cm (series 3, image 46), previously 1.8 x 1.3 cm. Reference right hilar lymph node measures 2.3 x 1.6 cm (series 3, image 56), previously 2.2 x 1.5 cm. Heart size is normal. No pericardial effusion.CHEST WALL: Bilateral axillary lymphadenopathy. Reference right axillary lymph node measures 2.6 x 2.1 cm (series 3, image 41), previously 2.7 x 2.2 cm.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific right hepatic lobe hypodensity is too small to further characterize, but unchanged and likely benign.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: The left adrenal gland is not visualized secondary to overlying lymphadenopathy.KIDNEYS, URETERS: Nonobstructive left renal calculus.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal, celiac, gastrohepatic, peripancreatic, and iliac lymphadenopathy. Reference left para-aortic conglomerate of lymph nodes measures 6.5 x 6.2 cm (series 3, image 124), previously 6.4 x 5.7 cm. This lymph node mass encases both the left renal artery and vein.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Extensive pelvic lymphadenopathy. Reference right obturator lymph node measures 4.1 x 3.7 cm (series 3, image 192), previously 4.0 x 3.7 cm. Enlarged left obturator lymph node measures 4.1 x 2.1 cm (series 3, image 207), previously 3.4 x 2.0 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Increasing lymphadenopathy in the chest, abdomen, and pelvis. |
Generate impression based on findings. | Female; 72 years old. Reason: eval for interval change of metastatic disease History: known malignancy LUNGS AND PLEURA: There is no focal air space opacity, pleural effusion, or pneumothorax. No suspicious pulmonary nodules or masses to suggest metastatic disease. Scattered pulmonary micronodules are grossly unchanged. Mild upper lung zone centrilobular emphysema. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Mild coronary and aortic arch calcifications. Small hiatal hernia with retained barium products. CHEST WALL: Postsurgical changes status post right mastectomy. Right central venous catheter tip at cavoatrial junction. Enlarged left axillary lymph nodes are suspicious for metastatic disease, and reference node measures 1.8 cm in short axis (series 4, image 32). Left chest wall nodule is also suspicious for metastasis and measures 2.0 x 1.4 cm (series 4, image 67). No evidence of osseous metastases. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Innumerable hypodense hepatic lesions are new since the prior CT and compatible with diffuse metastatic disease. | 1.Left axillary lymphadenopathy, left chest wall nodule, and innumerable new hepatic lesions are compatible with diffuse metastatic disease. 2.No evidence of pulmonary metastases. |
Generate impression based on findings. | Neoplasm of the glottis. CHEST:LUNGS AND PLEURA: A new right upper lobe 6-mm nodule (image 26 series 5) with otherwise stable scattered micronodules. No effusions.MEDIASTINUM AND HILA: No lymphadenopathy. Cardiac and pericardium are within limits other than moderate coronary calcifications.CHEST WALL: Right chest port has been removed ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered bilateral renal cysts with right renal colliculi, are associated with previously described complex lesions with central calcifications. A on the right a single lesion appears mildly larger, currently measuring 1.8 cm or prior measurement of 1.2 cm (image 115 series 3) . Dedicated imaging may be indicated.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Moderate degenerative changes unchanged. No suspicious new lytic or blastic lesions.OTHER: No significant abnormality noted. | New right upper lobe pulmonary nodule and questionable changes involving the right kidney; both concerning for progression in metastatic disease |
Generate impression based on findings. | Abdominal pain, history of for a cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Ectatic descending aorta is unchanged measuring 4.7-cm image number 31, series number 4.CHEST WALL: Enlarged right axillary lymph node is stable measuring 1.9 by 1.7-cm image number 28, series number 4.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymph nodes are unchanged. Index portacaval lymph node measures two by 0.7 cm on image number 89, series number 4.BOWEL, MESENTERY: Proximal small bowel loops are dilated measuring of two 3.9 cm. Distal small bowel loops in the right lower quadrant are collapsed. These findings are compatible with distal small bowel obstruction.Ventral hernia containing nonobstructed transverse colon segments.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: Index right external iliac lymph node measures 2.1 x 1.1 cm image number 142, series number 4. Left inguinal adenopathy measures two by 2.4-cm image number 157, series number 4, not significantly changed.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | New, distal small bowel obstruction. Index measurements are stable. The etiology is unknown the and small bowel obstruction can be secondary to carcinomatosis versus adhesions.Dr. Lee was notified about these findings at the time of dictation. |
Generate impression based on findings. | Reason: 65 y/o M w/ stage iV neuroendocrine small call carcinoma, extensive mets. Please assess therapy response. Please perform a triple phase liver scan. Thanks! 3972 History: none CHEST:LUNGS AND PLEURA: Stable nonspecific 5 mm right upper lobe pulmonary nodule (series 12, image 34). No new suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Nodular thyroid is unchanged. No mediastinal or hilar adenopathy. Heart size is normal. No pericardial effusion. Coronary artery calcifications.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Hepatic metastases. Reference right hepatic lesion measures 1.3 x 1.1 cm (series 14, image 81), previously 1.6 x 1.5 cm. Reference left hepatic lobe lesion measures 1.0 x 0.8 cm (series 14, image 85), previously 1.4 x 1.2 cm.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral simple appearing renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Reference anterior peritoneal soft tissue nodule measures 1.2 x 0.9 cm (series 14, image 83), previously 2.4 x 1.5 cm.BONES, SOFT TISSUES: Diffuse skeletal sclerotic lesions compatible with metastases, new from prior exam. Reference left anterior abdominal wall soft tissue nodule measures 0.9 x 0.5 cm (series 14, image 132), previously 1.0 x 0.6 cm.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Punctate focus in the right anterior subcutaneous soft tissues is unchanged.OTHER: No significant abnormality noted. | 1. New diffuse sclerotic skeletal metastases. 2. Decrease in size of reference lesions. |
Generate impression based on findings. | Thyroid cancer, please follow-up CHEST:LUNGS AND PLEURA: Scattered bilateral micronodules are all unchanged. No new suspicious nodules or masses. No effusions.MEDIASTINUM AND HILA: Postoperative changes in the thyroid bed unchanged.Interval progression of a high right paratracheal lymphadenopathy, for reference the right paratracheal node previously measuring 1.5 cm currently measures 2.0 cm (image 21 series 3). Adjacent confluent additional lymph nodes are also larger.The cardiac and pericardium are within limitsModerate hiatal herniaCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered suspected hepatic cyst are unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval enlargement of right paratracheal lymph nodes with associated new adjacent lymphadenopathy, some necrotic. Concern for focal advancement and recurrence, all correlating with concomitant exams |
Generate impression based on findings. | Male; 58 years old. Reason: eval for fluid collection surrounding LVAD tracking through driveline, eval for abscess History: chronic bacteremia, chills, drainage surrounding driveline. Significant streak artifact due to mediastinal hardware limits diagnostic sensitivity. CHEST:LUNGS AND PLEURA: Minimal basilar scarring/atelectasis. Minimal bronchiectasis is also noted at the lung bases and unchanged. Mild centrilobular emphysema. No focal air space opacity, pleural effusion, or pneumothorax.MEDIASTINUM AND HILA: Cardiomegaly with left ICD and leads in place. Left ventricular assist device appears to be in position. No focal fluid collection or evidence of inflammation in the soft tissues surrounding the LVAD components. Right central venous catheter tip in SVC. Small hiatal hernia. CHEST WALL: Mildly enlarged left internal mammary lymph node measures 1.8 cm and is unchanged in size (series 3, image 29).ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hyperdense material within the gallbladder is again noted and may represent calcified sludge.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Mild nodularity of the right adrenal gland, which is poorly visualized due to overlying streak artifact. KIDNEYS, URETERS: Right lower pole renal cyst is unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Focus of anterior abdominal wall soft tissue inflammation may be secondary to prior injection at this site. OTHER: Mild abdominal aortic calcifications. | No fluid collection seen around the driveline or other LVAD components as clinically questioned. |
Generate impression based on findings. | Tongue cancer, follow-up CHEST:LUNGS AND PLEURA: Mild dependent atelectasis superimposed upon moderate central lobular emphysema. No suspicious new focal nodules or masses. No effusions.MEDIASTINUM AND HILA: Previously identified right thyroid cysts appear somewhat smaller, possibly due to changes in gantry angle and patient positioning. Please correlate with physical exam and relate with the neck CT.No lymphadenopathyThe cardiac and pericardium are within limits other than moderate coronary calcifications and atherosclerotic disease of the aortaCHEST WALL: Scattered stable appearing degenerative changes largely found in the lower thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Small scattered hypodensities suggesting simple liver cysts unchangedSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts and left-sided and nonobstructing calcificationsPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No findings to suggest metastatic disease and old nephrolithiasis |
Generate impression based on findings. | 69-year-old male with history of follicular non-Hodgkin lymphoma CHEST:LUNGS AND PLEURA: Moderate to severe centrilobular emphysema, unchanged.MEDIASTINUM AND HILA: Index pretracheal lymph nodes measures 2.1 x 0.8 cm image number 40, series number 3, significantly smaller compared to previous study. Other mediastinal and hilar lymph nodes are also smaller.CHEST WALL: Index left axillary lymph node measures 1 cm in diameter image number 24, series number 3, significant a smaller compared to previous study. Other axillary lymph nodes are also decreased in size compared to previous study.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Lipoma in the duodenum is unchanged.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval decrease in the size of the mediastinal and axillary lymph nodes. Cholelithiasis. |
Generate impression based on findings. | Reason: History of pulmonary nodules (aspergillosis) on Vfend, eval for change History: SOB LUNGS AND PLEURA: Significant improvement and/or resolution of multiple pulmonary nodules noted on the prior exam.Mild upper lobe predominant centrilobular emphysema.MEDIASTINUM AND HILA: Stable mild cardiac enlargement without evidence of a pericardial effusion. Mild improvement in the retrosternal fluid collection which most likely was postoperative in origin.No hilar or mediastinal lymphadenopathy.CHEST WALL: Median sternotomy with presternal loop recorder.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. | Significant interval improvement and/or resolution of multiple pulmonary nodules compatible with treatment response in this patient with a history of aspergillosis. |
Generate impression based on findings. | Tonsil cancer LUNGS AND PLEURA: Minimal bilateral and apical radiation fibrotic change without superimposed suspicious nodules or masses. Other than mild and largely basilar atelectasis, no acute pulmonary abnormality. Mild bronchial wall thickening and basilar bronchiectasis with mild centrilobular emphysemaMEDIASTINUM AND HILA: No lymphadenopathy. The reference high right paratracheal lymph node (image 15 series 3) remained 8 mm. A subcarinal lymph node all appear borderline in size and unchanged.Moderate to severe coronary calcifications. The cardiac and pericardium are otherwise within limits. Small hiatal herniaCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No gross upper abdominal abnormality next limited evaluation, however there is a somewhat cystic structure adjacent to the left renal hilum partially visualized on the last image of the scan and similar to a scan in 2011 | No evidence of metastatic disease. |
Generate impression based on findings. | History of follicular NHL. Status post 4 cycles of chemotherapy. There has been a significant decrease in size of all index nodes measured within the soft tissues of the neck when compared to measurements on the prior exam. There is residual adenopathy demonstrated which is most prominent in the left jugular chain. Measurements are as follows:Submental nodal cluster: 5 mm, 7 mm, 5 mm, 5 mm (previously 13 mm, 10 mm, 10 mm, 8 mm - se 4 im 56-59)Right level III nodal cluster: Three discrete nodes measuring 6 mm each (previously a conglomerate mass measuring 27 x 39 mm - image 68) Left level IIb nodal cluster: Discrete nodes measuring up to 11 x 21 mm (previously a conglomerate measuring 31 x 42 mm - image 44)Left level III node: 15 x 25 mm (previously 30 x 37 mm - image 54)Left node of Rouviere: 7 x 4 mm (previously 13 x 16 mm - image 36) The oral cavity, nasopharynx, oropharynx, hypopharynx and larynx demonstrate a normal appearance. There are no mucosal lesions demonstrated to the level of the clavicles. Orbits and paranasal air sinuses are unremarkable. There are degenerative changes demonstrated at the right facets from C2-C4. Otherwise bones are unremarkable. There are no aggressive appearing bone lesions demonstrated. There are small periapical lucencies associated with the right second maxillary incisor and right first mandibular incisor which could represent small periapical abscesses.There are significant emphysematous changes of the lung apices. These would be better delineated on designated CT of the chest. | 1.Significant interval regression of lymphadenopathy at each previously described level. Residual lymphadenopathy largely isolated to the left jugular chain.2.Lucencies associated with dental apices most like representing sequela of dental disease.3.Emphysematous changes at the lung apices.4.Degenerative changes of the cervical spine as described. |
Generate impression based on findings. | Sarcoidosis and lung cancer, please compare CHEST:LUNGS AND PLEURA: Postsurgical changes including right middle and lower lung resections and a persistent right paramediastinal consolidation, mediastinal shift and volume loss. No definite associated effusion and the previously described reticular opacities and traction bronchiectasis remain compatible with prior radiation therapy. Mild pleural thickening however is noted.The patchy and moderately nodular lung opacities scattered throughout the left lung, predominately the upper lobe in a peri-bronchovascular distribution appears grossly unchanged other continued improvement of the referenced left upper lobe nodular opacity. This is lesion again appears mildly improved, currently measuring 1.0 x 1.0 cm when measured in a similar fashion (image 38 series 4) from a prior measurement of 1.7 x 1.3 cm.MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy is unchanged. The reference right paratracheal lymph node remains 1.2 cm (image 35 series 3). The reference AP window lymph node remains 1.2 cm (image 37 series 3).The cardiac and pericardium are within limitsCHEST WALL: Right supraclavicular lymphadenopathy again observed and grossly unchangedABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered small hypodensities again suggest benign hepatic cysts. Gallbladder unremarkableSPLEEN: Remains mildly enlarged with a scattered heterogeneity of uncertain significance. No discrete focal lesionsADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Injection granuloma and fat stranding in the anterior soft tissues unchanged. Scattered degenerative changes with mild wedged form is at T10 and T11, unchanged.OTHER: No significant abnormality noted. | 1. Essentially stable appearing pulmonary appearance with numerous scattered innumerable pulmonary nodules again most consistent with sarcoidosis. The single larger reference left upper lobe lesion however appears mildly improved, yet this possibly and partially may be due to differences in patient positioning 2. Postoperative and post therapy changes |
Generate impression based on findings. | Male 68 years old Reason: Water density nodule in the prevascular space most compatible with a thymic cyst. History: none. Quit cigs 2007 LUNGS AND PLEURA: Interval decrease in previously described scattered foci of nodular plaque-like pleural thickening.Interval resolution of the small right pleural effusion.Minimal bibasilar dependent atelectasis.MEDIASTINUM AND HILA: Well-circumscribed water density nodule in the prevascular space now measures 28 x 25 mm (image 1.7, series 3), previously measuring 28 x 24 mm. Given the interval stability this likely represents a thymic cyst.Stable nonspecific mildly enlarged subcarinal lymph nodes and no evidence of hilar lymphadenopathy.Borderline cardiomegaly and ectatic aorta.Minimal calcifications of the coronary arteries.CHEST WALL: Mild gynecomastia.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Diverticulosis without evidence of diverticulitis. | 1. Unchanged water density nodule in the prevascular space likely representing a thymic cyst.2. Interval resolution of the small right pleural effusion and pleural plaques.. |
Generate impression based on findings. | Reason: peritoneal mesothelioma s/p surgery in the past. please evaluate for residual disease and compare with previous scans History: peritoneal mesotheliomas CHEST:LUNGS AND PLEURA: Pulmonary micronodules. No suspicious pulmonary nodules or masses. No pleural nodularity or effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal. No pericardial effusion. Coronary artery calcifications.CHEST WALL: Spiculated left breast nodule is incompletely characterized by CT.ABDOMEN:LIVER, BILIARY TRACT: Fatty infiltration of the liver. Enhancing segment VI lesion, which on prior MRI demonstrates imaging characteristics of FNH. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Simple appearing right renal cyst.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdominal aorta. No enlarged abdominal or retroperitoneal lymph nodes.BOWEL, MESENTERY: Postsurgical changes in the right lower quadrant. No evidence of bowel obstruction, ascites, or peritoneal nodularity.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right iliac sclerotic lesion, stable and likely benignOTHER: No significant abnormality noted. | 1.No evidence of recurrent or metastatic disease.2.Spiculated left breast mass. Recommend mammographic correlation.3.Findings text paged to Dr. Jennifer Hull at time of dictation. |
Generate impression based on findings. | Laryngeal cancer, follow-up CHEST:LUNGS AND PLEURA: Mildly shifting and largely improving multiple patchy mixed areas of partial consolidation most improved in the right upper lobe and right lung base. Stable scattered solid micronodules are less unchanged with basilar scarring and atelectasis. Central lobular emphysema unchanged. No new suspicious nodules or masses. No effusions.MEDIASTINUM AND HILA: Tracheostomy tube unchanged. Prominent central pulmonary vessels including a pulmonary artery similar to the descending aorta but measuring 3.8 cm (image 49 series 3). Concern for pulmonary arterial hypertension remains. Cardiac and pericardium are otherwise unchanged with marked coronary calcifications and a small pericardial effusion or thickening.Mild and unchanged lymphadenopathy, the reference subcarinal lymph node remains at 1.3 cm (image 45 series 3).Moderate hiatal herniaCHEST WALL: Skin thickening and subcutaneous stranding consistent with patient's anasarca. Right chest portABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered calcified granulomas and unchanged appearance overall.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Suspected renal cysts unchangedPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.G-tube with a J-tube extension and an expanded retention device. Evaluation is otherwise limited due to extensive artifact anomaly involving the left hemi-abdomen secondary to previously described metallic artifact and possible innumerable BBs.BONES, SOFT TISSUES: Degenerative changes more pronounced abnormalities observed and lower lumber spine, partially visualized.OTHER: No significant abnormality noted. | Interval near complete resolution of the intrapulmonary opacities representing interval treatment of the suspected opportunistic infection. The remaining underlying pulmonary appearance is baseline with atelectasis. Reference measurements are provided. |
Generate impression based on findings. | Reason: pt with lung ca s/p resection in 2011 History: now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Postsurgical changes reflecting right upper lobe segmentectomy. There is a focal consolidation within nodular component that is stable in size 11 mm (series 4 image 25), adjacent to surgical staples. Postsurgical changes in the right hilar location unchanged.Scattered micronodules, some of which are calcified, unchanged. Stable apical predominant centrilobular emphysema. No interval suspicious pulmonary nodule or pleural effusion.MEDIASTINUM AND HILA: Heterogeneous nodular goiter unchanged.Cardiomegaly with left sided chamber enlargement is stable. Benign calcification of the capillary and again noted. No interval pericardial effusion. Moderate native coronary artery and aortic valvular calcification.No interval mediastinal or hilar lymphadenopathy. Several calcified mediastinal lymph nodes indicative of prior granulomatous disease.Small hiatal hernia stable.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable mild to moderate intrahepatic biliary ductal the location with evidence of prior cholecystectomy. The central common duct is mildly dilated, stable. Several hypodensities unchanged.SPLEEN: Ill-defined low density in the posterior spleen is unchanged over several exams.ADRENAL GLANDS: Left adrenal nodule is stable. Minimal thickening of the right adrenal gland unchanged.KIDNEYS, URETERS: Bilateral renal hypodensities are too small to characterize.PANCREAS: Prominence of the central pancreatic duct is stable. RETROPERITONEUM, LYMPH NODES: Small porta hepatis lymph nodes are unchanged in size (series 3 image 93).BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 47-year-old male with history of Hodgkin's disease and stem cell transplant CHEST:LUNGS AND PLEURA: Previously described cavitary lesion in the right upper lobe is much smaller and measures 2.8 x 1.1 cm image number 17, series number 6. Surrounding consolidation around this lesion has also significantly resolved.Slight interval increase in bilateral pleural effusions. Previous described multiple patchy consolidations have decreased in size and number.MEDIASTINUM AND HILA: Multiple calcified mediastinal lymph nodes are unchanged.CHEST WALL: Index right axillary lymph node measures 2.2 x 1.8 cm image number 32, series number 401, not significantly changed from previous study.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Index. left external iliac node measures 5 mm on image number 175, series number 401.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic bone lesion involving the L3 vertebral body and associated compression fracture with other sclerotic lesions L2 and L4 vertebral bodies are unchanged.OTHER: No significant abnormality noted | Significant interval improvement of the lung lesions. Stable abdominal and pelvic lesions. |
Generate impression based on findings. | Reason: Pulm nodule History: Abnormal CT LUNGS AND PLEURA: Right middle nodules unchanged with reference nodule (image 59 series 4) measuring 8 mm previously measuring 9 mm.Stable basilar predominant minimal fibrosis in the UIP pattern.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Mild cardiac enlargement without evidence of pericardial effusion.Moderate coronary artery calcifications .CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Right middle lobe nodules and mild basilar fibrosis unchanged. |
Generate impression based on findings. | Reason: Check for ARDS History: Check for ARDS LUNGS AND PLEURA: Interval appearance of near complete lower lobe consolidation with atelectasis. Coarse groundglass within the right lower lobe and a component affecting in the lateral segment of the right middle lobe suspicious for edema. Bilateral pleural effusions, moderate on the right and small left.Apical predominant centrilobular emphysema is again noted, although obscured by respiratory motion. No interval pneumothorax.MEDIASTINUM AND HILA: A large, predominantly right-sided goiter which is stable compared to recent cervical spine CT. This causes mild leftward tracheal deviation. Heart size upper limits of normal with low-density blood pool indicative of anemia. No pericardial effusion is present.CHEST WALL: Diffuse osseous abnormalities and right superior posterior expansile rib deformity and stable, associated posterior chest wall soft tissue mass reflecting known multiple myeloma. Multiple stable vertebral lesions are present with complete collapse of about T8, and height loss at other levels.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Interval appearance of ascites in the visualized upper abdomen. | Interval appearance of near complete lower lobe consolidation with atelectasis. This may represent aspiration pneumonia. Coarse groundglass within the right lower lobe and a component affecting in the lateral segment of the right middle lobe suspicious for edema. Bilateral pleural effusions, moderate on the right and small left. |
Generate impression based on findings. | Reason: history of lung cancer, new right lung nodule History: None CHEST:LUNGS AND PLEURA: Interval improvement in the right apical pneumothorax, postoperative right upper lobe atelectasis/consolidation, and edema.Right pleural effusion almost completely resolved.Right pleural nodular density (image 59 series 3) smaller than on the prior exam compatible with loculated pleural fluid or hematoma.Moderate upper lobe predominant centrilobular emphysema.MEDIASTINUM AND HILA: Significant interval improvement in the pericardial effusion.Cardiac size is normal.No hilar or mediastinal lymphadenopathy.CHEST WALL: Healing right rib fractures.Diffuse trabecular thickening and increased density throughout the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable renal cysts and nonobstructing right renal calculi.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Diffuse trabecular thickening and sclerosis within the axial skeleton unchanged.OTHER: No significant abnormality noted. | 1.Almost complete interval resolution of the right pneumothorax.2.Interval improvement in right paramediastinal atelectasis/consolidation and interstitial edema in the right upper lobe.3.Interval resolution of right pleural effusion . |
Generate impression based on findings. | Clinical question: Assess degree of tracheal narrowing. Signs and symptoms: History of metastatic thyroid cancer or origin mass. The likely received RAI, but not to assess degree of tracheal narrowing first. Nonenhanced neck CT:Partially visualized intracranial content partially demonstrates few of patient's known intracranial metastatic lesions. Please referred to the report of dedicated CT of the head and brain MRI for more detailed information.Unremarkable images through the skull base.Limited exam due to lack of intravenous contrast for more precise assessment of soft tissues of neck. This examination however is performed as requested without intravenous contrast and primarily for assessment of tracheal compromise.Examination demonstrates a large mixed density mass in the left thyroid bed and extending across the isthmus of the thyroid into a smaller right thyroid lobe. Compared to prior exam there is slight interval decreased size of tumor. There is subtle mass effect on the trachea with a slight deviation/tilting toward the right. The narrowest portion of tracheal measures 14.4-mm in transverse axis and 20-mm in AP. The trachea immediately superior to this level without associated mass effect measures approximately 19.3 in transverse and 22.7mm in AP axis. There is slight interval improvement of mass effect on the trachea since prior exam due to decreased tumor size. The largest transaxial dimension of thyroid mass measures at 82 x 67-mm compared to prior measurements of 87 x 70 millimeter. Also previously noted cluster of necrotic rim enhancing nodes in the left supraclavicular region demonstrate interval decreased size to 22 x 25-mm on coronal reformatted images compared to prior study measurement of 36 x 40-mm also measured on coronal reformatted images. | 1.There is mild decreased tracheal caliber at the level of thyroid mass which measures at 14.4 in transverse and 20-mm in AP axis. Normal appearing trachea immediately superior to the mass measures at 19.3 in transverse and 22.7 mm in AP axis.2.Interval decreased size of thyroid mass and its left supraclavicular cluster of lymph nodes as detailed/measured above. Nonenhanced study however significantly reduces the sensitivity of the exam for more precise assessment. |
Generate impression based on findings. | 62 year-old female with flank trauma This study is limited due to left of IV contrastABDOMEN:LUNG BASES: Small right-sided pleural effusion and dependent atelectasisLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephrolithiasis without evidence of hydronephrosisRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Limited study due to lack of IV contrast. No evidence of post traumatic changes. Right nephrolithiasis. Small right pleural effusion with linear atelectasis. |
Generate impression based on findings. | History of esophageal cancer CHEST:LUNGS AND PLEURA: Right upper lobe index nodule measures 1.4 x 0.7 cm in image number 27, series number 5, not significantly changed. Left upper lobe nodule measures 7 by 5-mm image number 59, series number 5, not significantly changed from previous study.Interval increased in the size of the bilateral pleural effusions. Dependent atelectasis, unchanged.MEDIASTINUM AND HILA: Postoperative changes consistent with esophagectomy and gastric pull-up, unchanged. Interval placement of Metallic stent in the esophagus. superior mediastinal node in the right thoracic inlet measures 1.7 x 1 cm image number 19, series number 3, no significant change.Cluster of right hilar nodes measures 1.6 x 2.5 cm on image number 44, series number 3, not significant change. Previously measured subcarinal node on the same image is not well seen on today's study.CHEST WALL: Sclerotic appearance of the humeral heads, unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal gland cannot the well seen separate from the left retroperitoneal adenopathy.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index left retroperitoneal adenopathy now measures 3 x 2 cm on image number 107, series number 3, increased in size compared to previous study.BOWEL, MESENTERY: Left lower quadrant J-tube unchanged.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: New expansile lytic lesion involving the right iliac bone and multiple sclerotic lesions in the pelvic bones, suspicious for metastatic disease. New sclerotic lesion involving the L3 vertebral body.OTHER: Generalized anasarca. | New bone metastases involving the pelvic bones and L3 vertebral body. Bone scan may be helpful for further evaluation of the bone metastases.Interval increase in the amount of pleural effusion and left retroperitoneal adenopathy. |
Generate impression based on findings. | Mantle cell lymphoma with auto SCT 2005 and recent relapse on maintenance Rituxan. There has been continued interval increase in size of a cluster of enlarged lymph nodes in the left subclavicular region, with the largest measuring approximately 20 x 23 mm, previously 19 x 17 mm. Otherwise, no new pathological lymph node is identified. The thyroid gland and major salivary glands are unchanged. There is high-grade stenosis of the proximal left internal carotid artery associated with mixed attenuation atherosclerotic plaque. There are mild atherosclerotic calcifications at the right carotid bifurcation. The paranasal sinuses and mastoid air cells are clear. There is unchanged multilevel degenerative cervical spondylosis with associated heterogenous appearance of the bone marrow. The imaged intracranial structures are orbits are grossly unremarkable. The imaged portions of the lungs are unchanged. Refer to the separate chest CT report for additional details. | 1. Continued interval increase in size of a cluster of enlarged lymph nodes in the left subclavicular region, with the largest measuring approximately 20 x 23 mm, previously 19 x 17 mm. 2. Severe stenosis of the proximal left internal carotid artery. |
Generate impression based on findings. | Reason: Lung cancer in f/u - please compare to previous. Thanks. History: Lung ca CHEST:LUNGS AND PLEURA: Post surgical changes and volume loss in the right lung with evidence of a previous right upper lobectomy.Stable scattered nonspecific micronodules.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Metallic foreign bodies within the pulmonary vasculature unchanged from the prior exam.CHEST WALL: Median sternotomy intact.Multiple healing rib fractures unchanged.Metallic wire fragments within the left supraclavicular vasculature.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts unchanged.PANCREAS: Atrophy with pancreatic head hypodensities and calcification unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of the aorta and its branches. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post right upper lobectomy. No evidence of recurrence or metastatic disease. Embolized wire fragments unchanged. |
Generate impression based on findings. | Reason: H/o mediastinal fibrosis, PleurX catheter, recurrent effusions, clogged catheter, SOB History: As above LUNGS AND PLEURA: Interval increased size of a left pleural effusion that is now large with associated, near complete atelectasis of the left lower lobe. Aeration is isolated to the superior segment. The left upper lobe is clear.A Pleurex catheter remains in place on the right. There is interval decreased loculated posterior pleural fluid collection. The additional loculated fluid collections along the right lateral pleural surface and extending into the major fissure are relatively stable.There is persistent ground glass, patchy consolidation and associated bronchial wall thickening involving the right upper lobe. Previously noted peripheral micronodule in the right upper lobe is unchanged.Dilated intercostal veins are noted at the right apex.MEDIASTINUM AND HILA: Massive soft tissue density with associated calcification extending from the left paratracheal space, extending to the prevascular and aortopulmonary locations. Anterior mediastinal thickening representing known fibrosis. Soft tissue density with associated dense calcifications encases the aortic arch and pulmonary arteries. The overall heart size remains normal. Soft tissue density in the subcarinal location with lymphadenopathy unchanged. Extensive coronary artery calcification. Large hiatal hernia unchanged. CHEST WALL: Persistent bilateral axillary lymphadenopathy. Anasarca with skin thickening.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Splenic granulomatas. Low-density posterior mid pole left kidney incompletely visualized and characterized. | 1. A Pleurex catheter remains in place on the right. There is interval decreased loculated posterior pleural fluid collection. The additional loculated fluid collections along the right lateral pleural surface and extending into the major fissure are relatively stable.2. Interval increased size of a left pleural effusion that is now large with associated, near complete atelectasis of the left lower lobe. Aeration is isolated to the superior segment.3. There is persistent ground glass, patchy consolidation and associated bronchial wall thickening involving the right upper lobe. |
Generate impression based on findings. | 52-year-old female with history of mesothelioma ABDOMEN:LUNG BASES: Chest CT will be dictated separately.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Portacaval lymph node is unchanged measuring 2.2 by 1.1-cm image number 53.BOWEL, MESENTERY: Interval increase in the amount of ascites. Nodularity of the peritoneum, again noted.BONES, SOFT TISSUES: Soft tissue tumor in the left abdominal wall measures 4.3 by 2.5-cm image number 64, unchanged.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Interval increase in the amount of ascites. Previously measured peritoneal deposit is increased in size and now measures 4.5 x 4.1 cm image number 115. Other pelvic deposits also increased in size within the interval.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval increase in the size of the ascites and peritoneal nodularity most prominently in the pelvis. |
Generate impression based on findings. | Reason: pt with mesothelioma s/p 4cycles of chemo History: doing well now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Postsurgical changes related to a previous right pleurectomy, decortication, and diaphragmatic patch.Resolution of small right apical pneumothorax. Decreasing right pleural effusion.No new suspicious pulmonary or pleural masses.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Aberrant right subclavian artery.CHEST WALL: Status post right thoracotomy with healing and fractures.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Postsurgical changes related to a previous right pleurectomy, decortication, and diaphragmatic patch. 2.No evidence of recurrent or residual disease.3.Resolution of right apical pneumothorax with interval decrease in right pleural effusion |
Generate impression based on findings. | Reason: Pt with HNC need baseline scans prior to starting CRT. please re-eval and compare to prior scans History: as above CHEST:LUNGS AND PLEURA: Subsegmental atelectasis involves the lingula and medial basal segment right lower lobe.There are scattered pulmonary micronodules which are nonspecific. The largest nodule is pleural-based, at the level of the right middle lobe (series 5 image 63 and measures 4 mm. Given the difference in slice thickness (current exam is 3 mm, as compared to 5 mm on outside exam), this pleural-based nodule stable.No pleural effusion.MEDIASTINUM AND HILA: There is mucus within the central trachea.Heart size is normal. Incidental lipomatous hypertrophy of the interatrial septum. No pericardial effusion. Anterior to the pericardium, medially superior to the right atrial appendage, there is a soft tissue nodule that measures 2.2 x 0.7 centimeters (series 3 image 46). This is unchanged.No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Low-density lesion suggestive of a cyst is stable.ADRENAL GLANDS: There is a left adrenal mass composed of hypervascular soft tissue component and fat density raising a question of myelolipoma measuring 2.6 x 3.5 cm (series 3 image 91).KIDNEYS, URETERS: Asymmetric right-sided cortical atrophy.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Scattered pulmonary micronodules which are nonspecific. The largest nodule is pleural-based, measuring 4 mm. Given the difference in slice thickness, this pleural-based nodule is stable. 2. No mediastinal or hilar lymphadenopathy. |
Generate impression based on findings. | Follicular NHL status post 4 cycles of chemotherapy. There has been overall interval increase in size of the majority of the diffuse parotid and cervical lymphadenopathy. For example, a level IA lymph node now measures 16 x 20 mm, previously 15 x 17 mm. A right superficial parotid lymph node now measures, 10 x 11 mm, previously 8 x 9 mm. A left level 5 lymph node now measures 13 x 18 mm, previously 8 x 13 mm. The upper aerodigestive track is patent. The thyroid gland is unremarkable. The major cervical vessels are patent. There are no lytic or blastic lesions. The paranasal sinuses and mastoid air cells are clear. The imaged intracranial structures are orbits are unremarkable. The imaged portions of the lungs are clear. Refer to the separate chest CT for additional details. | Overall interval increase in size of the majority of the diffuse parotid and cervical lymphadenopathy. |
Generate impression based on findings. | 33 year old man with a variation of Shone's complex (double orifice mitral valve, abnormal aortic valve, aortic coarctation). He is referred to evaluate cardiac anatomy.CPT Code: 75574 Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There are no significant stenoses present in the left main.LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There are no significant stenoses in the LAD. The mid LAD forms a myocardial bridge.LCx: The left circumflex coronary artery is non-dominant. It courses normally in the left AV groove. It gives rise to the obtuse marginal branches. There are no significant stenoses in the LCx.RCA: The right coronary artery is small and non-dominant. It origination is above the sinotubular junction and is anteriorly rotated. There are no significant stenoses in the right coronary artery.Left Ventricle: The left ventricular late diastolic volume is severely (LV volume 377ml). There is a large apical muscular VSD. The right ventricular apex is functioning as part of the left ventricle is separated from the remainder of the right ventricle by a hypertrophied moderator band. A very small left to right shunt is noted through the moderator band in between the true apex of the right ventricle and the true body of the right ventricle.Right Ventricle: The right ventricular late diastolic volume is moderately dilated (RV volume 245ml).Left Atrium: The left atrial volume during ventricular diastole is severely increased (LAV 177ml). There are five distinct pulmonary veins which drain normally into the left atrium (3 right-sided and two-left sided). There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrial volume appears to be moderately dilated. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Aortic Valve. The aortic valve morphology is complex. One of the leaflets appears to prolapse into the LVOT. Additionally, there is a supravalvular membrane which tethers the aortic valve leaflets to the wall of the aorta just distal to the left main coronary origin.Mitral Valve. There is a double orifice mitral valve present. The leaflets are not attached to a papillary muscle. Rather there is a large muscular band connected both leaflet tips to the basal inferolateral wall. There are several small chordae originating from the ventricular base that are attached to the mitral valve leaflets. There is one major papillary muscle which abarently bridges the mid-lateral wall to the basal anteroseptum.Great vessels: The ascending aorta is mildly dilated with a maximum diameter of 40x40mm 5cm from the aortic valve plane. The descending aorta has a preductal fold resulting in a mild coarctation (the minimum diameter is 21x21mm). Distal to the coarctation, the descending aorta is 27x27mm in size. There is no evidence of dissection. The main pulmonary artery is moderately dilated (38x38mm). The RPA is 26x27mm and the LPA is 26x24mm. There is a patent ductus arteriosus which originates distal to the above described aortic fold and ends in the left pulmonary artery. The diameter is 7x5mm and the length is 7mm.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion. | 1. There are no significant coronary artery stenoses present. 2. The RCA origination is above the sinotubular junction and is anteriorly rotated. 3. The mid LAD forms a myocardial bridge. 4. The aortic valve morphology is complex. One of the leaflets appears to prolapse into the LVOT. Additionally, there is a supravalvular membrane which tethers the aortic valve leaflets to the wall of the aorta just distal to the left main coronary origin. 5. There is a double orifice mitral valve present. See detailed anatomy above. 6. Ascending aorta is mildly dilated. 7. The descending aorta has a preductal fold resulting in a mild coarctation 8. There is a patent ductus arteriosus 9. Severe LV and LA dilation.10.Moderate RV and RA dilation.11.Moderate dilation of the main pulmonary artery.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. |
Generate impression based on findings. | Concern for metastatic disease. There is no evidence of intracranial hemorrhage, mass, or abnormal enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are postoperative findings related to endoscopic sinus surgery and scattered paranasal sinus opacification, including the right sphenoid sinus. The mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial metastases. |
Generate impression based on findings. | Mesothelioma, please follow-up LUNGS AND PLEURA: Grossly stable appearance of the right hemithorax including postsurgical changes with associated volume loss and diffuse nodular pleural thickening and loculated effusions. Reference measurements are as follows:1. At the level of the innominate vein (image 25 series 80277), the 3 and 9 o'clock measurements are 5 and 14 mm when previously 6 and 15 mm, respectively.2. At the level of the aortic arch (image 30 series 80277), the 3 and 9 o'clock measurements remain 11 and 10 mm, unchanged.3. At the level of the main pulmonary artery (image 40 series 8 there are 277), the two and 9 o'clock measurements are 7 and 10 mm, previously 8 and 14 mm.Persistent yet partially resolving ground glass opacities remain most pronounced in the right upper lobe along the fissures. The multiple loculated fluid collections more pronounced the right lung base are otherwise unchangedMEDIASTINUM AND HILA: Mildly improving mediastinal lymphadenopathy, currently the reference precarinal lymph node (image 34 series 80277) is decreased in size, currently measuring 10 mm from a prior measurement of 12 mm. No additional new lymphadenopathy.The cardiac and pericardium are within limits. Please note however that the pleural disease is adjacent to and indistinguishable from the right pericardium and spinal anatomy.CHEST WALL: Stable soft tissue mass involving the lower right chest wall extending into the inframammary crease (see image 70 series 80277). In addition the right posterior chest wall mass adjacent to the eighth rib is also unchanged, reference measurement remains 14 mm (image 69 series 80277). The reference right paraspinal soft tissue mass (image 68 series 80277) is also unchanged again measuring 11 x 8 mm.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Essentially stable to mildly improved disease throughout the right hemithorax. Reference measurements provided2. Mild improvement of the nonspecific but possible drug reaction bleeding two an intrapulmonary ground glass abnormality. |
Generate impression based on findings. | Nasal congestion. There is minimal mucosal thickening within the bilateral maxillary and ethmoid sinuses. The frontal and sphenoid sinuses are clear. The nasal cavity is clear and there is minimal nasal septal deviation. The ethmoid roofs are nearly symmetric and intact. The lamina papyracea are also intact. The optic canals and carotid grooves are covered by bone. There is an ossiculum terminale and hyperostosis between the anterior arch of C1 and the basiocciput. The intracranial structures are grossly unremarkable. There are bilateral lens implants. There are multiple periapical lucencies, most of which are associated with treated dentition. | Minimal scattered paranasal sinus mucosal thickening and minimal nasal septal deviation. |
Generate impression based on findings. | 69 year-old female with angiosarcoma and pericardial peritoneal carcinomatosis CHEST:LUNGS AND PLEURA: 7 mm right upper lobe nodule unchanged on image number 50 postures number 5. Other scattered micronodules are also unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Focal asymmetry in the left breast is unchanged.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensity in the liver is unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Soft tissue mass in the transverse mesocolon is increased in size and now measures 8.9 x 6 cm on image number 117, series number 3.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Pelvic soft tissue density is unchanged. | Interval increase in the size of the transverse mesocolon mass on the right side of the abdomen. |
Generate impression based on findings. | Reason: 61 y/o with left palate adenoid cystic cancer. Compare to last CT \T\ measure 1) LUL nodule, 2) right lobe liver lesion \T\ 3) left parotid tissue nodule History: post 2 cycles of therapy CHEST:LUNGS AND PLEURA: Multiple bilateral metastases, unchanged from previous.Left upper lobe reference nodule (series 4 image 113) 12 x 14 mm, not significantlychanged.MEDIASTINUM AND HILA: Stable, mildly enlarged right hilar lymph node. Thymic tissue may represent thymic hyperplasia, without nodule. No mediastinal lymphadenopathy.The heart size is normal. No pericardial effusion.CHEST WALL: The base of the neck is included in the field of view, partially demonstrating an enlarged left parotid gland. This is better characterized on the CT neck performed on the same day.Mildly enlarged left axillary lymph node, unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple large hepatic metastases are present.Reference lesion in the right lobe (series 4 image 124) measures 5.1 x 5.2 centimeters, as compared to 4 .4 x 4 .7 centimeters. Other hepatic lesions have very slightly increased in size with the greatest growth demonstrated by the lesion in the left hepatic lobe, now measuring 5.5 x 5.4 cm (series 4 image 115).Status post cholecystectomy with stable intrahepatic, extrahepatic biliary and central pancreatic ductal dilatation.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Low-density lesions in both kidneys, the majority have remained stable over several studies and likely represent cysts. The largest in the superior pole and is mildly heterogeneous, measuring 2.2 x 2.8 cm. When compared to the initial CT chest from 3/2/13, this lesion has increased in size, 1.4 x 2.1 cm at that time. Slowly growing metastasis to the superior left pole is a consideration.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple mildly enlarged retroperitoneal lymph nodes are stable.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Stable pulmonary metastases.2. Progressive increased size of hepatic metastases.3. Low-density lesions in both kidneys, the majority have remained stable over several studies and likely represent cysts. The largest in the superior pole and is mildly heterogeneous, measuring 2.2 x 2.8 cm. When compared to the initial CT chest from 3/2/13, this lesion has increased in size (1.4 x 2.1 cm at that time). Slowly growing metastasis to the superior left pole is a consideration. |
Generate impression based on findings. | Reason: gi bleed recent History: blood in stool ABDOMEN:LUNG BASES: Mild bilateral lung base atelectasis. Coarse calcifications of the lung pleura bilaterally. Atherosclerotic calcifications of the coronary arteries.LIVER, BILIARY TRACT: Hypodense lesion in the right lobe of the liver, segment 8, measuring 0.9 x 1.2 cm. Another small subcentimeter, hypodense lesion in the right lobe of liver, segment 5. Hypodense lesion adjacent to the IVC measuring 1.3 x 1.4 cm. no intrahepatic or extra hepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: Punctate calcification at the tail of the pancreas. No pancreatic duct dilatation.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small renal cyst in the left kidney.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications of the aorta, iliac arteries and internal iliac arteries.BOWEL, MESENTERY: There is evidence of bowel resections with primary anastomosis compatible with Bilroth II anastomosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Punctate calcifications in the prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Bilateral surgical clips in the inguinal areas.OTHER: No significant abnormality noted | 1.Normal CT enterography.2.Bilateral pleural calcifications. |
Generate impression based on findings. | 17 year-old male. History of empyema, ARDS. Evaluate for changes of empyema. LUNGS AND PLEURA: Decreased sized of previously seen loculated right pleural collection, which now contains multiple pockets of air. In the right lower lung zone, there is a 5.7 x 6.5 cm air-fluid collection (series 3, image 43). This collection is surrounded entirely by atelectatic lung with the exception of its posterior margin, where there are finger-like extensions towards the pleural space. It is unclear if this collection is within the major fissure or is intraparenchymal. Trace left pleural effusion and mild left basilar subsegmental atelectasis. MEDIASTINUM AND HILA: Mediastinal lymphadenopathy, including enlarged subcarinal and paratracheal nodes. Right upper extremity PICC tip terminates in the SVC. Normal cardiothymic silhouette. CHEST WALL: No significant abnormality notedUPPER ABDOMEN: Partially visualized right upper pole cyst. | 1. Decreased size of right empyema.2. Large air-fluid collection in the right lower lung zone. It is unclear if this collection is within the major fissure or intraparenchymal. Recommend prone chest radiograph to determine if this collection communicates with the pleural space. |
Generate impression based on findings. | 56 yo with HCV cirhrosis please eval for HCC ABDOMEN:LUNG BASES: Basilar scarring/atelectasis. Hiatal hernia.LIVER, BILIARY TRACT: Cirrhotic morphology of the liver. No arterially enhancing lesions. The portal vein is patent. No ascites. Punctate gallstones.SPLEEN: Hypoattenuating lesion in spleen measures 16 mm in craniocaudal dimension and demonstrates lobulated margins, likely a hemangioma.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Indeterminate left upper pole hypodense lesion is unchanged and likely benign.RETROPERITONEUM, LYMPH NODES: Mildly prominent retroperitoneal lymph nodes, nonspecific in the setting of chronic liver disease.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Sigmoid diverticulosis without diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No CT evidence of HCC. |
Generate impression based on findings. | Male; 38 years old. Reason: mesothelioma, s/p 6 doses of immunotherapy. please evaluate for disease and compare with previous scans using the same reference lesions. LUNGS AND PLEURA: Right pleurectomy with an associated diaphragmatic mash and loculated fluid occupying the hemithorax. Nodular pleural thickening is again observed with the following measurements.1. At the level of the aortic arch (image 35 series 5) the 7 o'clock lesion remains 12 mm2. At the level of main pulmonary artery (image 41 series 5), 3 and 9 o'clock position remains 3 at 11 mm respectively3. At the level of the left atrial appendage (image 47 series 5), the 3 o'clock measurement remains 5 mm unchanged.The reference left lower lobe small subcentimeter nodule remains similar, currently measuring 8 mm from a prior measurement of 9 mm (image 73 series 7). The slight difference is likely due to differences in breathing. No additional new nodules or masses yet stable mild pleural subcentimeter subpleural lesions. Mildly enlarging and yet small left pleural effusion. MEDIASTINUM AND HILA: Nonspecific mildly enlarged right paratracheal solitary lymph node (image 25 series 5) currently measuring 14 mm in short axis from a prior measurement of 9 mm. The remainder of the mediastinal and pericardial scattered lymph nodes are unchanged. Specifically the mass in the pericardial fat, AP window and pericardium were all isolated and stable.The cardiac and paracardial appearance is otherwise unchangedCHEST WALL: A non-index right intramammary node (image 27 series 5) remains unchanged. Tumor involving the deep gutter on the right also unchanged (image 90 series 5).UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No appreciable change in the peritoneal tumor, partially visualized but please correlate with concomitant abdomen and pelvis CT pending. | Stable reference measurements with the one exception of a single solitary right paratracheal lymph node demonstrate mild enlargement. This may be partially artifact in differences in patient positioning and gantry angle. Please see reference measurements providedI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 39 years old Reason: s/p OHT with increasing dyspnea LUNGS AND PLEURA: Scattered pulmonary micronodules are unchanged and likely benign in etiology. Partially resolved right basilar atelectasis with scarring. Interval resolution of small pleural effusions.MEDIASTINUM AND HILA: Postsurgical changes consistent with heart transplant. Trace pericardial effusionNo evidence of mediastinal or hilar lymphadenopathy.CHEST WALL: Sternal fixation hardware without complication. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Diverticulosis without evidence of diverticulitis. | No specific etiology found to account for the patient's shortness of breath with continued improvement in right basilar atelectasis and effusion. |
Generate impression based on findings. | 79-year-old female with history of bladder cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis. Fatty infiltration of the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts. Some of the hypodense kidney lesions are too small to accurately characterize. Contrast in the collecting systems of the kidneys and in the pouch limits evaluation of the kidneys for stones.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ileostomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of recurrence or metastatic disease. |
Generate impression based on findings. | Evaluate for metastatic prostate cancer. History of rising PSA. ABDOMEN:LUNG BASES: Scarring at both lung bases as noted previously.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Multiple right adrenal nodules are unchanged.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Enlarged mesenteric lymph node measures 2.3 x 1.8 cm (image 90; series 4). This previously measured 2.2 x 1.1 cm (image 84; series 4; 8/28/2006 study).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: A few sclerotic areas in the vertebral column appear degenerative but should be correlated with bone scan.OTHER: Duplicated IVC.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Slight interval enlargement of lymph nodes in the pelvis. For reference purposes, a right internal obturator lymph node (image 128; series 4) measures 2.3 x 1.1 cm. It previously measured 1.8 x 0.8 cm (image 118; series 4; 8/20/2006 study).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Slight interval enlargement of abdominal and pelvic lymph nodes. A few sclerotic areas in the vertebral bodies should be correlated with bone scan. |
Generate impression based on findings. | Reason: please evaluate ground-glass opacity in left upper lung lobe History: pre-existing ground-glass opacity in left upper lung lobe LUNGS AND PLEURA: Previously noted groundglass nodule within the left upper lobe has slightly increased in size. It currently measures 17 x 20 mm (series 4 image 80) on the high resolution images. Using similar measurement technique on high-resolution images on the prior study, this measured 13 x 22 mm. This is suspicious for a slow-growing adenocarcinoma.Persistent bands of subsegmental atelectasis occupy the left lower lobe. Surgical staples at the right major fissure again noted. No new suspicious pulmonary nodule or pleural effusion. Several scattered micronodules, one of which is calcified, stable. No pleural effusion.MEDIASTINUM AND HILA: Nodularity of the thyroid gland is unchanged.Heart size is normal. No pericardial effusion. Mild aortic valvular and coronary artery calcification. No mediastinal lymphadenopathy.CHEST WALL: Postsurgical change posterior right eighth rib.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Stable nodule left adrenal gland. Low density subcapsular right hepatic lobe inferior field of view is stable, likely cyst. | Previously noted groundglass nodule within the left upper lobe has slightly increased in size. It currently measures 17 x 20 mm, previously 13 x 22 mm. This is suspicious for a slow-growing adenocarcinoma.No mediastinal lymphadenopathy. |
Generate impression based on findings. | Male; 73 years old. Reason: mesothelioma, please evaluate disease and compare with previous scans. CHEST:LUNGS AND PLEURA: Reference nodule abutting the ascending aorta is unchanged in size, measuring 2.1 x 1.1 cm (series 3, image 39). The reference nodule abutting the aortic arch is also unchanged, measuring 1.2 x 0.8 cm (series 3, image 27). Additional nodularity along the left lateral pleura is unchanged.Small bilateral pleural effusions, right greater than left, are decreased in size since the prior study. There are scattered, lower lobe predominant pulmonary nodules, which are more apparent at the bases due to decreased overlying pleural effusions, but not significantly changed. The right lower lobe reference nodule measures 0.6 cm and is unchanged (series 5, image 45). MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Reference left cardiophrenic lymph node measures 5 mm in short axis and is unchanged. CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Nodularity along the right hepatic lobe is slightly less prominent (series 3, image 102).SPLEEN: Surgically absent. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Severe bilateral renal scarring. Unchanged right renal cyst. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered small retroperitoneal lymph nodes are unchanged. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Postsurgical changes in the stomach and duodenum. Reference left paracolic gutter implant is no longer well visualized.BONES, SOFT TISSUES: Mild multilevel degenerative changes of the visualized spine. OTHER: No significant abnormality noted. | 1.Interval stability of pleural based lesions, pulmonary nodules, and lymphadenopathy with reference measurements given above.2.Interval decrease in size of pleural effusions. |
Generate impression based on findings. | Male 57 years old Reason: head and neck cancer, s/p chemo and RT, now with recurrence disease at left neck. Pls evaluate dz status, try to obtain recent CD for comparison. History: recurrence head and neck cancer CHEST:LUNGS AND PLEURA: Scattered non-specific pulmonary micronodules. Mild centrilobular emphysema greater in both apices.MEDIASTINUM AND HILA: There is focal non-circumferential thickening of the posterior lateral trachea likely representing mucus or debris; however, neoplasm cannot be excluded.No evidence of mediastinal or hilar lymphadenopathy. There is severe calcifications of the coronary arteries and mild calcifications of the thoracic aorta.CHEST WALL: Right chest wall Port-A-Cath with the tip in the distal SVC. No evidence of supraclavicular or axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is an approximately 1.5 cm heterogeneous hypodense lesion in the left lower pole the left kidney containing punctate calcifications which is incompletely characterized on this examination. Two other water density lesions are seen within the left kidney consistent with simple renal cysts. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No evidence retroperitoneal lymphadenopathy. There is moderate calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.There is no evidence of mesenteric lymphadenopathy or peritoneal carcinomatosis.BONES, SOFT TISSUES: No evidence of metastatic disease to the osseous structures of the chest and pelvis.OTHER: No significant abnormality noted. | 1. No definite evidence of metastatic disease.2. Focal thickening of the posterior lateral trachea likely representing mucous/debris, serial imaging recommended to confirm benign etiology.2. Heterogeneous renal lesion of uncertain significance, recommend dedicated renal imaging for further evaluation.3. Mild apical predominant emphysema. |
Generate impression based on findings. | Left parotid acinic cell carcinoma with high grade transformation status post radical parotidectomy and facial nerve reconstruction. There are postoperative findings related to left total parotidectomy with diffuse thickening of the subcutaneous tissues and muscles along the surgical incision plane. No definite discrete mass lesions are present in the surgical bed. There is ill-defined soft tissue within the left stylomastoid foramen adjacent to a surgical clip. There is no significant cervical lymphadenopathy. The remaining major salivary glands are unremarkable. The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The thyroid gland is also unremarkable. The major cervical vasculature is patent. There are no suspicious lytic or blastic lesions. The paranasal sinuses and mastoid air cells are clear. There is a thin hyperattenuating structure in the left inferior orbit adjacent to the inferior oblique muscle, which may be post-treatment in nature. The imaged intracranial structures are unremarkable. There is a 4 mm wide skin excrescence in the midline of the upper chest. | No definite residual tumor in the left parotidectomy bed and no evidence of significant cervical lymphadenopathy. Ill-defined soft tissue within the left stylomastoid foramen adjacent to a surgical clip likely represents post-operative scar tissue and less likely perineural tumor. A dedicated MRI with contrast may nevertheless be useful for further evaluation. |
Generate impression based on findings. | Mesothelioma, please follow up CHEST:LUNGS AND PLEURA: Stable right apical scarring and scattered subpleural nodules more pronounced the left lung base. The reference and largest nodule remains 8 mm (image 86 series 5). Mild basilar atelectasis and/or scarring. No superimposed focal air space opacity or pleural effusions. Persistent moderately elevated right hemidiaphragm with associated surgical meshMEDIASTINUM AND HILA: No lymphadenopathyThe cardiac and pericardium are within limitsCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Large gallstone, otherwise the liver is unremarkableSPLEEN: Scattered calcified granuloma.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable right renal cysts. Left kidney unremarkablePANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Mild scattered degenerative changes more pronounced within the lower levels and lumbar spineOTHER: No significant abnormality noted. | Stable postsurgical pleurectomy findings and no associated evidence of recurrent or metastatic disease |
Generate impression based on findings. | Reason: hx idiopathic recurrent pancreatitis, and a 9 cm fluid collection. Evaluate History: abdominal pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: The splenic vein is narrowed but patent.PANCREAS: Encapsulated fluid collection replacing the pancreatic body and tail measures 8.6 x 4.3 cm (series 10, image 49), previously 8.9 x 4.3 cm. The pancreatic head is unremarkable. No peripancreatic fluid or fat stranding. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Pancreatic pseudocyst replacing the body and tail, unchanged. |
Generate impression based on findings. | Reason: pt with h/o lung ca in 2006 s/o Left lung s/p chemoRt now with right lesions of lung History: needs baseline data prior to initiation of therapy Hilar mass anything else CHEST:LUNGS AND PLEURA: Irregular nodular opacity in the central right upper lobe, adjacent to the hilum at the origin of the anterior segmental bronchus (series 6 image 45) has not significantly changed in size. There is central necrosis demonstrated on the mediastinal windows. This currently measures 1.7 x 2.7 cm, as compared to 1.6 x 2.7 centimeters.Stable postsurgical findings reflecting left upper lobectomy. Dense scarring at the apex is unchanged.Severe central lobular and paraseptal emphysema. Diffuse bronchial wall thickening is again noted, consistent with bronchitis. No new suspicious pulmonary nodules. No new pleural effusion. MEDIASTINUM AND HILA: Hypodensities within the thyroid gland stable. Leftward postsurgical mediastinal shift. The heart size remains normal. No interval pericardial effusion. Mild calcification of the aortic valve and coronary arteries. No mediastinal lymphadenopathy.Extensive atherosclerotic disease with a centric low-density plaques in the transverse arch and descending thoracic aorta.CHEST WALL: Scoliosis with fixation hardware in the thoracic and lumbar spine. Persistent left chest wall deformity. A spinal catheter is visualized to the superior thoracic level. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple large hepatic hypodensities consist with cysts. Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cystic lesion is stable.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable irregular nodular opacity in the central right upper lobe adjacent to the hilum at the origin of the anterior segmental bronchus. There is associated central necrosis. This continues to measure 1.7 x 2.7 cm. Although stable, it remains suspicious for primary lung cancer or metastasis. |
Generate impression based on findings. | Reason: Malignant neoplasm of prostate, bladder cander- lesions on liver seen on OSH scan 6/13/13 11 mm right lobe of the liver - two other smaller lesions also seen History: as above- please evaluate liver for liver lesions- pt has bladder cancer and prostate cancer ABDOMEN:LUNG BASES: ICD leads. Small micronodules in the left lower lobe (series 4, image 13). Small micronodules adjacent to the fissure (series 4, image two). A nodule in the left inferior lobe adjacent to the pleura measures 0.9 x 0.6 cm. Mediastinal lymphadenopathy largest measuring 2.2 x 2.2 cm. There appears to be a exophytic lesion arising from the esophageal wall.LIVER, BILIARY TRACT: Multiple nonenhancing, hypodense lesions scattered throughout both lobes of the liver. The largest lesion in the right lobe measures 2.6 x 2.5 cm. The largest lesion in the left lobe measures 2.9 x 2.2 cm. No evidence of intrahepatic or extrahepatic ductal dilatation. Status post cholecystectomy.SPLEEN: Hypodense lesion in the spleen measuring 2.4 x 2.3 cm. Splenule located adjacent to the spleen.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Ectopic left kidney in the mid to lower left quadrant. Three left renal arteries are visualized. Duplication of the right renal artery. RETROPERITONEUM, LYMPH NODES: Scattered retroperitoneal lymphadenopathy. Atherosclerotic calcification of the aorta and bilateral iliac arteries.BOWEL, MESENTERY: No significant abnormality noted. BONES, SOFT TISSUES: Disk osteophyte complexes of the thoracic vertebra.OTHER: No significant abnormality noted | 1.Mediastinal lymphadenopathy with possible esophageal mass. Consider upper endoscopy.2.Multiple nonenhancing, hypodense hepatic lesions consistent with metastases. |
Generate impression based on findings. | Male; 72 years old. Reason: pt with mesothelioma and lymphoma off therapy x 6 months History: now needs disease evaluation, compare to previous scans and comment. CHEST:LUNGS AND PLEURA: Postsurgical changes compatible with left pleurectomy and diaphragmatic graft placement are unchanged. Irregular thickening of the peripheral pleura is again noted and unchanged. Reference measurements are as below:1. At the level of the aortic arch (series 7, image 28), the 7 o'clock measurement is unchanged at 9 mm.2. At the level of the pulmonary artery (series 7, image 44), the lesion abutting the descending aorta is unchanged at 5 mm.Diffuse ground glass left upper lobe may represent post inflammatory changes, similar to the prior study. The reference right upper lobe ground glass nodule is unchanged in size since 7/26/2013, measuring 9 mm (series 8, image 32). While it is also unchanged in size when compared to CT from 6/5/2013, the incomplete resolution is suggestive of indolent primary adenocarcinoma.Upper lobe predominant centrilobular emphysema and basilar scarring/atelectasis are unchanged. No focal airspace opacity or pleural effusion. MEDIASTINUM AND HILA: Multiple mild to moderately enlarged supraclavicular lymph nodes remain stable. Prevascular and AP window lymphadenopathy unchanged. Enlarged left paratracheal lymph nodes are slightly less prominent than on the prior CT. The right infrahilar mass is not significantly changed in size and measures 2.9 x 2.5 cm, previously 2.9 x 2.6 cm (series 7, image 57). Multiple nodular soft tissue lesions are present along the pericardium and unchanged. Specifically, reference soft tissue nodule in the anterior pericardial fat measures 2.5 x 1.3 cm, unchanged (series 7 comment 62). Right cardiophrenic lymphadenopathy is also again noted. Normal heart size without pericardial effusion. Severe coronary and aortic calcifications s/p median sternotomy. CHEST WALL: Multiple large axillary and subpectoral lymph nodes are again noted and unchanged. Multiple healed left rib fractures. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Splenic granulomata. Splenomegaly again noted. ADRENAL GLANDS: Right adrenal adenoma is unchanged. KIDNEYS, URETERS: Multiple left renal cysts. High riding left kidney, a normal variant. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate-severe retroperitoneal and periaortic lymphadenopathy with adjacent mesenteric stranding appears similar to prior CT. Mildly enlarged mesenteric lymph nodes are also stable. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Multilevel degenerative changes of the visualized spine, with large anterior osteophytes. Appearance of the superior right rectus abdominus muscle is unchanged.OTHER: Dense abdominal aortic calcifications. | 1.Stable mesothelioma and lymphoma, without change in pleural lesions or lymphadenopathy as detailed above.2.Persistent right upper lobe ground glass nodule is suggestive of indolent primary lung adenocarcinoma. |
Generate impression based on findings. | Reason: s/p lap DS History: abdominal pain/nausea ABDOMEN:LUNG BASES: Motion artifact limits evaluation of the lung bases. Basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mildly prominent mesenteric and retroperitoneal lymph nodes, likely reactive.BOWEL, MESENTERY: Status post sleeve gastrectomy and duodenal switch. No evidence of bowel obstruction. No free intraperitoneal air, pneumatosis intestinalis, or free fluid in the pelvis. Mild mesenteric and subcutaneous stranding compatible with postsurgical change. No loculated fluid collections in the abdomen or pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Postoperative changes without evidence of complications or findings to account for the patient's symptoms. |
Generate impression based on findings. | Reason: eval for infection, infiltrate History: pre-transplant LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Cardiac size is mildly enlarged.Hypoattenuating blood pool compatible with anemia.Moderate coronary artery calcifications.CHEST WALL: Diffuse osteosclerosis compatible with history of myelofibrosis.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Marked splenomegaly. Cholelithiasis. | No significant pulmonary or pleural abnormalities. Hypoattenuating blood pool (anemia ), splenomegaly, and diffuse osseous sclerosis compatible with history of myelofibrosis. |
Generate impression based on findings. | Reason: Evaluate submucosal rectal mass History: rectal mass seen on colonoscopy PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality noted.LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: No discrete rectal mass. Sigmoid diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Round sclerotic sacral lesion, likely benign. Anterior abdominal wall sutures.OTHER: No significant abnormality noted. | No lymphadenopathy or evidence of pelvic metastasis. |
Generate impression based on findings. | 50 yr old female with h/o AML, pre-stem cell transplant evaluation. History of cervical cancer with mediastinal metastases. MEDIASTINUM AND HILA: There is a left hilar lesion with internal foci of calcification that extends into the lung, measuring approximately 2.6 x 1.7 cm (series 9, image 52). Normal heart size without pericardial effusion. Mild aortic arch calcifications. LUNGS AND PLEURA: The left hilar lesion is seen extending into the lung, with surrounding bronchial wall thickening and clustered nodules with a tree-in-bud appearance. These extend inferiorly to the lung periphery. The largest peripheral left lower lobe nodule measures 1.3 x 1.2 cm (series 8, image 270). Imaging findings are most compatible with infection. No pleural effusion or pneumothorax. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Scattered hypodense hepatic lesions of varying size measure water attenuation and are compatible with benign cysts. | Peripheral left lower lobe nodule, surrounding clustered nodules and bronchial wall thickening, and central hilar enlargement with calcifications as described above. Imaging findings are most compatible with infection such as histoplasmosis. |
Generate impression based on findings. | Colon cancer CHEST:LUNGS AND PLEURA: Biapical fibrosis. Bilateral small lung nodules. Index nodule in the left lower lobe measures 8 x 8 mm on image number 52, series number 5. Metastatic disease cannot be excluded.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hypodense liver lesion replacing most of the left lobe. This lesion cannot be characterized due to lack of IV contrast. Evaluation of focal liver lesions is limited due to the Cahaba contrast. MRI of the liver may be helpful for further evaluation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Indeterminate small hypodense lesions in both kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ostomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Limited study due to lack of IV contrast. Bilateral small nodules suspicious for metastatic disease.Ill-defined hypodense lesion replacing most of the left lobe of the liver. MR of the liver is recommended for further evaluation.Indeterminate small hypodense kidney lesions of uncertain etiology and significance. Lack of IV contrast severely limits evaluation of these lesions. |
Generate impression based on findings. | Reason: mesothelioma, s/p 6 doses of immunotherapy. please evaluate for disease and compare with previous scans using the same reference lesions. History: mesothelioma ABDOMEN:LUNG BASES: Please refer to the separately reported CT of the chest. Enlargement of cardiophrenic lymph nodes as noted.LIVER, BILIARY TRACT: No suspicious focal hepatic lesion.SPLEEN: No significant abnormality noted. There is a collection of fluid surrounding the spleen, likely ascites, increased compared to prior exam.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Multiple surgical clips scattered throughout the retroperitoneum. There appears to be an slight overall increase in size and confluence of the retroperitoneal lymphadenopathy. There periaortic lymph node measures 3.0 x 1.8 cm, previously measuring 2.4 x 1.8 cm (series 8, image 34).The caval lymph node measures 4.3 x 3.0 a cm previously measuring 2.9 x 3.5 cm (series 8, image 64).IVC appears compressed by surrounding lymphadenopathy. Nonocclusive thrombus cannot be excluded.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Multiple scattered inguinal lymph nodes bilaterally. Redemonstration of common iliac lymphadenopathy bilaterally.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Redemonstration of changes from subcutaneous injections in the soft tissue of the anterior abdominal wall.OTHER: Redemonstration of peritoneal nodularity in the pelvis, relatively stable compared to prior exam. Small amount of pelvic ascites. | 1.Slight overall increase in size and confluence of retroperitoneal and pelvic lymphadenopathy.2.Relatively stable peritoneal nodularity consistent with carcinomatosis.3.Increase in pelvic and abdominal ascites.4.Please refer to the same day separately dictated CT chest. |
Generate impression based on findings. | Reason: Pt states she was told she has clogged arteries in her neck, incidental finding picked up on CT scan at Roseland Hospital and was sent here for evaluation, however CT does not upload. She also has neck pain, 30 lb weight loss and h/o stroke. History: Pt states she was told she has clogged arteries in her neck, incidental finding picked up on CT scan at Roseland Hospital and was sent here LUNGS AND PLEURA: Subsegmental atelectasis of the posterior basal segments of bilateral lower lobes and lingula.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion.No mediastinal or hilar lymphadenopathy. The aorta is normal in size. Calcification occupies the distal transverse arch at the ligamentum arteriosum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: There has been a cholecystectomy. Small nodule on the left adrenal gland measures 10 mm. | 1. Subsegmental atelectasis involving the lingula and posterior basal segments of lower lobes. 2. Normal size of the thoracic aorta.3. 10 mm left adrenal nodule which may represent an adenoma. If clinically appropriate, further characterization with in-and-opposed phase MRI may be obtained. |
Generate impression based on findings. | 77-year-old female with history of adrenal hemorrhage ABDOMEN:LUNG BASES: Small left-sided pleural effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: There is a 6.9 x 6.5 cm hypodense lesion involving the left adrenal gland. This lesion cannot be characterized due to lack of IV contrast. There are some calcifications in the wall of this lesion making an acute hemorrhage less likely.KIDNEYS, URETERS: Atrophic right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 8.9 x 6 cm heterogeneous, multicystic mass in the pelvis. Lack of IV contrast limits its optimal evaluation.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Right adrenal lesion with peripheral calcifications. This lesion cannot be optimally characterized due to lack of IV contrast. This lesion may represent hemorrhage versus an adrenal mass. MRI of the adrenal gland may be helpful for further characterization.Pelvic mass suspicious for ovarian neoplasm. Further evaluation with pelvic ultrasound or MRI is recommended. |
Generate impression based on findings. | Clinical question: 47-year-old male with history of ischemic stroke, need for anticoagulation. Please evaluate for any hemorrhage. Signs and symptoms: As above. Nonenhanced head CT:Examination today demonstrated a large subacute right MCA territory ischemic stroke in the right frontal lobe, right basal ganglia and right temporal lobe. There is resultant complete effacement of adjacent cortical sulci, significant mass effect on the right lateral ventricle with resultant collapse of the ventricle and midline shift of approximately 5 mm to the left at the level of the septum pellucidum.There is no evidence of hemorrhagic conversion of stroke.Minimally dilated left lateral ventricle remains is stable since prior exam. There is no evidence of any acute new findings. | Stable large right MCA territory subacute ischemic stroke in size, extent and overall associated mass-effect and 5-mm leftward midline shift. No evidence of hemorrhagic conversion. |
Generate impression based on findings. | Clinical question: 50-year-old female with history of AML, pre stem cell transplant evaluation. Signs and symptoms: As above. Maxillofacial CT:Frontal sinuses.No evidence of disease.Ethmoid sinuses.Minimal left to right sinus disease and unremarkable otherwise.Sphenoid sinus.No evidence of disease and patent sphenoethmoidal recess.Maxillary sinuses.Unremarkable right maxillary sinus and patent ostiomeatal unit.There is acute sinusitis of the left maxillary sinus overlapping minimal chronic sinus disease. This compromised the left ostiomeatal unit.Nasal cavity.There is nasal septum deviation to the right and minimal increased soft tissue density (mucosal thickening or small polyp is present in the right nasal cavity superior to the right middle turbinate no bony septal spur.Bilateral mastoid air cells and middle ear cavities are well pneumatized and unremarkable.Images through the orbits are unremarkable. | 1.Acute on chronic left maxillary sinus disease with compromised left ostiomeatal unit.2.Minimal left anterior ethmoid air cell opacification.3.Unremarkable other paranasal sinuses.4.Nasal septum deviation to the right and a small soft tissue density in the right nasal passage may represent a small polyp and/or mucosal thickening/secretions.5.Well pneumatized mastoid air cells and middle air cavities. |
Generate impression based on findings. | Male 52 years old Reason: lung ca screen in pt w +++ smoking hx - quit 5 y ago History: chronic phlegm (no change) LUNGS AND PLEURA: 6-mm right fissural nodule appears unchanged in size since the 2009 examination consistent with an intrapulmonary lymph node. MEDIASTINUM AND HILA: No evidence of mediastinal or hilar lymphadenopathy. Moderate calcifications of the coronary arteries.CHEST WALL: Calcified thyroid nodule unchanged since the prior examination. Mild multilevel degenerative changes seen in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis without evidence of cholecystitis. | No evidence of suspicious pulmonary nodules. |
Generate impression based on findings. | Female 60 years old Reason: s/p gastropexy 9/22/2013 r/o PE History: dyspnea, fatigue, cough PULMONARY ARTERIES: There is no evidence of pulmonary embolism and the main pulmonary artery is normal caliber. Streak artifact from contrast in the SVC somewhat limits the evaluation of a right superior segment pulmonary artery.LUNGS AND PLEURA: Minimal bilateral dependent atelectasis.MEDIASTINUM AND HILA: There is new elevation of the left hemidiaphragm. There is no evidence of mediastinal or hilar lymphadenopathy. Small sliding-type hiatal hernia.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Subcutaneous soft tissue density in the right upper abdominal wall compatible with healed gastrocutaneous fistula. Patient status post gastropexy and cholecystectomy. | 1. No evidence of pulmonary embolism.2. New elevation of left hemidiaphragm.3. Resolution of previous gastrocutaneous fistula. |
Generate impression based on findings. | Hearing loss. On the right, there is soft tissue attenuation material within the external auditory canal, which may represent cerumen. Otherwise, the external auditory canal is patent. The ossicular chain is intact without evidence of bony fixation. Lucency within the head of the incus represents a normal marrow variant. The middle ear and mastoid air cells are well-pneumatized and clear. The facial nerve describes a normal course. The inner ear structures are intact without evidence of semicircular canal dehiscence, cochlear deficiency, cochlear fossette narrowing, or vestibular aqueduct enlargement.On the left, the external auditory canal is patent. The ossicular chain is intact without evidence of bony fixation. Lucency within the head of the incus represents a normal marrow variant. The middle ear and mastoid air cells are well-pneumatized and clear. The facial nerve describes a normal course. The inner ear structures are intact without evidence of semicircular canal dehiscence, cochlear deficiency, cochlear fossette narrowing, or vestibular aqueduct enlargement.The bilateral temporal horns of the lateral ventricles are enlarged. | 1. No evidence of incomplete partition, cochlear fossette narrowing, cholesteatoma, or ossicular fixation. Nevertheless, a dedicated temporal bone MRI may be useful for further interrogation if the patient exhibits sensorineural hearing loss.2. The bilateral temporal horns of the lateral ventricles are enlarged. A brain MRI would be useful Discussed with Dr. Suskind at 5:15 PM on 10/2/13. |
Generate impression based on findings. | Status post robotic pyeloplasty 9/13 with postoperative ileus, now with diarrhea, coffee ground emesis, leukocytosis, flank pain, hematuria, evaluate for urinary leakage, intra-abdominal fluid collection, GI pathology ABDOMEN:LUNG BASES: No consolidation or pleural effusion is seen the lung bases.LIVER, BILIARY TRACT: No focal liver lesion or biliary duct dilation is present.SPLEEN: No focal splenic lesion is identified.PANCREAS: The pancreas appears normal.ADRENAL GLANDS: No focal nodule is seen within the adrenal glands.KIDNEYS, URETERS: Left renal pelvis is dilated and there is moderate left hydronephrosis, increased from the prior study. Contrast does not completely filled the dilated left renal collecting system on the 8 minute delayed images. On the 90 minute delayed images, contrast material is seen leaking from the left renal pelvis into the peritoneal space best seen on image 36, series 4. Contrast material surrounds the bowels. Both ureters appear normal. Incomplete rotation of the left kidney is noted; the renal pelvis is oriented anteriorly instead of medially.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Nasogastric tube tip lies in the gastric fundus. No bowel obstruction or free intraperitoneal air.BONES, SOFT TISSUES: A moderate amount of ascites is present, increased from the prior study. On the 90 minute delayed images, the ascites increases in density and is consistent with urine.PELVIS:PROSTATE, SEMINAL VESICLES: Prostate and seminal vesicles are normal for the patient's age.BLADDER: No bladder wall thickening.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No bowel obstruction or free intraperitoneal air.BONES, SOFT TISSUES: Moderate amount of ascites has increased from the prior study. | Urine leak from the left renal pelvis into the peritoneum. Urine ascites. |
Generate impression based on findings. | Clinical question: Cerebellar pathology. Signs and symptoms: Tremor Nonenhanced head CT:Examination through posterior fossa demonstrate normal density and morphology of cerebellar hemispheres, vermis as well as normal appearing midline position of the fourth ventricle. The CSF spaces remain widely patent and unremarkable.Images through supratentorial space demonstrate normal density and morphology of brain. Normal appearing ventricular system and CSF spaces.Calvarium and soft tissues of the scalp are unremarkable.All paranasal sinuses and mastoid air cells are well pneumatized. Unremarkable images through the orbits. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Evaluate for intracranial hemorrhage or fracture. Signs and symptoms: Head injury due to fall. Nonenhanced head CT:There is no detectable acute posttraumatic intracranial findings.There is no detectable posttraumatic calvarial findings.There is evidence of a left-sided supra-orbital soft tissue thickening of the scalp with a small laceration and soft tissue emphysema.Stable changes of craniofacial surgery.Unremarkable cerebral cortex, cortical sulci and ventricular system without change since prior exam. | 1.No acute intracranial findings.2.Small left supraorbital scalp small laceration and soft tissue swelling.3.Stable exam since prior head CT from 9 -- 18 -- 2013 otherwise. |
Generate impression based on findings. | Clinical question: Intracranial hemorrhage. Signs and symptoms: Head contusion. Nonenhanced head CT:There is no detectable acute posttraumatic intracranial or calvarial findings.There is evidence of a large left parietal scalp laceration with underlying hemorrhage and edema.Unremarkable cerebral cortex, cortical sulci, ventricular system and the CSF spaces as well as gray -- white matter differentiation.Unremarkable images through the orbits, paranasal sinuses, mastoid air cells and medullary cavities. Very small right maxillary sinus retention cyst however is noted. | 1.No acute posttraumatic intracranial or calvarial findings.2.Left parietal scalp laceration underlying hemorrhage. |
Generate impression based on findings. | 66 year old female with carcinomatosis suggestive of GYN cancer, status post neoadjuvant chemotherapy CHEST:LUNGS AND PLEURA: Moderate centrilobular and paraseptal emphysema. Scattered nonspecific micronodules. No suspicious pulmonary mass is seen.MEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes. No mediastinal or hilar lymphadenopathy. No pericardial effusion.CHEST WALL: Bilateral hypodense thyroid nodules with calcification in the right lobe. Subcentimeter lymph nodes.ABDOMEN: LIVER, BILIARY TRACT: Hepatic steatosis. No focal hepatic lesions seen. No intrahepatic or extrahepatic biliary ductal dilatation. Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Few bilateral subcentimeter hypodense renal lesions, which are nonspecific and too small to characterize.PANCREAS: The hypodense lobulated lesion in the pancreatic head appears similar to the prior study, measuring 2.0 x 1.7 cm (series 3, image 118). There is no pancreatic ductal dilatation. There is no evidence of vascular encasement.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdominal aorta, without aneurysm. The reference portacaval lymph node measures 1.4 x 0.8 cm (series 3, image 105), previously 1.8 x 1.0 cm.BOWEL, MESENTERY: Nondistended loops of bowel without apparent wall thickening, associated mesenteric stranding, or fluid collections. Peritoneal thickening and nodularity, particularly in the left upper abdominal quadrant and right paracolic gutter appears grossly similar to the prior exam.BONES, SOFT TISSUES: No significant abnormality noted. No suspicious lytic or sclerotic lesion seen.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified fibroids. No significant abnormality noted by CT.BLADDER: No significant abnormality notedLYMPH NODES: Pelvic lymphadenopathy. The reference right common iliac lymph node measures 1.6 x 1.4 cm (series 3, image 155), previously 1.8 x 1.5 cm.BOWEL, MESENTERY: Nondistended loops of bowel without apparent wall thickening, associated mesenteric stranding, or fluid collections. Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted. No suspicious lytic or sclerotic lesion seen.OTHER: No significant abnormality noted | 1. Peritoneal thickening and nodularity suggestive of pneumatosis, which appears stable compared to the prior exam2. Unchanged pancreatic head mass, which may represent malignancy or less likely an IPMN.3. Emphysema, without evidence of pulmonary metastatic disease.4. Thyromegaly with bilateral nodules. |
Generate impression based on findings. | 67 year old male. Reason: AFP 1900, eval for HCC History: cirrhosis, s/p TIPS ABDOMEN:LUNG BASES: Small left pleural effusion.LIVER, BILIARY TRACT: Cirrhotic morphology of the liver. No arterially enhancing lesions. TIPS in place and patent. Hepatic vasculature is patent. No biliary ductal dilatation. No ascites.SPLEEN: Splenomegaly. Peripheral splenic calcifications. Splenic artery endovascular coils. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable right renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Cirrhosis without CT evidence of HCC. |
Generate impression based on findings. | Female; 37 years old. Reason: PE? History: SOB, tachycardia. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Minimal basilar scarring/atelectasis. No focal air space opacity, pleural effusion, or pneumothorax. No suspicious pulmonary nodules or masses. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of pulmonary embolism or other acute cardiopulmonary abnormality. |
Generate impression based on findings. | Hypo-osmolality and hyponatremia. Abnormal chest radiograph. LUNGS AND PLEURA: Scattered benign appearing punctate micronodules.The lungs are otherwise unremarkable.MEDIASTINUM AND HILA: There is no evidence of mediastinal or hilar lymphadenopathy.Aortic root and coronary calcifications are mild.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small right renal cyst like hypodensity. Vascular calcifications are present. | No significant abnormality. Specifically, no abnormality to account for the chest x-ray finding. |
Generate impression based on findings. | 76 year old female. Reason: eval TEVAR repair. History: hx of saccular aneurysm of distal aortic arch CHEST:LUNGS AND PLEURA: Basilar subsegmental atelectasis and consolidation.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Coronary artery calcifications.VASCULATURE: Stent graft in the aortic arch. Saccular aneurysm arising from the left lateral wall of the aortic arch measures 4.4 x 4.0 cm (series 8, image 171), previously 5.1 x 4.9 cm. The contents of the aneurysm measures 62 HU on precontrast images and 66 HU on postcontrast images compatible with hyperdense clot without evidence of endoleak. There is peripheral calcification of the aneurysm. The ascending aorta measures 3.7 x 2.9 cm and the descending aorta measures 2.7 x 2.5 cm, grossly unchanged. The pulmonary artery measures 3.3 cm in diameter, which can be seen in pulmonary arterial hypertension.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.VASCULATURE: The infrarenal abdominal aorta is mildly ectatic and demonstrates extensive calcification. The right renal stent is widely patent. The celiac axis, SMA and IMA are patent. There is extensive calcification of the bilateral iliac vessels. The right common / external iliac stent is patent.BOWEL, MESENTERY: Right lower quadrant calcified mesenteric nodule is 2.9 x 2.3 cm (series 10, image 138), previously 2.9 x 2.5 cm. Correlate with surgical history.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right groin postoperative fluid collection measures 8.1 x 6.3 cm (series 10, image 26). Smaller left anterior abdominal wall hematoma.OTHER: No significant abnormality noted. | 1.Status post TEVAR with persistent aortic arch saccular aneurysm. No evidence of endoleak. 2.Right groin postoperative fluid collection. |
Generate impression based on findings. | Reason: 55 M with significant hypoxia History: hypoxia PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolism.Large main pulmonary artery, 38 mm, consistent with pulmonary arterial hypertension.No reliable evidence of right heart strain, however.LUNGS AND PLEURA: Severe centrilobular predominant emphysema is present, upper lobe predominant.Basilar bronchial wall thickening, bronchiolitis and consolidation right greater than left is accompanied by small pleural effusions, consistent with infection or aspiration.MEDIASTINUM AND HILA: Prominent lymphoid tissue is seen in both hila, possibly reactive from infection or chronic aspiration.An NG and ET tube are present. A right jugular catheter terminates in the SVC.Coronary artery calcifications are present. CHEST WALL: Mild degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Ascites, and a right renal cyst, but a separately reported abdomen and pelvis CT obtained concurrently should be referenced. | 1. No evidence of pulmonary embolism.2. Pulmonary arterial hypertension.3. Basilar opacities consistent with infection or aspiration; prominent hilar lymphoid tissue could be related to this, reactive. |
Generate impression based on findings. | 84 year-old female with upper abdominal pain, predominantly epigastric and right upper quadrant. The pain is worse with meals associated with weight loss and a Sister Mary Joseph periumbilical nodule in ABDOMEN:LUNG BASES: 0.6-cm right lower lobe pulmonary nodule. Scattered nonspecific micronodules. No pleural effusions or focal air space opacities.LIVER, BILIARY TRACT: Several cystic lesions, some with fine septations, likely representing simple cysts. Additional subcentimeter hypodense lesions are too small to characterize. No lesions suspicious for malignancy are seen.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: There is 1.8 x 0.9 cm thickening of the left adrenal gland, suggestive of a metastatic mass. The right adrenal gland is mildly nodular.KIDNEYS, URETERS: Subcentimeter hypodense renal lesions, which are nonspecific and too small to characterize on this exam.PANCREAS: There is marked dilatation of the pancreatic duct throughout the body and tail with associated parenchymal atrophy. There is an ill-defined lesion in the pancreatic body measuring approximately 1.2 x 0.9 cm (series 3, image 39). This is suspicious for a pancreatic malignancy. There is no definite arterial or venous encasement. There is loss of the fat plane anterior to the splenic artery, which may represent abutment by tumor or normal pancreatic tissue.RETROPERITONEUM, LYMPH NODES: Markedly atherosclerotic disease of the abdominal aorta and iliac arteries. There are enlarged gastrohepatic lymph nodes, with a reference lymph node measuring 1.1 cm in short axis (series 3, image 39). No retroperitoneal lymphadenopathy by CT size criteria.BOWEL, MESENTERY: No gross abnormalities noted.BONES, SOFT TISSUES: 1.2-cm umbilicus, with a small amount of surrounding fluid. No evidence of periumbilical soft tissue nodule. Moderately severe degenerative disk disease. OTHER: There is extensive omental caking measuring approximately 2 cm in AP thickness. There is a small amount of ascites throughout the abdomen and pelvis.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Sigmoid diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.2 cm ill-defined pancreatic mass with extensive ductal dilatation and pancreatic atrophy, suspicious for pancreatic adenocarcinoma. There are findings of extensive metastatic disease, including omental carcinomatosis and adrenal and pulmonary nodules. |
Generate impression based on findings. | 63 year old female. Reason: infection? History: hemodynamic concerning for infxn CHEST:LUNGS AND PLEURA: Endotracheal tube terminates above the carina. Anterior bowing of the posterior tracheal wall reflects expiration. Low lung volumes with basilar atelectasis. Mixed density right pleural effusion, which may reflect blood products, is partially loculated anteriorly. Small left pleural effusion. Basilar compressive atelectasis. MEDIASTINUM AND HILA: Status post aortic valve replacement with a small amount of pneumomediastinum and pneumopericardium. Loculated substernal fluid collection with rim enhancement measures 3.8 x 2.1 cm (series 3, image 32). Prominent mediastinal lymph nodes are likely reactive. Cardiomegaly with small pericardial effusion. Nodular thyroid.CHEST WALL: Body wall anasarca.ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology of the liver. Moderate perihepatic ascites. Nonspecific gallbladder wall edema.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys with bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Prominent retroperitoneal lymph nodes, likely reactive.BOWEL, MESENTERY: No evidence of bowel obstruction. No free intraperitoneal air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Surgically absent.BLADDER: Collapsed secondary to Foley catheter.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of free fluid in the pelvis. Right femoral venous catheter. | 1.Loculated substernal fluid collection consistent with abscess.2.Bilateral pleural effusions, partially loculated on the right and likely containing blood products.3.Postsurgical changes s/p aortic valve replacement.4.Cirrhotic morphology of the liver with abdominal / pelvic ascites. |
Generate impression based on findings. | Female 46 years old; Reason: eval for abcess, fluid collection History: ABD pain CHEST:LUNGS: Bilateral lower lobe consolidation and moderate right pleural effusion. Heart size is enlarged. Trace pericardial effusion. Sternotomy wires. Tracheostomy tube is in the expected position. MEDIASTINUM: Cardiomegaly with bilateral basilar opacities effusions, greater on the right are again observed. Appearance is minimally improved since 9/30/13.Tracheostomy tube and bilateral jugular catheters are unchanged. Bilateral jugular catheters end in the SVC. Small amount of gas in the right atrium, probably related to recent instrumentation and IV administration. Orogastric tube is in the expected position. ABDOMEN:LIVER, BILIARY TRACT: Liver has a nodular contour suggesting cirrhosis. Cholelithiasis with hyperdense material within the gallbladder. Hepatomegaly with overall span of 19 cm. Periportal edema is nonspecific. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Diffuse enlargement of the left kidney may be compensatory hypertrophy. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Jejunostomy tube with tip within the jejunum in the left abdomen. No bowel obstruction. BONES, SOFT TISSUES: Post operative changes in the anterior abdomen wall and large wound in the left upper abdomen. Superficial surgical drains and dressings. OTHER: Extensive abdominal ascites which appears hypodense indicating that hematoma has resolved. Surgical skin staples in the midline. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild sigmoid and rectum thickening.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate ascites. | 1.Moderate abdominal / pelvic ascites. No definite hematoma.2.Right pleural effusion. Bilateral lower lobe consolidation.3.Other findings are stable since 9/23/2013. |
Generate impression based on findings. | Clinical question: Metastatic basal cell cancer. On chemotherapy now. New onset of gait and balance. Evaluate for possible CNS metastases. Signs and symptoms: New onset of gait imbalance. Enhanced head CT:Examination demonstrate no detectable abnormal parenchymal or leptomeningeal enhancement to suggest metastatic disease.In the cerebral cortex, cortical sulci, ventricular system, CSF cisterns and gray -- white matter differentiation remains within normal for patient of stated age of 73.Calvarium is unremarkable.No convincing evidence of a scalp abnormality/enhancement.Unremarkable images through the orbits.Unremarkable partially visualized maxillofacial region including all visualized paranasal sinuses.Well pneumatized bilateral mastoid air cells and middle ear cavities.Bilateral small soft tissues within the external auditory canals (with suggestion of minimal calcification) are believed to represent debris. Direct inspection is recommended. | Unremarkable enhanced head CT. Please see above comments. |
Generate impression based on findings. | 34 year old F with a history of ALL with newly found CNS relapse. Patient had a CT of the chest which showed nodule and lymphadenopathy. Will go for biopsy per pulmonary on 10/7, will need CT with SuperD protocol prior to bronch with biopsy History: AMS, fatigue, ALL with CNS relapse, pulmonary nodules. LUNGS AND PLEURA: Multiple subcentimeter nodules are again noted throughout the lungs in a subpleural and bronchovascular distribution, with mild interval improvement since the prior CT. Elevation of the right hemidiaphragm is again noted. There is no focal air space opacity or pleural effusion.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: Left PICC tip in the proximal SVC. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. Splenomegaly. | Mild interval improvement in numerous subpleural and bronchovascular pulmonary nodules, compatible with resolving atypical infection from fungal or viral agents. However, if the patient has not been treated, differential considerations can also include pulmonary lymphoma or leukemic deposits. |
Generate impression based on findings. | 48 year old male. Reason: Evaluate for peri-rectal or peri-anal abscess History: Hx of Crohn's Disease, s/p surgical drainage of perianal abscess 6 weeks ago now with recurrent symptoms. 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: Large nonobstructing calculus in the left lower renal pole. Multiple simple cortical cysts at the left kidney. No hydronephrosis or perinephric collections.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal tube is in expected position. Multiple perirectal and perianal fistulae are present. One of these extends to the skin surface, seen best on sagittal image 74, associated with a 2 x 3 cm abscess at the left buttock medially. A small drainage catheter is present in the dorsal midline at the anus, extending through the buttock crease. If indicated, MRI examination may be helpful to delineate the size and course of fistulae in this region. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Superficial abscess at the left medial buttock is associated with a fistulous tract that extends to the anus. Multiple smaller perianal fistulae and collections are present, with a midline drain tube at the anus extending through the buttock crease. |
Generate impression based on findings. | 45-year-old male. Reason: metastatic penile ca w/ inguinal mass/LAD, renal failure. Reassess masses and need for R inguinal drain, rule out hydrophrosis History: metastatic penile ca w/ inguinal mass/LAD, renal failure. Reassess masses and need for R inguinal drain, rule out hydronephrosis ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild hepatomegaly. Liver span is 25 cm. No focal lesion is evident within limits of noncontrast exam. Cholelithiasis. SPLEEN: Splenomegaly. Overall length is 17 cm. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Anomalous right kidney in the pelvis. Right renal enlargement with perinephric fat standing. Right hydroureteronephrosis and herniation of right ureter into the inguinal region, which then courses back up into the pelvis and inserts normally at the bladder trigone. Punctate nonobstructing calculus in the left upper renal pole.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: Pelvic lymphadenopathy is stable, including the right obturator reference node measuring 6 x 4.6 cm (series 4, image 104).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Large pannus with subcutaneous fat stranding/edema. OTHER: Right pelvic kidney. Right ureter courses down into a fat-containing right inguinal hernia and then back up into the pelvis to terminate normally at the bladder trigone. A ureteral stent is positioned with its proximal end in the mid ureter located in the inguinal hernia and distal end terminating in the bladder. No kinks or discontinuity in the stent is evident. Unchanged since 9/5/2013. Fat-containing left inguinal hernia. Bilateral inguinal hernias extend into the scrotum, right more so than left. Large bilateral necrotic inguinal masses. | 1. Hepatosplenomegaly. Right pelvic kidney with decreased hydroureteronephrosis. Herniation of the right ureter into a fat-containing right inguinal hernia.2. Right ureteral stent with proximal end in the inguinal portion of the mid-ureter and terminating in the bladder. No kinking or discontinuity of the stent. This is unchanged since 9/5/2013.3. Bilateral large necrotic inguinal masses. 4. Pelvic lymphadenopathy.5. No acute change. |
Generate impression based on findings. | 48 year old male. Reason: retracted ostomy, check for free air History: metastatic renal cell carcinoma, status post left nephrectomy. ABDOMEN:LUNG BASES: Moderate bilateral pleural effusions with bilateral lower lobe atelectasis has increased since the prior exam. Small amount of coronary artery calcification.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Parasplenic collection is stable in size.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left nephrectomy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No bowel obstruction. Mildly dilated jejunum persists in the left midabdomen. Probable post-op ileus. BONES, SOFT TISSUES: Stable ventral herniaOTHER: Small amount of free air is present. Anasarca. Trace ascites in the mesentery. Open midline abdominal wound. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Status post interval removal of the left lower quadrant mesenteric metastatic mass. No bowel obstruction. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Distal end of surgical drainage catheter within the mesentery | Interval removal of left lower quadrant metastatic mesenteric mass. Increased pleural effusions, especially on the left. Minimal free air. No bowel obstruction. Other findings appear stable since 9/21/2013. |
Generate impression based on findings. | 55 year old male. Reason: 55 y.o.male found down, abdominal tenderness. History: abdominal tenderness ABDOMEN:LUNG BASES: Chest PE CT scan was done. Please refer to that report for details. Small bilateral effusions. Right lower lobe consolidation. Coronary artery calcifications. Orogastric tube tip is in expected position.LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. Periportal edema is nonspecific. Gallbladder wall edema.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cortical hypodensities are compatible with simple cysts. No hydronephrosis or perinephric collections.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of ascites. Anasarca.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in a decompressed urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Moderate ascites. Anasarca. No bowel obstruction or free air. No acute abnormality to explain abdominal tenderness. Right lower lobe consolidation and volume loss. Bilateral pleural effusions. |
Generate impression based on findings. | Female 63 years old Reason: Head and neck cancer. Screening evaluation. History: as above CHEST:LUNGS AND PLEURA: Right middle lobe cavitary nodule now measures 21 x 24 mm (image 33, series 4), previously measuring 29 x 20 mm. The internal cavity has increased in size.The right upper lobe ground groundglass opacity are represent a minimally invasive adenocarcinoma or atypical adenomatous hyperplasia. Scattered micronodules unchanged.Mild/moderate emphysema.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy. Mild atherosclerosis of the thoracic aorta.Right internal jugular venous catheter with tip in the proximal SVC.CHEST WALL: There is no evidence of supraclavicular, internal mammary or axillary lymphadenopathy. Redemonstration of an osteolytic lesion in the sternumABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Left hepatic lobe cyst unchanged. The right hepatic lobe subcentimeter hypodense foci too small to characterize. Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No evidence for retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.The peripancreatic soft tissue mass now measures 4.6 x 5.3 cm (image 109, series 3), previously measuring 1.7 x 1.4 cm. There is mass effect on the pancreas and the fat plane between the pancreas and the mass has been obliterated. The mass abuts the medial aspect of the left hepatic lobe with obliteration of the intervening fat plane.The soft tissue mass in the right paracolic gutter region now measures at least 2.2 x 3.4 cm (image 176, series 3) previously measuring 1.7 x 1.6; however, this lesion is incompletely visualized. BONES, SOFT TISSUES: Mild multilevel degenerative changes of the thoracic and lumbar spine.OTHER: No significant abnormality noted. | 1. right middle lobe nodule demonstrates increased cavitation from the prior exam.2. Right upper lobe mixed groundglass/solid lesion unchanged but may represent and may represent an indolent minimally invasive adenocarcinoma.3. Significant interval enlargement of the peripancreatic and paracolic gutter soft tissue masses.4. Stable sternal metastasis.4. No new metastatic foci identified. |
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