instruction stringclasses 1 value | input stringlengths 6 8.98k | output stringlengths 5 3.11k |
|---|---|---|
Generate impression based on findings. | Male 29 years old; Reason: evaluate for infectious processes of lung, abdomen, pelvis in pt w/ AIDS, CD4 = 7, recently treated for PCP and H. flu pna History: cough, SOB, diarrhea, vomiting, abdominal pain CHEST:LUNGS AND PLEURA: Diffuse pulmonary airspace opacities with multiple areas of cavitation predominantly in the upper lobes which are predominantly air-filled. These findings have progressed suggesting worsening infection.The pleural spaces remain clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy. CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: The liver has a smooth contour. No focal solid hepatic lesion. Biliary system is normal in caliber.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Suboptimal evaluation of the small bowel due to lack of enteric contrast.Multiple air fluid levels in the small bowel and colon indicate a diarrheal and possibly nonobstructive state.The findings are most likely due to infection of the small bowel possibly with an opportunistic infection.No bowel obstruction is evident. No free air. Trace mesentery edema and ascites.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.Progression of airspace opacities in the lungs with multiple cavitary lesions. 2.Air-fluid levels in the small bowel and colon most likely due to small bowel involvement by infection. |
Generate impression based on findings. | Male, 78 years old, neck pain, right arm numbness. There is a grade 1 retrolisthesis of C5 relative to C6, and a grade 1 anterolisthesis of C7 relative to T1.No acute fractures are seen. Degenerative loss of vertebral body height is noted most conspicuously at C6. The intervertebral disk spaces are narrowed at all levels. There are bulky anterior osteophytes at most levels.C2-3: The left worse than right facet hypertrophy. Posterior disk bulge. Minimal thecal sac effacement. Moderate bilateral foraminal narrowing. C3-4: Bilateral facet hypertrophy. Posterior disk-osteophyte complex. Mild thecal sac effacement. Moderate bilateral foraminal narrowing. C4-5: Right worse than left facet hypertrophy. Fusion of the right facet complex. Posterior disk-osteophyte complex. Mild thecal sac effacement. Moderate bilateral foraminal narrowing. C5-6: Bilateral facet hypertrophy. Posterior disk-osteophyte complex. Mild thecal sac effacement. Moderate bilateral foraminal narrowing. C6-7: Bilateral facet hypertrophy. Posterior disk-osteophyte complex. Mild thecal sac effacement. Moderate bilateral foraminal narrowing. C7-T1: Bilateral facet hypertrophy. Posterior disk-osteophyte complex. Mild thecal sac effacement. Moderate bilateral foraminal narrowing. | 1. No evidence of fracture or acute malalignment.2. Degenerative disk disease at all levels resulting in mild effacement of the bony spinal canal. Please note that MRI would be more sensitive for soft tissue/disk encroachment.3. Moderate narrowing of the bony neural foramina at all levels. |
Generate impression based on findings. | Reason: 49 y/o with CP and elevated d-dimer History: 49 y/o with CP and elevated d-dimer PULMONARY ARTERIES: Limited exam due to suboptimal opacification of the pulmonary arterial tree.No large central pulmonary emboli can be identified.The pulmonary artery is normal caliber.LUNGS AND PLEURA: A right middle lobe calcified granuloma.No significant pulmonary or pleural abnormalities.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal upon evidence of a pericardial effusion.CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Limited exam shows no evidence of large central pulmonary emboli. No significant pulmonary or pleural abnormalities identified. |
Generate impression based on findings. | Female 55 years old; Reason: please evaluate etiology of chest pain and tachycardia History: chest pain and tachycardia. PULMONARY ARTERIES: No evidence of pulmonary emboli.LUNGS AND PLEURA: Decreased lung volumes. Bilateral dependent consolidation consistent with atelectasis is visualized. A nodule is visualized in the left lower lobe measuring 1.7 x 2.4 cm (series 9, image 52), on 8/16/2006 CT there was no abnormality present, on 3/16/2010 abdomen/pelvis CT in retrospect there was equivocally a small peripheral scar like opacity in this area though this scan did not include the entire chest. This nodule was present on 10/6/2013 abdomen. Emphysema. MEDIASTINUM AND HILA: No cardiomegaly or pericardial effusion. Subcentimeter lymph nodes are noted in the left supraclavicular, pre-cardiac, and mediastinal regions including the right paratracheal and subcarinal regions.CHEST WALL: Hypodensity within the left T5 vertebral body is sclerotic in its margin and likely represents a hemangioma. Other small hypodense foci are too small to characterize.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Gastrostomy tube is partially visualized in the excluded limb. | 1.No pulmonary emboli.2.Left lower lobe nodule highly suggestive of primary lung carcinoma. |
Generate impression based on findings. | 65-year-old female patient with a condensation after ERCP. Evaluate for leak. ABDOMEN:LUNG BASES: Bibasilar atelectasis with bilateral pleural effusions, right greater than left.LIVER, BILIARY TRACT: Patchy areas of poor hepatic enhancement in the peripheral liver parenchyma. Periportal edema with patent, attenuated portal vein. Surgical clips in the porta hepatis. Status-post cholecystectomy. Metallic common bile duct stent without ductal dilatation.SPLEEN: Patchy, wedge-shaped areas of poor enhancement may be consistent with early infarct.PANCREAS: Pancreatic stent. Edema with heterogeneous enhancement at the pancreatic head and uncinate process consistent with acute pancreatitis. No evidence of necrosis or pseudocyst formation. There is adjacent fluid with extension into the right pericolic gutter.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: G-tube in excluded stomach with hematoma. Dilated small bowel with air fluid levels without transition point.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate abdominal ascites with trace free air, likely from instrumentation.PELVIS:UTERUS, ADNEXA: Atrophic or surgically removed.BLADDER: Foley catheter in place. No significant abnormalities noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate free fluid in the pelvis. Peritoneal enhancement is consistent with peritonitis. | 1.Pancreatitis in the head and uncinate process without evidence of necrosis or pseudocyst formation. 2.Dilated small bowel without transition point, suggesting ileus.3.Ascites and mild peritoneal enhancement consistent with peritonitis.4.Patchy liver enhancement in the peripheral parenchyma consistent with infarctions versus infection.5.Patchy enhancement of the subcortical regions of the spleen suggestive of early infarctions. |
Generate impression based on findings. | High INR, low platelets, AMS, r/o ICH. History of Sjogren's syndrome, CREST, PBC, CKD, and urothelial cell carcinoma s/p TURB. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is extensive diffuse soft tissue within the orbital fat bilaterally as well as diffuse enlargement of multiple extraocular muscles without appreciable exophthalmos. There are also calcifications along the expected insertion sites if the inferior oblique muscles bilaterally. | 1. No evidence of intracranial hemorrhage, mass, or cerebral edema.2. Extensive diffuse soft tissue within the orbital fat bilaterally as well as diffuse enlargement of multiple extraocular muscles likely represents a sclerosing orbital inflammatory process related to the patient's known autoimmune disorders and less likely hemorrhage or neoplasm. Nevertheless, ophthalmological exam and MRI of the orbits may be useful for further characterization. |
Generate impression based on findings. | 58-year-old male with history of ulcerative colitis status post colectomy with J-pouch and diverting ileostomy presenting with rectal pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis. No focal hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant diverting ileostomy.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: Fluid-filled J-pouch with enhancing rim, suggesting inflammation. A thin linear collection tracking inferiorly may represent fistulization, but could be further evaluated with MRI. No pelvic loculated fluid collections.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Fluid-filled J-pouch with enhancing rim with suggestion of fluid tracking inferiorly, if there is concern for perianal fistula MRI is recommended further evaluation. No evidence of loculated fluid within the pelvis. |
Generate impression based on findings. | 31 year-old female with headache, assess for tumor/sinusitis. Small hypoattenuating foci in the subcortical white matter of the bilateral frontal lobes without associated mass effect.The CSF spaces are appropriate for the patient's stated age with no midline shift. No intracranial hemorrhage is identified. No hydrocephalus or intra-/extra axial fluid collections.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Congenital fusion anomaly of C1 vertebrae. | Small hypoattenuating foci in the subcortical white matter of the bilateral frontal lobes without associated mass effect. These may represent normal variant perivascular spaces. However, MRI is suggested to confirm these findings.These findings were text paged to Dr. Rios-Alba at 10:30 a.m. on 10/21/2013. |
Generate impression based on findings. | 80 year-old male with altered mental status, evaluate for hemorrhage versus other acute changes. Intracranial atherosclerotic vascular calcifications. Enlarged ectatic bilateral intracranial internal carotid arteries.Several punctate mildly hyperdense foci are identified in the right frontal and parietal lobes which are seen on several consecutive slices and most likely represent penetrating vessels.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma.Air-fluid level in the right sphenoid sinus. Partial opacification of the left mastoid air cells. The visualized portions of the orbits are intact. | 1. No acute intracranial abnormalities.2. Enlarged ectatic bilateral intracranial internal carotid arteries. Recommend CTA of the head for further characterization of this finding.These findings discussed with Dr. Gibson at 10:15 a.m. on 10/21/2013 |
Generate impression based on findings. | Male, 68 years old, seizure. Periventricular hypoattenuation is a non-specific finding which most commonly represents age-indeterminate small vessel ischemic disease. Hypoattenuation is also evident within the right temporal lobe extending to the level of the cortex, likely representing chronic territorial ischemia. These findings are unchanged.Scattered, likely dystrophic parenchymal calcifications are seen, along the sylvian fissure and within the inferior right temporal sulcus.No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. A mucus retention cyst is partially visualized in the left maxillary sinus. Paranasal sinuses are otherwise well pneumatized.The bones of the calvarium and skull base are intact. Extensive dermal calcifications are reidentified. Also noted are calcifications along the lenses of the globes. | 1. No acute intracranial abnormality.2. Age indeterminate small vessel ischemic disease.3. Chronic right temporal territorial ischemic change. |
Generate impression based on findings. | Female 65 years old; Reason: PE History: tachy, SOB. PULMONARY ARTERIES: No evidence of pulmonary emboli.LUNGS AND PLEURA: Small bilateral pleural effusions are noted with overlying consolidation and air bronchograms most likely atelectasis, though aspiration or pneumonia should also be considered..MEDIASTINUM AND HILA: Endotracheal tube is in place. No cardiomegaly. Small pericardial effusion. No significant hilar or mediastinal 2adenopathy.CHEST WALL: Degenerative changes are noted about the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Ascites is noted in the abdomen. Postsurgical changes from prior gastric procedure. See separate A/P CT report for further details. | 1.No pulmonary emboli.2.Small bilateral pleural effusions and bibasilar dependent atelectasis. |
Generate impression based on findings. | 39-year-old male with possible new onset seizures, evaluate for mass, hemorrhage, ischemia. Loss of consciousness. The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the orbits are intact. | No acute intracranial abnormalities. |
Generate impression based on findings. | 63-year-old female patient with flank pain. Evaluate for renal stone. Note that lack of intravenous contrast limits evaluation of vasculature, lymph nodes, solid and hollow viscera.ABDOMEN:LUNG BASES: Lung bases and pleural spaces are clear.LIVER, BILIARY TRACT: Diffusely hypoattenuating liver parenchyma is consistent with fatty infiltration. No ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Multiple bilateral adrenal nodules with low attenuation. Largest adrenal nodule measures 1.9 x 1.7 cm in the lateral limb of the left adrenal gland measures -10 Hounsfield units (series 4, image 92).KIDNEYS, URETERS: Right perinephric fat stranding and mild hydronephrosis. Obstructing renal calculus at the ureteropelvic junction measures 9 mm (series 4, image 137).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Scattered calcifications within the wall of the abdomen aorta is consistent with atherosclerotic changes.PELVIS:UTERUS, ADNEXA: Calcified fibroid uterus. Otherwise, no significant abnormalities noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.9-mm obstructing renal calculus at the ureteropelvic junction with mild hydronephrosis and perinephric fat stranding.2.Diffuse fatty infiltration of the liver.3.Multiple bilateral adrenal adenomas. |
Generate impression based on findings. | MVC. Head: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are grossly unremarkable. Cervical Spine: There is no evidence of fracture or spondylolisthesis. Indeed, the cervical spine alignment is normal. The vertebral body and disc space heights are preserved. The craniocervical junction is intact. The prevertebral soft tissues are unremarkable. There is right apical scarring with associated course calcifications, which may represents a sequela of prior granulomatous disease. | 1. No evidence of intracranial hemorrhage, mass, or cerebral edema.2. No evidence of fracture or spondylolisthesis. |
Generate impression based on findings. | 39-year-old male with new onset seizures No abnormal intracranial enhancement is identified. The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | No acute intracranial abnormalities or abnormal intracranial enhancement. |
Generate impression based on findings. | Female, 64 years old, with stroke. Extensive cortical and subcortical hypoattenuation is demonstrated within the left occipital and temporal regions compatible with chronic territorial infarct. This hypoattenuation extends to some degree into the left parietal lobe where the changes are age indeterminate. Mild cortical encephalomalacia is also demonstrated within the right parietal lobe.Extensive periventricular hypoattenuation is seen bilaterally, compatible with age indeterminate small vessel ischemic change.No mass effect is demonstrated. No intracranial hemorrhage or abnormal extra-axial fluid collections are seen. The ventricular system is patent with mild prominence of the ventricular atria, perhaps secondary to ex vacuo effect.Extensive intracranial vascular calcifications are noted. In particular, the basilar artery is calcified and one ectatic.The bones of the calvarium are intact. The paranasal sinuses and mastoid air cells are clear. | Evidence of territorial ischemia within the occipital and temporal lobes on the left, most likely chronic. Hypoattenuation also extends into the left parietal region which may also be chronic. However, given the extensive background abnormalities, the possibility of an acute superimposed process cannot be excluded. MRI would provide a more sensitive evaluation. |
Generate impression based on findings. | 57-year-old male with intracerebral hemorrhage. There is a large right hemispheric hematoma with intraventricular extension and surrounding edema with right to left midline shift stable to slightly increased, measuring 12 mm. There is a small right uncal herniation which is unchanged from prior study. There is a lacunar infarct in the left corona radiata which is unchanged from prior exams. The left ventriculostomy catheter is in unchanged position, terminating within the left lateral ventricle. The left lateral ventricle is dilated and has slightly increased in size. There is persistent effacement of the right lateral ventricle and third ventricle. There is unchanged fluid in the sphenoid sinus, bilateral mastoid air cells, and mucosal thickening in the left maxillary sinus. The extracranial structures are unchanged. | 1.Large right hemispheric hematoma with right to left midline shift is stable to slightly increased.2.Dilated left lateral ventricle with ventriculostomy tube. The size of the ventricle has slightly increased which may indicate increased ventricular outflow obstruction. |
Generate impression based on findings. | 32-year-old male with dizziness and giddiness, evaluate for intracranial or bony process. Patient experienced a head butt 3 days ago The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear.Probably chronic fracture of the right lamina papyracea given the lack of fluid in the maxillary and ethmoid sinuses.C1 vertebrae congenital fusion anomaly. | 1. No acute intracranial abnormalities.2. Probably chronic fracture of the right lamina papyracea given the lack of fluid in the maxillary and ethmoid sinuses and no clinical history of pain at this location. |
Generate impression based on findings. | Motor vehicle traffic accident. Head: There is a 5 mm diameter hyperdense focus in the posterior pituitary. The brain parenchymal otherwise appears unremarkable. There is no evidence intraparenchymal hematoma, subarachnoid hemorrhage, epidural hematoma, or subdural hematoma. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Cervical Spine: There is a well-corticated osseous structure along the inferior pole of the anterior arch of C1, which likely represents a sequela of chronic avulsion injury. There is mild straightening of the cervical spine in the sagittal plane. The vertebral body and disc space heights are intact. There is no evidence of acute fracture or spondylolisthesis. There are prominent bilateral C7 transverse processes. There is an accessory vascular channel that traverses the left C2 lateral mass, which is a normal variant. The prevertebral soft tissues are unremarkable. | 1. A 5 mm diameter hyperdense focus in the posterior pituitary, which may represent a Rathke cleft cyst, and less likely pituitary apoplexy. This can be further evaluated via a dedicated pituitary MRI. Otherwise, no evidence of intraparenchymal hematoma, subarachnoid hemorrhage, epidural hematoma, or subdural hematoma. 2. A well-corticated osseous structure along the inferior pole of the anterior arch of C1, which likely represents a sequela of chronic avulsion injury or unfused apophysis. Otherwise, no evidence of acute cervical spine fracture of spondylolisthesis. |
Generate impression based on findings. | Female, 75 years old, palpable mass in the right neck with obstructive symptoms when swallowing for two days. Non-angiographic findings:Within the limitations of an arterial phase study, no mucosal based lesions or pathologic adenopathy is detected. The salivary glands and the thyroid are free of focal lesions. Lung apices are unremarkable. No concerning bony lesions are detected.Angiographic findings:Common origin of the brachiocephalic and left common carotid artery is seen. Mild atherosclerotic calcification affects the great vessel origins. The origins are patent.The right brachiocephalic artery is tortuous and the branch point of the right common carotid artery is relatively high in the neck at the level of the thyroid. It is possible that this anatomic variation accounts for the patient's palpable abnormality.The carotid and vertebral vasculature in the neck is otherwise unremarkable. No vascular occlusion is evident. There is no evidence of vascular stenosis significant by NASCET criteria.Limited intracranial imaging is significant for atherosclerotic irregularity of the intracranial ICAs. In addition, there is an aneurysm arising from the right M1 segment measuring 2.4 mm in length, 2.6 mm in width, with a 1.5-cm neck, oriented inferolaterally.The left intracranial ICA is very irregular with areas of alternating dilatation and stenosis. For example, there is a 40 to 50% stenosis at the level of the supraclinoid left ICA.Also noted is prominence at the origin of the right PICA. The origin appears to be extradural and is somewhat bulbous with an abrupt change in caliber after crossing the dura. This caliber change may reflect penetration of the dura, but aneurysmal dilatation at this location cannot be excluded. | 1. No masses or pathologic adenopathy in the neck.2. The right brachiocephalic artery is tortuous and the origin of the right common carotid artery is higher than typical. This is an anatomic variation which may account for the patient's palpable abnormality.3. The cervical vessels are otherwise unremarkable.4. The intracranial vessels are incompletely evaluated. However, there is a small aneurysm arising from the right M1 segment of the MCA, a stenosis of the left supraclinoid ICA, and a questionable aneurysm at the origin of the right PICA. These would be better assessed on dedicated vascular imaging of the head. |
Generate impression based on findings. | 84-year-old female with fall two days ago now with some confusion. Patchy hypoattenuation in the periventricular and subcortical white matter is nonspecific, but likely represents the sequela of small vessel ischemic disease of indeterminate age.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Partial opacification of the sphenoid sinuses, left greater than right. Partial opacification of the posterior right ethmoid air cells. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Radiodense rectangular shaped object projects over the C3 vertebral body on the scout image and is of uncertain etiology and clinical significance. This may be superficial and superimposed over the patient. | 1. No acute intracranial abnormalities.2. Patchy hypoattenuation in the periventricular and subcortical white matter is nonspecific, but likely represents the sequela of small vessel ischemic disease of indeterminate age. |
Generate impression based on findings. | Male 74 years old; Reason: R/O PE. Also to better characterize previously seen lung nodules History: Hypoxia, tachycardia. PULMONARY ARTERIES: No pulmonary emboli. The main pulmonary artery measures 3.2 cm which is above the upper limit of normal likely consistent with pulmonary hypertension although this has not significantly changed compared to previous exam.LUNGS AND PLEURA: Moderate centrilobular emphysema again seen. There has been interval resolution of the previously visualized right lower lobe clustered nodules which are probably infectious/inflammatory in etiology. Unchanged right lower and middle lobe scarring/atelectasis.MEDIASTINUM AND HILA: No cardiomegaly or pericardial effusion. No significant hilar or mediastinal lymphadenopathy. Severe coronary calcifications are present.CHEST WALL: Degenerative changes in the thoracic spine especially at the midthoracic level where there is intervertebral disk space narrowing and mild anterior end plate height loss.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. The stomach is distended with a large amount of fluid and debris. Bilateral renal hypodensities are again seen and not significantly changed consistent with renal cysts. | 1.No pulmonary emboli.2.Interval resolution of the previously visualized right lower lobe clustered nodules, likely post infectious or inflammatory in etiology. Unchanged basilar scarring. |
Generate impression based on findings. | T4N2b paranasal sinus SCC undergoing chemoradiation. Poor arousability, on anticoagulation, s/p fall several days before. There has been interval resolution of the right parafalcine subdural hematoma. No new intracranial hemorrhage is identified. There is no significant midline shift or herniation. There is unchanged mild scattered cerebral white matter hypoattenuation that likely represents small vessel ischemic disease. The ventricles are stable in size and configuration. There are partially imaged postoperative findings, including a right frontal sinus stent, within the paranasal sinuses, which are partially opacified. In particular, there is a mass within the right retromaxillary fat pad that extends into a widened pterygomaxillary fossa, infraorbital fissure, and foramen rotundum. There is dehiscence of the right carotid groove. There is also complete right and partial left tympanomastoid opacification. The extracranial soft tissues are unremarkable. | 1. Interval resolution of the right parafalcine subdural hematoma. No new intracranial hemorrhage is identified. 2. A mass within the right retromaxillary fat pad that extends into a widened pterygomaxillary fossa, infraorbital fissure, and foramen rotundum is compatible with residual squamous cell carcinoma. MRI of the brain and paranasal sinuses would be useful for further characterization. |
Generate impression based on findings. | History head and neck cancer, pulmonary hypertension. Evaluate lung parenchyma. LUNGS AND PLEURA: Multiple bilateral pulmonary nodules have increased in size and number.The reference right lower lobe nodule measures 30 x 20 mm on image 59/95 of soft tissue windows (15 x 13 mm on prior).The reference left upper lobe nodule measures 16 mm on image 16/95 (6 mm on prior). Presumed post XRT changes are new and noted in the right upper lobe, right perihilar area and right lower lobe.MEDIASTINUM AND HILA: New mediastinal lymphadenopahy with a reference node measuring 16 mm on image 32/95 in the right paratracheal space. Coronary calcification.CHEST WALL: No significant abnormality noted..UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Exophytic renal nodules are incompletely evaluated but presumably cysts. | 1. Interval increase in size and number of pulmonary metastases.2. New mediastinal lymphadenopathy.3. New presumed post XRT changes involving the right pulmonary parenchyma. |
Generate impression based on findings. | 34-year-old male with intracranial hemorrhage. There is hemorrhage within and along the margins of the surgical cavity, including within presumably residual tumor, although noncontrast CT is limited for the evaluation of residual tumor. There are multiple surgical clips in the surgical bed. There is slight interval decrease in the hemorrhage and vasogenic edema surrounding the surgical cavity. There is also interval decrease in the pneumocephalus. The right-sided ventriculostomy catheter is in unchanged position and the right lateral ventricle is collapsed. There is a small amount of intraventricular hemorrhage in the left lateral ventricle. The visualized paranasal sinuses and mastoid air cells are clear. The extracranial structures are unchanged. | Expected interval evolution of postoperative findings in the posterior fossa with mild interval decrease in hemorrhage, edema, and pneumocephalus. |
Generate impression based on findings. | History of head and neck cancer. LUNGS AND PLEURA: Stable 5-mm pulmonary micronodule in left lower lobe (series 5 image 118). Scattered punctate micronodules, some of which are calcified, are stable and presumably postinflammatory. No new pulmonary nodules.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Coronary calcification. Small focus of air in left brachiocephalic vein presumably related to power injection. Scattered small subcentimeter lymph nodes are unchanged.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. The previously noted left adrenal nodule is not completely included within the field of view. | Stable small left lower lobe 5-mm micronodule which is much more likely to represent a post inflammatory nodule than metastatic disease, however continued follow-up is recommended. |
Generate impression based on findings. | Female 59 years old; Reason: lung cancer s/p 6 cycles of chemo. please evaluate for disease adn compare with previous scans History: lung cancer. CHEST:LUNGS AND PLEURA: There has been continued interval decrease in the size of the right lower lobe mass which now measures 3.5 x 4.4 cm (series 5, image 62), previously 3.8 x 4.7 cm. A reference left upper lobe nodule measures 2 x 3 mm (series 5, image 31), previously measured 5 x 5 mm which is again smaller. Near resolution of the previously described right middle lobe patchy round glass opacities and airspace opacities with only residual involvement in the very inferior aspect of the right middle lobe. Vague patchy nodular consolidation in the right lung base is also significantly improved with only residual remaining.MEDIASTINUM AND HILA: Continued interval reduction in the size of the mediastinal lymphadenopathy with reference subcarinal lymph node measuring 7 millimeters in short axis (310 image 42), previously measured 10 mm. Again seen are mild coronary artery calcifications. No cardiomegaly or pericardial effusion.CHEST WALL: Anterior compression deformity of L2 not significantly changed from previous exam. Sclerotic focus in the anterior aspect of L4 was present previously likely representing a bone island. A similar punctate density in the T8 posteroinferior vertebra is too small to characterize.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: Calcific atherosclerotic changes of the abdominal aorta with mural thrombus, unchanged. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Continued reduction in the right lower lobe mass, left upper lobe reference lesion, and mediastinal lymphadenopathy.2.Interval near resolution of the right middle lobe ground glass/airspace opacities, likely from infection. |
Generate impression based on findings. | Reason: ground glass opacities seen on previous CT, recovery from sepsis History: ground glass opacities on prior CT LUNGS AND PLEURA: Significant interval increase in nodular and groundglass opacities in both lungs with new bilateral pleural effusions. Marked increase in interlobular septal thickening as well as new left upper lobe consolidation. Right apical pleural and parenchymal fibrotic changes.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Mild cardiac enlargement without evidence of a pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy.Dobbhoff tube with its tip in the stomach. | 1.Significant interval increase in nodular and groundglass opacities in both lungs , interlobular septal thickening, and new left upper lobe consolidation with bilateral pleural effusions. Findings are consistent with infection which may be atypical in origin. 2.Probable concomitant CHF/volume overload. |
Generate impression based on findings. | Chronic lymphoid leukemia without mention of having achieved admission CHEST:LUNGS AND PLEURA: Stable 11-mm peripherally calcified apical nodule (image 33, 6). Adjacent cystic apical lesion with some layering debris may represent a bronchocele and is unchanged. Few small subpleural nodules grossly unchanged. No new nodules noted. No pleural effusion.MEDIASTINUM AND HILA: Previously described near occlusive thrombus along the course of the left-sided Port-A-Cath is not seen on today's imaging. Interval removal of left-sided Port-A-Cath. Right-sided Port-A-Cath in appropriate location of the junction of right atrium and SVC. Referenced right paratracheal lymph node measures 1 x 1.3 cm (image 35, 4), previously measured 2 x 2.6 cm, decreased in size.Mild pericardial effusionCHEST WALL: Interval decrease in bilateral axillary lymphadenopathy. Referenced right axillary lymphadenopathy measures 1.2 x 1 .1 cm, previously measured 1.7 x 1.5 cm (image 27, 4).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: Diffuse retroperitoneal lymphadenopathy has decreased in size. Referenced lymph node measures 2.3 x 1 .2 cm, previously measured 3 x 1.7 cm (image 158, 4).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Interval decrease in pelvic lymphadenopathy. Referenced left inguinal lymph node measures 1.3 by 2.2 cm, previously measured 1.8 x 2.8 cm (image 200, 4). Other external and inguinal lymph nodes have also decreased in size.BOWEL, MESENTERY: No significant abnormality noted BONES, SOFT TISSUES: No significant abnormality notedOTHER: No evidence of ascites | Interval decrease in mediastinal, abdominal and pelvic lymphadenopathy.Stable partially calcified left apical lung nodule.No new sites of disease |
Generate impression based on findings. | 66-year-old male with history of subdural hemorrhage. There is an unchanged holohemispheric left subdural collection tracking along the falx and tentorium measuring up to 10 mm in thickness. There is unchanged effacement of the left hemispheric cortical sulci and mild left to right midline shift. There is effacement of the occipital horn of the left lateral ventricle which is not significant changed, the ventricles and basal cisterns are otherwise normal in size and configuration. The osseous structures are unremarkable. The imaged paranasal sinuses and mastoid air cells are clear. | Unchanged holohemispheric left subdural collection with associated midline shift and effacement of the cortical sulci. |
Generate impression based on findings. | History of recurrent laryngeal cancer. Evaluate for distant metastases. CHEST:LUNGS AND PLEURA: Minimal scarring or atelectasis in the right middle lobe. This could also be the result of aspiration. The appearance is not typical of metastatic disease. Minimal emphysema.MEDIASTINUM AND HILA: Coronary calcification, status post CABG. Scattered small subcentimeter lymph nodes.CHEST WALL: Degenerative change involving the spine. Status post median sternotomy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Gallbladder sludge.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: Atherosclerotic calcification of the aorta and its branches. Scattered small subcentimeter upper abdominal lymph nodes.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Possible small lipoma in the transverse duodenum (image 132/159).BONES, SOFT TISSUES: Degenerative change involving the spine.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | 39-year-old male with pancreatic cancer, restaging exam. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Right port catheter extends to the SVC. No mediastinal adenopathy.CHEST WALL: Right chest wall port.ABDOMEN:LIVER, BILIARY TRACT: Diffuse hepatic steatosis. Segment 4 hypoattenuating lesion measures 1.5 x 1.0 cm (image 23, series 9) and previously measured 1.5 x 1.0 cm. Peripheral wedge-shaped hyperdensity in the right hepatic lobe appears similar to the prior study and likely represents focal fat sparing. Cholelithiasis. The gallbladder is collapsed.SPLEEN: No significant abnormality notedPANCREAS: Pancreatic mass measures 3.3 x 4.1 cm (image 92, series 12) and previously measured 3.8 x 4.7 cm, mildly decreased in size from the prior study. Infiltration of the surrounding mesentery suggests local invasion. There is encasement of the SMA, SMV and proximal splenic artery. The splenic vein is not visualized and likely occluded.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal sub-centimeter lymph nodes are 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. | Mild interval decrease in size of locally invasive pancreatic mass as detailed above. |
Generate impression based on findings. | Laryngeal cancer s/p surgical excision and PORT completed on 10/2012. There is a right transglottic mass that measures approximately 30 AP x 21 RL x 30 SI mm. The mass extends to the anterior commissure and along the inferior aspect of the right aryepiglottic fold, which otherwise appears swollen with edema. There is sclerosis of the right arytenoid cartilage. There is also mild widening of the right thyroarytenoid space, but no definite tumor extension into the post-cricoid space. The thyroid cartilage appears to be grossly intact. There is no evidence of subglottic extension. The left vocal cord and epiglottis are unremarkable. There is no significant cervical lymphadenopathy by size criteria. The thyroid gland and major salivary glands are unremarkable. There is moderate atherosclerotic plaque at the bilateral carotid bifurcations. The imaged portions of the intracranial structures and orbits are unremarkable. The imaged paranasal sinuses and mastoid air cells are clear. | 1. The recurrent right transglottic squamous cell carcinoma measures approximately 30 AP x 21 RL x 30 SI mm. The mass extends to the anterior commissure and along the inferior aspect of the right aryepiglottic fold with sclerosis of the right arytenoid cartilage and mild widening of the right thyroarytenoid space, but no definite tumor extension into the post-cricoid space. 2. No evidence of significant cervical lymphadenopathy. |
Generate impression based on findings. | 78-year-old male with acute mental status changes. There are mild scattered white matter hypodensities and a hypodense lesion of the left caudate nucleus which is consistent with a lacunar infarct of indeterminate age. There is no evidence of intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration. The calvaria and skull base are radiographically normal. There is scattered mucosal thickening of the paranasal sinuses. The mastoid air cells are clear. | 1. Lacunar infarct of the left caudate nucleus of indeterminate age. Dedicated MR imaging could be considered if clinically relevant.2. No evidence of intracranial hemorrhage or mass lesions. |
Generate impression based on findings. | 9-year-old female with female with VP shunt who presents with status epilepticus Motion artifacts degrades images at the vertex.No evidence of acute intracranial hemorrhage, edema or mass. Redemonstrated are nonspecific punctate calcifications in the right frontal lobe.Stable left posterior parietal VP shunt catheter with tip terminating near the midline at the level of the third ventricle. No evidence of discontinuity or kinking of the catheter. The ventricles and basal cisterns are unchanged in size or configuration.Left posterior parietal burr hole. Otherwise, the calvaria and skull base are radiographically within normal limits. The previously demonstrated opacification of the dependent left mastoid air cells has resolved. The right mastoid air cells are well-pneumatized. Both orbits are within normal limits. | No significant interval change with stable left posterior parietal shunt catheter and ventricular system. |
Generate impression based on findings. | 54-year-old female patient with non-Hodgkin's lymphoma. Evaluation for interval change. CHEST:LUNGS AND PLEURA: No lung nodules or effusions.MEDIASTINUM AND HILA: No pathologically enlarged lymph nodes. Interval removal of central venous catheter.CHEST WALL: Interval removal of Port-A-Cath in left chest wall. No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly, measuring 20 cm in craniocaudal dimension. Mild diffuse hypoattenuation consistent with fatty infiltration.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No pathologically enlarged lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted | 1.No pathologically enlarged lymph nodes. Stable examination.2.Fatty, enlarged liver. |
Generate impression based on findings. | 65 year-old female with right lower quadrant pain 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 significant abnormality noted.RETROPERITONEUM, LYMPH NODES:No significant abnormality noted.BOWEL, MESENTERY: Large hiatal hernia. The small bowel is normal in caliber. The appendix is not visualized.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: A collapsed segment of transverse colon is incompletely evaluated, and likely represents peristalsis, although correlation with colonoscopy is suggested.BONES, SOFT TISSUES: Moderate degenerative change worst at L5/S1.OTHER: No significant abnormality noted. | 1. No specific findings to account for the patient's pain. 2. Collapsed segment of transverse colon which is incompletely evaluated but could be correlated with colonoscopy if clinically warranted.3. Hiatal hernia. |
Generate impression based on findings. | History of metastatic thyroid cancer. CHEST:LUNGS AND PLEURA: Multiple subcentimeter bilateral pulmonary nodules are not significantly change. The reference left upper lobe nodule measures 7 x 7 mm on image 64/102 (8 x 7 mm on prior). Emphysema. Postop change from left lower lobectomy.Bronchial wall thickening with clustered centrilobular nodules and tree in bud opacity in the superior segment of the right lower lobe (image 45/102) suggestive of aspiration bronchiolitis.MEDIASTINUM AND HILA: Status post thyroidectomy. No pathologically enlarged nodes are present.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Punctate hepatic hypodensities are too small to characterize but stable. Gallbladder sludge versus stones.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable presumed renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered small upper abdominal lymph nodes are unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable pulmonary metastases. New opacities in the right lower lobe suggestive of aspiration bronchiolitis, continued follow up is recommend |
Generate impression based on findings. | 43-year-old male with abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appendix. Poor small bowel distention, but no evidence of wall thickening/inflammation. The terminal ileum is unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appendix. Poor small bowel distention, but no evidence of wall thickening/inflammation. The terminal ileum is unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No specific findings to account for the patient's abdominal pain. No evidence of inflammation. |
Generate impression based on findings. | Female 74 years old; Reason: 74F w/ h/o intraabdominal abscess, likely perforated appendicitis, s/p IR drain placement; please assess resolution of abscess History: intraabdominal abscess, IR drain in place ABDOMEN:LUNGS BASES: Bibasilar atelectasis noted. Coronary artery calcifications.LIVER, BILIARY TRACT: The liver is normal in morphology. Gallstone noted in the gallbladder without inflammatory change.SPLEEN: No significant abnormality noted.PANCREAS: Mild prominence of the pancreatic duct, nonspecific.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 1.5-cm complex cystic lesion midpole right kidney incompletely characterized and unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval placement of a right lower quadrant drain. Inflamed soft tissue planes with no measurable fluid collection present. No new abscess or free air noted. No obstruction seen. Reactive ileus has resolved. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval placement of a right lower quadrant drain. Inflamed soft tissue planes with no measurable fluid collection . No new abscess or free air. No obstruction seen. Reactive ileus has resolved. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Interval placement of a right lower quadrant drain with no measurable fluid collection.. 2. Interval resolution of the previously noted ileus. |
Generate impression based on findings. | 54-year-old male patient with history of renal cell cancer status post right partial nephrectomy. Evaluate for recurrence of renal cancer. 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: Status post partial right nephrectomy without evidence of residual lesion. No hydronephrosis or perinephric fluid collection.Left kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: Small retroperitoneal lymph nodes unchanged compared to prior examination.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted | Status post right partial nephrectomy without evidence of residual lesion. |
Generate impression based on findings. | 67-year-old male with neurologic symptoms, assess for aortic dissection. CHEST:LUNGS AND PLEURA: Calcified nodules compatible with prior granulomatous disease. Cluster of left lower lobe cysts is unchanged since 2009.MEDIASTINUM AND HILA: Moderate atherosclerotic calcification of the aortic arch. No evidence of aortic dissection or aneurysm.Severe coronary disease status post CABG.Calcified mediastinal and hilar lymph nodes compatible with prior granulomatous disease.CHEST WALL: Sternal fixation wires.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. Several hypoattenuating hepatic lesions, likely represent cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No evidence of aortic aneurysm or dissection. Moderate atherosclerotic calcification and plaque of the abdominal aorta and its branches including the origin of the SMA, left renal artery and IMA without evidence of occlusion. There is moderate narrowing at the origin of the left renal arteries. Symmetric renal cortical enhancement.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. No evidence of aortic aneurysm or dissection. Moderate atherosclerotic calcification and plaque of the thoracic and abdominal aorta as detailed above.2. Severe coronary artery disease, status post CABG.3. Cholelithiasis. |
Generate impression based on findings. | Sarcoidosis and dizziness. Head: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is thinning and perhaps dehiscence of the floor of the sella, which appears to be partially empty. The extracranial soft tissues are unremarkable. Temporal Bones: The bilateral external auditory canals are patent and clear. The bilateral middle ears and mastoid air cells are well-pneumatized and clear. The ossicular chains are intact bilaterally. The bilateral facial nerve describe a normal course, but appear to be dehiscent along the tympanic segments. The inner ear structures are unremarkable bilaterally.Maxillofacial: There is a small left maxillary sinus retention cyst and minimal mucosal thickening within the right maxillary sinus. There is complete opacification of the posterior ethmoid sinus air cell. The sphenoid sinuses are clear. The nasal cavity is clear and there is no significant nasal septal deviation. The orbits are unremarkable. | 1. No evidence of intracranial hemorrhage, mass, or cerebral edema. However, MRI with contrast is more sensitive for subtle manifestations of neurosarcoidosis.2. Unremarkable temporal bones.3. Mild scattered paranasal sinus opacification in a sporadic pattern. |
Generate impression based on findings. | 68 year-old female patient with history of renal cell carcinoma status post partial nephrectomy with pseudoaneurysm and embolization. Evaluate for recurrence of RCC. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Hepatomegaly with hypoattenuating parenchyma. There is a subcentimeter hypoattenuating focus within the right hepatic lobe adjacent to the gallbladder fossa that is too small to characterize (series 10, image 60). Cholelithiasis without evidence of cholecystitis or ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post left partial nephrectomy without evidence of definite residual mass. Redemonstration of embolization coils in the left upper pole. No perinephric fluid collection or hydronephrosis. No extravasation of contrast on delayed images.RETROPERITONEUM, LYMPH NODES: Stable prominent retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Redemonstration of right hip arthroplasty.OTHER: No significant abnormality noted. | 1.Status post left partial nephrectomy and embolization coil placement without definite evidence of residual renal mass.2.Hypoattenuating focus within the liver that is too small to characterize.3.Fatty, enlarged liver. |
Generate impression based on findings. | CLL s/p MUD. There are a few scattered mildly prominent cervical lymph noes with effacement of the fatty hila. For example, a left level 2B lymph node measures 12 x 12 mm (image 39, series 8) and a right level 5 lymph node measures 11 x 9 mm (image 51, series 8). Thre is also prominence of several bilateral axillary lymph nodesThe thyroid gland and major salivary gland are unremarkable. The Waldeyer ring structures are not significantly enlarged. The aerodigestive track is patent. There is a right subclavian catheter. The major cervical vessels are otherwise patent. There is multilevel degenerative spondylosis, but no lytic or blastic lesions. The imaged portions of the intracranial structures and orbits are grossly unremarkable. There is a partially calcified left apical nodule that measures up to 11 mm. Refer to the separate chest CT report for additional details. | 1. Several scattered mildly prominent cervical and axillary lymph nodes suggest residual involvement with leukemia or perhaps graft versus host disease.2. Partially calcified left apical nodule that measures up to 11 mm. Refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 24 year-old male, non-Hodgkin's lymphoma. Restaging. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Index paratracheal lymph node measures 1.1 x 0.5 cm (image 27, series 3) and previously measured 1.1 x 0.5 cm, unchanged. Additional scattered small mediastinal lymph nodes are unchanged. Anterior mediastinal tissue is unchanged, likely representing thymic tissue.CHEST WALL: No significant abnormality notedABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse hepatic steatosis and hepatomegaly are again noted.SPLEEN: Small splenule is unchanged. Moderate splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Small bilateral inguinal lymph nodes are unchanged. No new lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. No evidence of new lymphadenopathy with unchanged reference measurements as detailed above.2. Hepatic steatosis. |
Generate impression based on findings. | 39-year-old female, evaluate for kidney stones. 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: Bilateral nephrolithiasis that is increased on the right. Nephrocalcinosis is again noted. No hydronephrosis. Gas is noted in both collecting systems. Post surgical change consistent with ureterosigmoidostomies with dilated gas-filled ureters extending to the colon. No perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post surgical change of right hemicolectomy again 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: Fluid-filled rectum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral nephrolithiasis and nephrocalcinosis, with increase in stone burden on the right and persistent gas within the collecting system. |
Generate impression based on findings. | DLBCL s/p R-CHOP. There are stable postoperative findings related to left lateral 5 neck dissection with an unchanged 4 mm soft tissue nodule adjacent to the surgical clips. Otherwise, there is no significant lymphadenopathy by size criteria. The Waldeyer ring structures are not significantly enlarged. No mass lesions are identified. The thyroid gland and major salivary glands are unremarkable. The airway appears patent. The major cervical vessels are patent. There are no lytic or blastic lesions. The aerodigestive track is unremarkable. The imaged portions of the orbits and intracranial structures are intact. The paranasal sinuses and mastoid air cells are clear. The imaged lung apices appear clear. | No evidence of recurrent mass lesions or significant cervical lymphadenopathy by CT size criteria. |
Generate impression based on findings. | Reason: mesothelioma, s/p 2 cycles of immunotherapy. please evaluate for disease and compare with previous scans History: mesothelioma CHEST:LUNGS AND PLEURA: Significant interval increase in the pleural and pulmonary nodules throughout both lungs.Left lower lobe nodule (image 46 series 4) now measuring 14 mm x 14 mm previously this measured 6 mm x 7 mm.Left upper lobe nodule (image 46 series 4) measures 9 mm x 7 mm previously this measured 5 mm x 4 mm.Multiple new right lower lobe pulmonary nodulesincreased nodular right pleural thickening with reference lesions :1. At the level of the aortic arch (image 33 series 3) at the 4 o'clock position pleural thickening measures 13 mm previous and measuring 12 mm.2. At the level of the atrium (image 57 series 3) at the 8 o'clock position pleural thickening measures 21 mm previously measuring 16 mm.Loculated right -sided hydropneumothorax with an increase in the amount of pleural fluid. Right pleural patch.MEDIASTINUM AND HILA: Stable mediastinal and hilar lymphadenopathy with index right hilar lymph node (image 45 series 3) measuring 22 mm and previously the same. Other large subcarinal right paratracheal and anterior mediastinal lymph nodes are stable the increase in size.Left chest port with catheter tip in the SVC.CHEST WALL: Interval increase in the extra thoracic right chest wall metastases (image 76 series 3).Degenerative changes throughout the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic hypodensities unchanged. Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal cysts without interval change.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality.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.Interval increase in size and number of multiple pulmonary nodules with increasing right pleural nodularity/thickening compatible with progression of metastatic disease.2.Stable increase in mediastinal and hilar lymphadenopathy.3.Increasing right chest wall, extrathoracic metastases.4.Loculated right hydropneumothorax with increasing right pleural fluid. |
Generate impression based on findings. | Reason: mesothelioma, s/p 2 cycles of chemo. please evaluate and compare with outside scan. History: mesothelioma CHEST:LUNGS AND PLEURA: Lobulated right sided enhancing pleural thickening consistent with known mesothelioma, compressing the right lung particularly in the basilar region. A right pleural effusion is present and a pleural catheter is in place.Represented measurements are as follows:1. 14 mm 4 o'clock position and 21 mm 9 o'clock position, level of the top of the aortic arch image 26 series 3.2. 16 mm 2 o'clock position adjacent to the ascending aorta, image 42 series 3.3. 9 mm 6 o'clock position right lung base, image 70 series 3.MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes are present, some enhancing but none abnormally enlarged.Severe coronary artery calcifications are present as well as the aortic root.CHEST WALL: There is no evidence of penetration of tumor through the chest wall.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholecystectomy clips are present.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Mild nodularity right adrenal gland.KIDNEYS, URETERS: Small renal cystlike hypodensities in nonobstructing calculus are present.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive aortic calcifications are seen.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Retained radiodense material is seen in the cecum and there are numerous colonic diverticula.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Right-sided mesothelioma with measurements provided above. |
Generate impression based on findings. | Reason: Evaluate for progression of metastatic disease; compare to previous scan. History: none CHEST:LUNGS AND PLEURA: Previously noted focal groundglass opacity in the superior segment of the left lower lobe (image 50/109) is now relatively solid and measures 11 mm. A similar appearing nodule is also noted in the superior segment of the left lower lobe more medially (43/109) is also now more solid. Subpleural scar like opacity in the right upper lobe (image 43 since 19) is unchanged. Other scattered punctate micronodules are unchanged (right lower lobe image 57/109, left lower lobe partially obscured by atelectasis image 78/109).MEDIASTINUM AND HILA: Reference left paratracheal lymph node is stable at 9 mm (image 27/158).CHEST WALL: Bilateral breast implants.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: Degenerative change involving lower lumbar spine.OTHER: No significant abnormality noted. | Two ground glass nodules in the left lower lobe from 7/2/2013 scan have become solid and are suspicious for metastatic disease. |
Generate impression based on findings. | Female 59 years old; Reason: pt with metastatic breast cancer History: pt with metastatic breast cancer CHEST:LUNGS AND PLEURA: Bilateral pleural effusions have resolved. The pleural nodularity representing metastatic disease to the pleura has improved. No dominant parenchymal lung lesion with the nodularity predominately involving the pleura.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion or mediastinal lymphadenopathy.CHEST WALL: Osseous metastatic disease to the thoracic spine. Left breast mass has decreased in size with adjacent soft tissue thickening.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nodularity of the left adrenal gland.KIDNEYS, URETERS: Left renal cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Osseous metastatic disease to the lumbar spine.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: Metastatic disease to the pelvic osseous structures.OTHER: No significant abnormality noted. | 1.Resolution of the pleural effusions with multiple areas of pleural nodularity suspicious for metastatic disease.2.Osseous metastatic disease. |
Generate impression based on findings. | Reason: History of metastatic breast cancer on treatment. Evaluate for response and extent of disease. History: History of metastatic breast cancer on treatment. Evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary metastases are stable. The previously referenced left lower lobe subpleural nodule measures 8 mm (image 31, series 5), previously 8 mm. The previously referenced right lower lobe nodule measures 4 mm (image 45), previously 4 mm. MEDIASTINUM AND HILA: Reference calcified prevascular lymph node measures 6 mm, unchanged (image 28/136).CHEST WALL: Status post bilateral mastectomy and axillary lymph node dissection. No evidence of axillary lymphadenopathy. Diffuse sclerosis of T4 is unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Right hepatic metastasis is stable 9 x 8 mm on image 98/136 (9 x 8 mm on prior).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: Sclerotic focus in L2 is unchanged and likely represents a metastasis. Punctate focus of sclerosis in L3 is too small to characterize but unchanged.OTHER: No significant abnormality noted. | Stable pulmonary, hepatic and osseous metastases. |
Generate impression based on findings. | 33-year-old malignant lymphomas unspecified site, external, and solid organ sites. Large diffuse B-cell lymphoma staging examination CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Referenced pretracheal lymph node measures 0.9 x 1 cm (image 33, 3), previously measured 1 x 1.1 cm, was unchanged. Confluent lymphadenopathy in the anterior mediastinum has reduced from prior study.Trace right pericardial effusion.CHEST WALL: Tip of Port-A-Cath at the junction of right atrium and SVC.Normal size left cardiophrenic lymph node.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of mediastinal or abdominal lymphadenopathy. No new sites of disease. |
Generate impression based on findings. | Male 70 years old; Reason: bladder cancer- s/p cystectomy f/u from September 2013 CT scans- pelvic fluid collection History: bladder cancer- s/p cystectomy CHEST:LUNGS AND PLEURA: Calcific pleural plaques are unchanged. No suspicious pulmonary lesion.MEDIASTINUM AND HILA: Patulous esophagus.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic native kidneys with hyperdense material filling the right ureter.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of aorta.BOWEL, MESENTERY: Post operative changes in the small bowel with ileal conduit reconstruction.BONES, SOFT TISSUES: Right lower abdominal ostomy. Persistent soft tissue thickening in the lower mid abdomen. The gas and fluid portion has nearly resolved.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: CystoprostatectomyBLADDER: CystoprostatectomyLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Right iliac fossa renal allograft without hydronephrosis.The fluid collection in the pelvis has decreased in size measuring approximately approximately 2.9 x 1.8 cm (image 187/series 4) previously, 4.5 x 3.7 cm. | 1.Decrease in the body wall and pelvic fluid collections. |
Generate impression based on findings. | Male 77 years old; Reason: 77M s/p cystectomy and ileal conduit, transferred from OSH with abscess adjacent to bowel anastomosis in distal ileum, r/o bowel leak History: para-anastomotic abscess ABDOMEN:LUNGS BASES: Bibasilar atelectasis noted. Small bilateral pleural effusions, left greater than right.LIVER, BILIARY TRACT: The liver is normal in morphology. Mild perihepatic ascites is noted. No focal lesion detected.Patient is status post cholecystectomy. SPLEEN: Small granuloma noted in the spleen. No focal lesion detected.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The patient is status post cystoprostatectomy with ileal conduit.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is inflammatory changes with foci of gas at to the bowel to bowel anastomosis site in the right lower quadrant. No oral contrast is seen extravasating into peritoneum, however adjacent findings are suspicious for small bowel leak. No definite drainable fluid collection . No bowel obstruction .BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Wound dehiscence is seen in the midline abdominal wall. PELVIS:BLADDER: Patient status post cystoprostatectomy with ileal conduit. No residual tumor or infiltrating mass detected. LYMPH NODES: 1.7 x 1.5 cm left common iliac chain node (series 4 image 94).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a trace amount of Fluid layering in the cul-de-sac | 1. Inflammatory changes with foci of gas at the bowel-bowel anastomosis site without extravasation of oral contrast. Adjacent findings are concerning for small bowel leak.2. Wound dehiscence in the midline abdominal wound.3. Left common iliac chain node as described above. |
Generate impression based on findings. | Reason: pt with mesothelioma s/p chemo and resection > 6 months ago History: doing well now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Postop change in the left hemithorax with volume loss and leftward mediastinal shift. Minimal residual left-sided pleural fluid with a small focus of air in the apex. Scattered peripheral areas of scarring or atelectasis, unchanged. No new pulmonary nodules.MEDIASTINUM AND HILA: Portcatheter tip at RA/SVC junction. No pathologically enlarged mediastinal nodes are present. Coronary calcification. CHEST WALL: Right chest wall port. Healing left-sided rib 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: Nonspecific subcentimeter renal hypodensities are too small to characterize but 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. | Postop change but no evidence of measurable disease. |
Generate impression based on findings. | Malignant neoplasm of upper lobe lobe, bronchus or lung CHEST:LUNGS AND PLEURA: Referenced right upper lobe solid nodule but typically margins measures 9 x 8 mm (image 148, 5), previously measured 13 x 10 mm, minimally reduced in size from prior study. Small metallic clip identified within the nodule. Stable apical and interlobar emphysema redemonstrated. Lingular atelectasis noted.Stable left apical scarring noted.MEDIASTINUM AND HILA: Multiple small normal sized pretracheal, AP window lymph nodes noted. Atherosclerotic changes of the thoracic aorta and coronary arteries noted.CHEST WALL: Sternotomy wires noted over the midline.Metallic structure along the right medial chest within the subcutaneous tissue that courses through the chest laterally and terminates substernally, represents portion of a prior epicardial lead from surgery, unchanged since at least 3/2012.ABDOMEN:LIVER, BILIARY TRACT: Few small hypodensities in the liver are too small to further characterize. No focal lesions noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal nodule measures 2.3 x 2 cm (image 91, 3) a previously measured 2.3 x 2.1 cm.KIDNEYS, URETERS: Vascular catheter is noted. Few areas of chronic scarring identified bilaterally. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Extensive atheromatous calcifications of the tortuous abdominal aorta without aneurysmal dilatation.Stable portacaval lymph node measures 17 x 10 mm, previously measured 17 x 12 mm (103, 3). This is mostly a nonspecific findingBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Surgically absent or atrophicBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Fem-fem bypass graft patent | Interval decrease in right upper lobe spiculated mass.Stable left adrenal lung nodule, previously, thought to be an adenoma.Extensive atherosclerotic changes in thoracic or abdominal aorta and its branches |
Generate impression based on findings. | Reason: mesothelioma s/p 2 cycles of chemo. please evaluate for disease and compare with previous scans using the same target lesions History: mesothelioms CHEST:LUNGS AND PLEURA: Left hemithorax volume loss. Circumferential left pleural nodular thickening, more extensive at the lung base.Reference measurements are as follows:1.At the level of the diaphragm in the 4 o'clock position, a soft tissue nodule measures 4.3 x 2.6 cm (series 3, image 93), previously 4.3 x 2.6 cm.2.At the level of the main pulmonary artery in the 10 o'clock position, nodular pleural thickening measures 8 mm (series 3, image 47), previously 9 mm.3.Along the medial crus of the left hemidiaphragm in the 8 o'clock position, a soft tissue nodule measures 3.0 x 2.0 cm (series 3, image 103), previously 3.0 x 1.9 cm.Loculated left pleural effusion has decreased in size.Bilateral calcified granulomas.MEDIASTINUM AND HILA: Coronary calcification.CHEST WALL: Degenerative involving the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Soft tissue mass is abutting the left adrenal gland associated with the crus of the diaphragm. Measurements are above.KIDNEYS, URETERS: Stable left renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable reference measurements. Interval decrease in left pleural effusion. |
Generate impression based on findings. | Patient with cognitive decline. History of diabetes and hypertension. Assess for cerebrovascular disease. There is prominent sulcal and ventricular spaces in keeping with global atrophic change. There is no intracranial mass, fluid collection, hemorrhage, hydrocephalus or CT evidence of acute ischemia. Gray-white matter differentiation is maintained bilaterally and the midline is intact. Orbits and visualized portions of paranasal sinuses and mastoid air cells are unremarkable. There are no visualized bony abnormalities. | Atrophic change without any focal lesion or abnormality. |
Generate impression based on findings. | Reason: f/u LLL nodule in pt w/ tobacco use history History: dyspnea on exertion LUNGS AND PLEURA: 5-mm smoothly marginated solid subpleural nodule in the left lower lobe (series 4 image 49), unchanged since the previous scan and also since an earlier scan of 2006. Additional subpleural micronodules and scarlike opacities are also unchanged.Mild subpleural reticular and cystic abnormalities in the upper lobes, greater on the left, consistent with fibrosis, unchanged.No suspicious nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.Severe coronary and aortic calcification.Transvenous pacemaker with leads extending to the area of the right atrial appendage and right ventricular apex.CHEST WALL: Degenerative disease in the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis and splenic calcifications. | Stable very small pulmonary nodules consistent with previous infection. No suspicious nodules. |
Generate impression based on findings. | Nasal congestion, h/o polyps s/p sinus surgery. The paranasal sinuses are clear. There is evidence of prior right concha bullosa decompression. The nasal cavity is clear. There is mild nasal septal deviation to the right. The right ethmoid roof is 3 mm lower than the left ethmoid roof. The optic canals and carotid grooves are covered by bone. The imaged portions of the intracranial structures and orbits are unremarkable. | Clear paranasal sinuses and nasal cavity. |
Generate impression based on findings. | Reason: r/o growth of lesions History: h/o thyroid cancer with small mets to lung LUNGS AND PLEURA: Innumerable very small nodules are present bilaterally. The reference nodules are stable measuring 6 mm in the right lower lobe (series 5 image 80) and 7 mm in the left lower lobe (series 5 image 73). No new pulmonary nodules.MEDIASTINUM AND HILA: Postop change involving the neck. Small anterior mediastinal soft tissue nodule versus lymph node is stable at 9 mm on image 48/110.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Stable pulmonary metastases. |
Generate impression based on findings. | NHL intermediate between HL and large B cell lymphoma, stage IIIA, IPI2,refractory to upfront chemotherapy, then treated with BEAM +autologous SCT (day0=7/23/12) and consolidative radiation to the R neck to 46 Gy in 2Gy fxs completed on 10/11/12. There are numerous abnormal cervical lymph nodes, which are stable to slightly decreased in size. For example, a right level 2B lymph node measures 10 x 16 mm (image 32, series 7), previously 10 x 16 mm, a right level 5 lymph node measures 8 x 11 mm (image 44, series 7), previously 9 x 13 mm, and a right level 3 lymph node measures 7 x 7 mm, previously 9 x 9 mm. The associated surrounding fat stranding associated with some of the lymph nodes has also decreased somewhat. The Waldeyer ring structures are unremarkable. The airways are patent. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There no lytic or blastic lesions. The imaged portions of the intracranial structures and orbits are unremarkable. | Numerous abnormal cervical lymph nodes related to NHL are overall stable to slightly decreased in size. |
Generate impression based on findings. | Reason: progression of bronchiectasis, nodules History: cough LUNGS AND PLEURA: Interval increase in the bronchiectasis and bronchiolitis in the right middle lobe with partial atelectasis and consolidation.Multiple small smoothly marginated pulmonary nodules measuring up to 8 mm, unchanged and presumably benign common.Anterior subpleural scarring in the left upper lobe with mild bronchiectasis suggestive of radiation reaction and benign type calcification in the left breast, unchanged.MEDIASTINUM AND HILA: Mildly enlarged mediastinal lymph nodes, unchanged and likely reactive.Moderately severe coronary artery calcifications.Moderately ectatic descending aorta, unchanged.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Presumed hemangioma in the left lobe of the liver, unchanged. | Interval increase in extent of bronchiectasis and bronchiolitis in the right middle lobe.Mild traction bronchiectasis in the lingula, unchanged. |
Generate impression based on findings. | Headache and blurred vision following motor vehicle accident on 9/19/2013. There is no evidence of intracranial hemorrhage, mass, or hydrocephalus. The ventricles are stable in size and configuration. The imaged paranasal sinuses and mastoid air cells are clear. There is an unchanged linear focus of subcutaneous soft tissue in the left occiput, which likely represents scar. There are no perfusion deficits. | No evidence of intracranial hemorrhage, mass, or hydrocephalus. No cerebral perfusion deficits.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 79 years old; Reason: prostate cancer, evaluation of disease after 54 days of investigational drug History: prostate cancer, ABDOMEN:LUNGS BASES: No pleural effusions. Lung bases are clear.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: Calcific arteriosclerotic disease of the aorta.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes, unchanged. BOWEL, MESENTERY: Large hiatal hernia with large portion of the stomach within the chest.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: Small pelvic lymph nodes are unchanged.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Sclerotic lesion involving the left superior pubic ramus. Post operative changes from a total right hip arthroplasty.Degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted. | 1.Sclerotic metastases to the left superior pubic ramus without evident change.. |
Generate impression based on findings. | Male 40 years old; Reason: evaluate hernia versus seroma History: inguinal bulge PELVIS:PROSTATE/SEMINAL VESICLES: ProstatectomyBLADDER: CystectomyLYMPH NODES: No evident pelvic lymphadenopathy. BOWEL, MESENTERY: Post operative changes in the ileum.BONES, SOFT TISSUES: Small amount of fluid in the right inguinal area that extends to the neobladder.OTHER: No significant abnormality noted. | 1.No evident lymphadenopathy. Post operative changes and fluid along the right inguinal region without herniation that extends to the neobladder and is likely part of the neobladder. |
Generate impression based on findings. | Reason: mesothelioma s/p chemotherapy on observation since 2010, eval EOD, compare to previous History: none CHEST:LUNGS AND PLEURA: Scarring and bronchiectasis at the right lateral lung base is unchanged. Scattered punctate micronodules are also unchanged. Emphysema. Minimal perifissural thickening or scarring on the right (image 54/117) is unchanged.Reference pleural measurement on the right at the level the coronary sinus 12 o'clock 3 mm, unchanged (image 74/148).MEDIASTINUM AND HILA: Postop change on the right. Reference precarinal lymph node stable at 16 x 13 mm on image 43/148. Reference right periesophageal lymph node stable 11 mm on image 10/148. Other scattered small lymph nodes are also unchanged.CHEST WALL: Unchanged presumably benign punctate soft tissue nodule on the right (image 41/148). Degenerative involving the thoracic spine. Punctate sclerotic focus in T11 unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable hepatic cyst.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Still presumed left renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification 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. | Stable CT with no definitive evidence of recurrent pleural disease. Stable adenopathy. |
Generate impression based on findings. | Reason: 75 yo M w/ T2a N3 M0 RML lung adenocarcinoma s/p chemoRT with completion in 11/2012 with hsitory of post-treatment radiation pneumonitis. Please compre to prior scans for disease status and signs fo pneumonitis History: lung cancer post-treatment surveillance CHEST:LUNGS AND PLEURA: Dense right perihilar and paramediastinal radiation reaction with architectural distortion and consolidation, but no measurable mass.Left retrohilar opacity, compatible with radiation reaction, unchanged.MEDIASTINUM AND HILA: Reference right paratracheal lymph node measuring 7 mm in short axis diameter, not significantly changed.No other significant lymphadenopathy.Severe and extensive coronary artery calcification.CHEST WALL: Degenerative disease in the spine.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Calcified hepatic granulomata. Stable chronic gallbladder wall thickening and calcifications.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: Severe aortic and iliac artery calcification.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Severe degenerative disease in the spine.OTHER: No significant abnormality noted. | Radiation reaction with extensive scarring and consolidation. No measurable tumor. |
Generate impression based on findings. | Reason: evidence of hypoxia History: hypoxia LUNGS AND PLEURA: Motion limits the study. Groundglass opacities identified in both lungs compatible with edema.No focal areas of consolidation.Basilar scarring and atelectasis was present on a remote exam dated 11/28/08.No pleural effusions.MEDIASTINUM AND HILA: Severe cardiac enlargement without evidence of a pericardial effusion.Prominent collateral circulation .Severe enlargement of the pulmonary artery measuring 4.1 cm and compatible with pulmonary arterial hypertension .CHEST WALL: Prominent chest wall collateral is with its amount of subcutaneous edema the left breast, left chest wall, and axilla. Osseous sequelae of sickle cell disease.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Autosplenectomy compatible with sickle cell disease.Increased density within and enlarged liver compatible with iron deposition.Small amount of perihepatic ascites.Mesenteric and retroperitoneal venous collaterals | 1.Severe cardiac enlargement and marked enlargement of the pulmonary artery compatible with pulmonary arterial hypertension.2.Groundglass opacities compatible with edema. Accentuated by the exam being obtained in expiration.3.Extensive venous chest wall, mediastinal, and abdominal collateral circulation with subcutaneous edema and skin thickening involving the left breast and left chest wall. Left breast and chest wall cellulitis cannot be excluded.4.Autosplenectomy with hepatomegaly with increased hepatic density compatible with iron deposition. |
Generate impression based on findings. | Female, 16 years old, fever, increased oxygen requirement. Evaluate for infection in the sinuses. The frontal sinuses and frontoethmoidal recesses are clear. The sphenoid sinuses and the sphenoethmoidal recesses are clear. Opacification of one of the right-sided ethmoid air cells is demonstrated, stable.Mild peripheral mucosal thickening is seen within the maxillary sinuses bilaterally, stable. The maxillary outflow pathways are patent bilaterally.The nasal cavity is clear. The nasal septum is intact. The turbinates are unremarkable. | Mild sinus mucosal thickening, similar to the prior examination. No evidence of active sinus infection. |
Generate impression based on findings. | 32-year-old male patient status post laparoscopic total abdominal colectomy with end ileostomy 9/2013 with history of rectal stump leak on CT status post IR drainage 10/7/2013. Please evaluate resolution of the collection and if drain can be removed. ABDOMEN:LUNG BASES: Trace left pleural effusion and associated 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: No significant abnormality noted.BOWEL, MESENTERY: Ileostomy in the right lower quadrant. Status post colectomy with Hartmann's pouch. Pigtail catheter enters from the anterior left lower quadrant, traverses superior to the bladder, with tip adjacent to Hartmann's pouch staple line. There is near complete resolution of loculated fluid collection within the mesentery.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BOWEL, MESENTERY: Ileostomy in the right lower quadrant. Status post colectomy with Hartmann's pouch. Pigtail catheter enters from the anterior left lower quadrant, traverses superior to the bladder, with tip adjacent to Hartmann's pouch staple line. There is near complete resolution of loculated fluid collection within the mesentery.Bilateral fat filled inguinal hernias.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Near complete resolution of loculated fluid collection within the pelvic mesentery.Findings needed to Dr. Michelle Rubin via telephone at 2:55 p.m.. on 10/21/2013 by Dr. Stephanie McCann. |
Generate impression based on findings. | 54-year-old female with gait instability, history of alcohol abuse, evaluate for intracranial abnormality. The CSF spaces are appropriate for the patient's stated age with no midline shift. Slightly asymmetric cerebellar atrophy.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. Deformity of the left nasal bone without soft tissue injury suggestive of a chronic fracture. Chronic right lamina papyracea fracture. | 1. No acute intracranial abnormalities.2. Slightly asymmetric cerebellar atrophy. |
Generate impression based on findings. | Reason: assess pleural effusion, r/o infiltrate History: pt s/p Bilateral lung tranpslant July 2013 and recent MVR LUNGS AND PLEURA: Diffuse pulmonary edema with scattered ground glass opacity and bilateral pleural effusions. Fluid extends into both fissures.MEDIASTINUM AND HILA: Collapse posterior wall of trachea consistent with expiratory phase scan.Multichamber cardiomegaly with trace pericardial fluid. Scattered small subcentimeter lymph nodes. Dual-lead pacemaker with leads in knee RV apex and right atrial appendage.S/P bilateral lung transplant. No evidence of anastomotic airway narrowing.CHEST WALL: Generalized soft tissue edema. Right chest wall pacemaker. Status post median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Pulmonary edema and pleural effusions consistent with CHF. |
Generate impression based on findings. | 16 year old female with daily fever, increasing oxygen requirement, increasing cough. CHEST:LUNGS AND PLEURA: Multiple ground opacities in all lung lobes, particularly increased in the left lung apex and base. The bibasilar ground glass opacities and patchy consolidations likely represent aspiration/infection. Scattered pulmonary micronodules are again seen, with the reference left upper lobe nodule unchanged at 5 mm (series 5, image 38).Small bilateral pulmonary effusions, slightly increased on the left and stable to decreased on the right. Septal thickening at the lung bases represents mild pulmonary edema.MEDIASTINUM AND HILA: Left subclavian central venous catheter tip lies at the cavoatrial junction. Several prominent right paratracheal lymph nodes are unchanged in size. No hilar lymphadenopathy. The heart is normal in size with a new moderate-sized pericardial effusion.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion seen. No intrahepatic or extrahepatic biliary ductal dilatation. The gallbladder is contracted with pericholecystic fluid.SPLEEN: No focal lesions or acute change in size.PANCREAS: Normal in appearance.ADRENAL GLANDS: Normal in appearance.KIDNEYS, URETERS: Normal symmetric renal enhancement, without hydronephrosis, renal calculi, or focal renal lesions.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Non-dilated loops of bowel without wall thickening, pneumatosis, or associated mesenteric stranding.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No loculated fluid collections to suggest abscess formation.PELVIS:UTERUS, ADNEXA: Normal in appearance.BLADDER: Normally distended without significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Non-dilated loops of bowel without wall thickening, pneumatosis, or associated mesenteric stranding. A radiopaque cylindrical object in a pelvic bowel loop likely represents an ingested object, possibly a pill.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of dependent pelvic free fluid, likely physiologic and unchanged. | 1. Increasing pulmonary opacities throughout the left lung, likely representing worsening infection. 2. New moderate-sized pericardial effusion. 3. Slightly increased size of the small left pleural effusion.4. No acute intra-abdominal process evident. |
Generate impression based on findings. | Persistent cough and post-nasal drip. There are postoperative findings related to bilateral uncinectomy and partial ethmoidectomy with moderate bilateral maxillary sinus mucosal thickening , which largely obstruct the neo-infundibula. There is also moderate opacification of the remaining bilateral ethmoid air cells. There is minimal mucosal thickening within the right sphenoid sinus and left frontal sinus. The left sphenoid and right frontal sinuses are clear. The ethmoid roofs are intact. The right ethmoid roof is slightly lower than the left. Theo carotid grooves and optic canals are covered by bone. The mastoid air cells are clear. The imaged intracranial structures and orbits are grossly unremarkable. | Status post endoscopic sinus surgery with persistent moderate maxillary and ethmoid sinus opacification. |
Generate impression based on findings. | 36 year-old female with septal deviation, recurring sinusitis, and Afrin abuse. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structures is unremarkable. There remains mild mucosal thickening and retention cysts in the bilateral maxillary and ethmoid sinuses, right more than left. The right maxillary infundibulum demonstrates patency, previously obstructed, and the left remains patent. Increased soft tissue density within the right nasal vault, interposed between the middle and inferior turbinates likely represents retained secretions given the lack of mass abnormality on the comparison study.The frontal sinuses, frontal-ethmoid recesses, and sphenoid sinuses are well developed and clear. The osteomeatal complexes are normal with intact uncinate processes . The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal except for minimal leftward nasal septal deviation. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable. | 1.There remains mild mucosal thickening and retention cysts in the bilateral maxillary and ethmoid sinuses, right more than left. The right maxillary infundibulum demonstrates patency, previously obstructed. 2.Increased soft tissue density within the right nasal vault, interposed between the middle and inferior turbinates likely represents retained secretions given the lack of mass abnormality on the comparison study. |
Generate impression based on findings. | Male 74 years old; Reason: w abd fluid collection s/p IR drain, rising WBC - eval fluid collection size, eval pna History: w abd fluid collection s/p IR drain, rising WBC - eval fluid collection size, eval pna CHEST:LUNGS AND PLEURA: Small left pleural effusion. Left basilar atelectasis. Trace right pleural effusion and atelectasis. Soft tissue mass adjacent to the left hilum representing either a pulmonary mass or necrotic nodes.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Extensive partially necrotic mediastinal lymphadenopathy that extends into the left hilum. Necrotic right paratracheal node measures 2.6 x 2.0 cm (image 36/series 3). Esophagus is patulous.Tracheostomy tube terminates above the carina.Right central venous catheter terminates at the cavoatrial junction.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Liver has a smooth contour. At least two right hepatic lobe subcentimeter hypodensities that are too small to characterize.There is gallbladder wall edema and pericholecystic fluid. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: Mild pancreatic tail atrophy. The pancreatic duct is mildly dilated..ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: Percutaneous gastrostomy catheter terminates within the stomach. Gas fluid collection anterior to the stomach.Multiple loculated fluid collections within the abdomen. The largest is located in the lower abdomen/pelvis measuring 8.7 x 3.4 cm. A fistulous tract connects the collection to the anterior abdominal surface.BONES, SOFT TISSUES: Large ventral abdominal wall defect. Right body wall drain terminates in a small pocket of fluid in the right hemi abdomen.Lytic lesion involving the L3 inferior endplate.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomyBLADDER: Status post cystoprostatectomyLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Paget's disease of the right hemipelvis. Focal lytic area in the right ilium (image 154/series 3) suspicious for metastatic disease.OTHER: Pelvic fluid collection that connects to the lower abdominal collection. The pelvic portion of the collection measures 10.4 x 6.8 cm. | 1.Large loculated fluid collections in the lower abdomen and pelvis with fistulous tracts to the body wall.2.Gas fluid collection in the left upper abdomen connects with the pelvic fluid collection. A drain is present in the right abdominal fluid collection.3.Necrotic lymphadenopathy in the mediastinum suspicious for malignancy - either primary or metastatic. 4.Pagetoid changes in the right ilium with a lytic lesions in the right ilium and L3 vertebral body representing metastatic disease 5.Gallbladder wall edema with some pericholecystic fluid. The differential considerations include acalculous or calculus cholecystitis, gallbladder wall edema due to hypoproteinemic state or cardiac causes. |
Generate impression based on findings. | 71-year-old female patient with high-grade ovarian cancer status post chemotherapy presents with rising CA-125. Evaluate for disease. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No pathologically enlarged lymph nodes.CHEST WALL: Redemonstration of right chest port with catheter tip in the cavoatrial junction. OTHER: Atherosclerotic changes in the coronary arteries and thoracic aorta with some adherent plaque.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis. Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral hypoattenuating subcentimeter foci within the renal parenchyma stable compared to prior examination and most likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Atherosclerotic changes in the abdominal aorta.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral salpingo-oophorectomy with surgical clips.BLADDER: No significant abnormality noted.LYMPH NODES: Enlarged, partially calcified right inguinal lymph node measures 1.6 x 2.0 cm (series 3, image 161) and is suspicious for disease.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Presacral soft tissue mass is redemonstrated and stable compared to the CT examination 3/25/2011. | 1.Enlarged right inguinal lymph node concerning for recurrent disease.2.Stable postsurgical changes in the pelvis. |
Generate impression based on findings. | Late stage MS with gross intention tremor treated via bilateral basal ganglia stimulators. There are bilateral deep brain electrodes that traverse the lateral ventricles and basal ganglia. There is mild cerebral white matter hypoattenuation and encephalomalacia in the left frontal lobe. There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. The ventricles are diffuse prominent reflecting cerebral volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1. Bilateral deep brain electrodes that traverse the lateral ventricles and basal ganglia. 2. Left frontal lobe encephalomalacia and scattered cerebral whiter matter hypodensities, but no evidence of acute intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Male 60 years old; Reason: right lung mass and mediastinal lymphadenopathy were noted on a recent cardiac CT; suspect primary lung carcinoma History: cough, dyspnea. LUNGS AND PLEURA: Moderate to severe centrilobular and paraseptal emphysema. The pleural-based nodule in the anterior aspect of the right middle lobe measures 1.1 x 3.1cm (series 4, image 67), which is unchanged in the last two examinations dating back to 7/8/2013. Left apical scarring again seen. There is bronchiectasis and architectural distortion of the left lung base consistent with scarring/atelectasis, similar to previous exam.MEDIASTINUM AND HILA: Multiple mildly enlarged non-specific lymph nodes are visualized in the precardiac, right paratracheal, subcarinal, aorticopulmonary window and axillary regions. Atherosclerotic calcifications in the coronary arteries and aorta again visualized.CHEST WALL: Degenerative changes of the thoracic spine are seen.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Fluid attenuating lesion in the left kidney not changed from previous exam and although lack of contrast limits full evaluation, renal cyst is likely. Two small hypodensities in the liver are too small to characterize but are likely hepatic cysts. | Right middle lobe nodule is unchanged in size over three months and biopsy was indeterminate. However, malignancy is still possible and bland are infarct is unlikely given the high FDG activity on the recent previous PET/CT. The differential diagnosis includes low grade primary malignancy, histoplasmosis, lymphoma, and organizing pneumonia. Repeat CT in approximately 3 months is recommended. |
Generate impression based on findings. | Nasal congestion and discharge. There are air fluid-levels in the bilateral maxillary sinuses, left greater than right, with bubbly secretions. There is also a 9 mm wide left maxillary sinus retention cyst. There is otherwise mild right maxillary sinus mucosal thickening and a 6 mm wide retention cyst in the right sphenoid sinus. There is mild scattered ethmoid sinus opacification. The frontal sinuses are clear. The nasal cavity is clear. There is mild nasal septal deviation. The right ethmoid roof is 2 mm lower than the left. The optic nerve canals and carotid grooves are covered by bone. The imaged intracranial structures and orbits are unremarkable. The imaged mastoid air cells are clear. | Scattered paranasal sinus opacification in a sporadic pattern with air-fluid levels in the maxillary sinuses that may indicate acute sinusitis in the appropriate clinical setting. |
Generate impression based on findings. | 22-year-old male status post IR drainage. Multiple fluid collections, open abdomen ABDOMEN:LUNG BASES: Left pleural effusion and adjacent atelectasis, mildly decreased from the prior study.LIVER, BILIARY TRACT: Mosaic attenuation of the liver is again noted. The hepatic vasculature appears patent. No biliary ductal dilatation. No intra-or extrahepatic biliary ductal dilatation. Small subcentimeter hypodense lesion in the peripheral right hepatic lobe is unchanged (image 44, series 3).SPLEEN: Perinephric fluid attenuating collection containing drain appear similar. The prior study.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple prominent mesenteric lymph nodes are again noted. Fistulous tract appears to extend from the small bowel in the right lower quadrant to the abdomen wall wound.BONES, SOFT TISSUES: Midline abdominal wound with packing material and wound VAC is again noted. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Loculated pelvic fluid collection measures 4.0 x 6.2 cm (image 124, series 3), decreased in size from the prior study. This fluid collection communicates with several additional rim enhancing fluid collections in the lower abdominal mesentery. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Interval decrease in size of perisplenic, pelvic and lower abdominal fluid collections.2. Large ventral abdominal wound with overlying wound VAC communicating with the small bowel.3. Hepatic steatosis. |
Generate impression based on findings. | Reason: Evaluate for progression of metastatic disease; compare to previous scan History: none CHEST:LUNGS AND PLEURA: Interval increase in right upper lobe mass and satellite nodules. Right upper lobe mass measures 49 x 40 mm on image 40/105 (35 x 26 mm previously). The previously referenced 5 mm satellite nodule cranial to the mass has been engulfed by the tumor and is no longer measurable. Right middle lobe nodule measures 17 mm on image 52/105 (12 mm previously). Scattered punctate nodules are unchanged. New small right pleural effusion.MEDIASTINUM AND HILA: Reference right paratracheal lymph node is stable at 7 mm (image 18/148). Other nodes are also stable.CHEST WALL: Expansile mass involving the right anterior third rib (image 52/148). In retrospect there is a small lucency involving this location on prior scan. New mass involving the left ninth rib posteriorly (image 66/148). New mass in right rotator cuff musculature (image 19/148).Increasing lytic lesion in T6 vertebral body. Sclerotic foci elsewhere are stable.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple new hepatic hypodense masses consistent with metastatic disease. A hypodense lesion in the right lobe measures 29 x 28 mm in image 1095 448.SPLEEN: Negative.ADRENAL GLANDS: Considerable increase in size of left adrenal metastasis (image 107/148). New right adrenal metastasis.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Equivocal subcentimeter hypodensity in the intrahepatic IVC (image 98/148) which may represent a small intrahepatic caval thrombus versus flow artifact. There is no evidence of DVT elsewhere on the scan.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Interval increase in L3 metastasis. Other lesions are stable.OTHER: No significant abnormality noted. | 1. Interval increase in pulmonary mass and nodules.2. Increased and new osseous metastases.3. Increased and new adrenal metastases.4. Increased and new hepatic metastases.5. New soft tissue metastasis right shoulder.6. Equivocal subcentimeter hypodensity in the intrahepatic IVC which may represent a small intrahepatic caval thrombus versus flow artifact. There is no evidence of DVT elsewhere on the scan. |
Generate impression based on findings. | 44-year-old malignant neoplasm of anus CHEST:LUNGS AND PLEURA: Multiple small calcified granulomas, with the largest in the left upper lobe.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenule noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Small pelvic lymph nodes not enlarged by CT criteria.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of metastatic disease |
Generate impression based on findings. | 37-year-old female patient with left flank pain. Evaluate for renal calculi. Note that the lack of intravenous contrast limits evaluation of vasculature, solid and hollow viscera.ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Gallbladder with sludge. No cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis or renal calculi. No perinephric fat stranding or fluid collections.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality notedPELVIS: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: Phleboliths identified in the pelvis. | No renal calculi or evidence of inflammatory changes in the kidneys. |
Generate impression based on findings. | 29-year-old male with Hodgkin's lymphoma, restaging. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Right port catheter extends to the cavoatrial junction. No mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest wall port.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: Extensive periaortic adenopathy has increased from the prior study, with reference lesion, measuring 3.6 x 1.9 cm and previously measuring 2.9 x 1.5 cm (image 140, series 701).BOWEL, MESENTERY: Multiple prominent mesenteric lymph nodes are noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Bulky left iliac lymph nodes are not significantly changed with reference left pelvic sidewall lymph node measuring 3.1 x 1.8 cm and previously measuring 3.3 x 2.4 cm (image 183, series 7, 01).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted. | Lymphadenopathy in the abdomen and pelvis with increase in size of periaortic lymph nodes from the prior study. |
Generate impression based on findings. | 46 year old female with elevated white blood cell count and altered mental status CHEST:LUNGS AND PLEURA: Small right pleural effusion and multifocal basilar consolidation and atelectasis.MEDIASTINUM AND HILA: Endotracheal tube, left central venous catheter and enteric tube extending to stomach. Gas is again noted in the right atrium. Cardiomegaly. Small pericardial effusion.CHEST WALL: Sternotomy wires.ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Cholelithiasis. Hepatomegaly.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: A jejunostomy tube is again noted. No evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Large volume abdominal ascites is again noted without evidence of loculation.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction. A rectal tube is noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Large volume pelvic ascites without evidence of loculation. Anasarca. | 1. Lower lobe consolidation, atelectasis and small right pleural effusion.2. Large volume abdominal and pelvic ascites appearing similar to the prior study without evidence of loculation. |
Generate impression based on findings. | Female, 71 years old, anosmia and history of recurrent sinusitis. The frontal sinuses and frontoethmoidal recesses are clear. The sphenoid sinuses are clear. The sphenoethmoidal recesses are not well visualized which is likely technical. The ethmoid air cells are clear.The maxillary sinuses are free of mucosal thickening and debris. The bony sinus walls are neither thickened nor sclerotic. The maxillary outflow pathways are patent.The nasal septum is intact. The nasal turbinates are unremarkable. The nasal cavity is free of mucosal thickening and debris.The mastoid air cells are clear. Debris is present in both external auditory canals, left side more than right. The middle ear cavities are normally aerated. | No evidence of active sinusitis. No definite sequelae of prior chronic sinusitis. |
Generate impression based on findings. | Reason: h/o HNC, CRT, compare to previous, measurements pls History: none LUNGS AND PLEURA: Scattered punctate micronodules are stable and presumably post inflammatory. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Borderline right hilar lymph node is unchanged. Port tip in SVC.CHEST WALL: Right chest wall port. Degenerative change involving thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Presumed left hepatic cyst is unchanged. Gastrostomy tube tip in stomach. | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: Head and neck cancer. Baseline evaluation. History: as above CHEST:LUNGS AND PLEURA: Centrilobular nodules and tree in bud opacities, most pronounced in the right lower lobe. Associated bronchiectasis and debris within the subsegmental bronchi of the right lower lobe. These findings are most consistent with the known history of chronic aspiration. Aspirated debris is seen in the central airways. Bibasilar atelectasis/consolidation. No pleural effusions or pneumothorax. Left upper lobe ground glass opacity, (image 52; series 5) is unchanged but of uncertain significance; continued follow up is recommended. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Reference right paratracheal lymph node is stable 8 mm on image 27/151. Port tip at RA/SVC junction.CHEST WALL: Right chest wall port. Small sclerotic focus in T1 is unchanged and presumably 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: Stable adrenal thickening.KIDNEYS, URETERS: Stable presumed left renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastrostomy tube tip in stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Chronic aspiration but no evidence of metastases. |
Generate impression based on findings. | Weakness. There are postoperative findings related to right pterional craniotomy and right MCA aneurysm clipping. There is extensive encephalomalacia in the right MCA territory with ex vacuo dilatation of the left lateal ventricle. There are new punctate hyperdense foci within the area of encephalomalacia, which may represent hemorrhage. The paranasal sinuses and mastoid air cells are clear. The extracranial structures are unremarkable. | Postoperative findings related to right pterional craniotomy and right MCA aneurysm clipping. with extensive encephalomalacia in the right MCA territory with ex vacuo dilatation of the left lateal ventricle. New punctate hyperdense foci within the area of encephalomalacia may represent hemorrhage. |
Generate impression based on findings. | 54-year-old female patient with history of endometrial cancer presents with right upper quadrant abdominal pain. Evaluate for liver metastases. ABDOMEN:LUNG BASES: Trace right pleural effusion with basilar atelectasis, new compared to prior. Multiple scattered tiny subpleural nodules.LIVER, BILIARY TRACT: Hepatomegaly, measuring 20 cm in the craniocaudal dimension. Liver parenchyma is diffusely studed with numerous hypoattenuating foci. Free fluid in the subhepatic space. Hepatic vasculature is patent and is attenuated peripherally. No cholelithiasis or ductal dilatation.SPLEEN: There is redemonstration of a hypoattenuating focus in the medial aspect of the spleen, stable.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is scarring and atrophy of the left kidney, most pronounced in the superior pole. Compensatory hypertrophy of the right kidney. RETROPERITONEUM, LYMPH NODES: Many small retroperitoneal lymph nodes. Reference aortocaval node measures 10 x 6 mm, previously 7 x 14 mm (series 12, image 63).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: There is redemonstration of a large heterogeneous uterine mass, which measures 9.1 x 8.4 cm (image 113, series 12) and demonstrates heterogeneous peripheral contrast enhancement. Mass effect upon the bladder and loss of fat plane between the uterus and bladder likely represents tumoral invasion of the superior and posterior bladder wall. This mass is consistent with the patient's known history of endometrial cancer.BLADDER: Superior and posterior bladder walls likely invaded by uterine mass.LYMPH NODES: Multiple small pelvic lymph nodes are again identified.BOWEL, MESENTERY: Sigmoid diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No evidence of metastatic lesions within the bones.OTHER: Small amount of free fluid in the pelvis. | 1.Hepatomegaly with diffuse studding of the liver parenchyma with hypoattenuating lesions. Findings concerning for metastatic disease given patient's history and less likely microabscesses.2.Large uterine mass with bladder invasion consistent with history of endometrial cancer.3.Trace right pleural effusion.Finding of liver lesions communicated to Dr. Padela via telephone at 4:20 PM on 10/21/2013 by Dr. Stephanie McCann. |
Generate impression based on findings. | Malignant neoplasm of bladder status post cystoprostatectomy, neobladder in 2007 ABDOMEN:LUNG BASES: Calcified left lower lobe nodule is stableLIVER, BILIARY TRACT: Fatty infiltration of the liver. Small, hypodense lesion in the dome of the right lobe of liver is unchanged. No focal lesion. Cholelithiasis. Hepatic vessels are patent.SPLEEN: No significant abnormality noted. PANCREAS: No significant abnormality notedADRENAL GLANDS: Stable left adrenal mass measures are 2 x 2.1 cmKIDNEYS, URETERS: Right renal hypodense lesion with a mural nodule measuring 2 x 2 cm (image 59, 6), has increased in size from prior study, with more than 20 HU enhancement noted within the mural nodule with washout consistent with Bosniak type IV lesion. Probable vascular calcifications identified in the left renal hilum. No hydronephrosis or hydroureter. Symmetric nephrogram and excretion noted in both kidneys. No filling defect within the collecting system or the ureters on delayed images.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Post cystoprostatectomy.BLADDER: Neobladder appears unremarkable.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Penile prosthesis identified | 1. Interval increase in a right renal hypodense lesion with an enhancing mural nodule consistent with Bosniak type IV lesion.2. Stable left adrenal masses3. Hepatic steatosisFindings conveyed to Dr. Norm Smith pager 6709 at 4:50 pm |
Generate impression based on findings. | Female, 51 years old, left parotid mass. A well marginated, lobular and uniformly enhancing mass is present within the superficial lobe of the left parotid gland. This lesion measures 1.7 x 1.6 cm transaxial and 2.0 cm craniocaudal. This lesion is positioned relatively low and posteriorly within the gland. It abuts the margin of the sternocleidomastoid muscle without definite evidence of invasion.A subcentimeter lesion with similar imaging characteristics is also present within the right parotid gland (see image 20 series 6), just at the border of the deep and superficial lobes. A few additional smaller enhancing nodules are evident within or around the parotids.Scattered lymph nodes are evident throughout both sides of the neck, but none of these reaches imaging criteria for pathologic enlargement.The palatine tonsils are mildly prominent for a patient of this age. Tonsiliths are evident on the right. The aerodigestive mucosa is otherwise unremarkable.The submandibular glands are free of focal lesions. The thyroid is within normal limits. Cervical vessels are patent. Lung apices are clear. No concerning bony lesions are demonstrated. | There is an enhancing, well marginated lobular mass within the superficial lobe of the left parotid gland. At least one if not several smaller, similar appearing lesions are also present in the right parotid gland. The differential diagnosis for these findings is broad and includes benign etiologies, such as Warthin's tumors or other benign salivary lesions, as well as malignant salivary tumors and intraparotid lymphadenopathy. |
Generate impression based on findings. | T1N2A left tonsil SCC s/p excisional biopsy and TFHX completed 4/27/12. Head: There is an unchanged avidly enhancing dural based mass along the planum sphenoidale that measures 20 AP x 19 RL x 8 SI mm. There are unchanged mild cerebral white matter hypoattenuating foci that likely represent microangiopathy. Otherwise, there are no foci of abnormal enhancement within the brain parenchyma. The ventricles are stable in size and configuration. The paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. Neck: There are stable post-treatment findings in the left tonsillar fossa without evidence of tumor recurrence. There is no significant cervical lymphadenopathy by size criteria. The airways are patent. The major salivary glands are unchanged with hyperemia and volume loss of the bilateral submandibular glands. There is an unchanged calcified let thyroid nodule that measures up to 7 mm. The major cervical vessels are patent. There are no lytic or blastic lesions. Refer to the separate chest CT report for relevant findings. | 1. No evidence of locoregional tonsillar squamous cell carcinoma recurrence or significant cervical lymphadenopathy.2. Unchanged presumed planum sphenoidale meningioma that measures up to 20 mm without evidence of brain metastases. |
Generate impression based on findings. | Reason: R/o PE History: R-sided CP, tachycardic, hx cancer on chemo/radiation PULMONARY ARTERIES: The multiple small pulmonary emboli are identified in the arterial tree of the right lung involving the right main pulmonary artery as well as lower lobar and segmental branches. The pulmonary artery is normal caliber. There is no evidence of right heart strain.LUNGS AND PLEURA: Small right pleural effusion and right basilar atelectasis.Scattered nodules along the fissures compatible with intrapulmonary lymph nodes, however intrathoracic metastatic disease cannot be excluded.Right upper lobe tree in bud opacities (image 47 series 11) may represent aspiration.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatomegaly. | 1.Multiple small pulmonary emboli within the right pulmonary artery and lobar and segmental arteries of the right lower lobe.2.Small right pleural effusion and associated right basilar subsegmental atelectasis.3. Numerous pulmonary subcentimeter nodules many which are associated with the fissures and may represent intrapulmonary lymph nodes. These were not present on a prior exam dated 8/30/13 and may be related to metastatic disease.4. Results were relayed to Dr. Mo in the ED per telephone at 3:15 p.m. |
Generate impression based on findings. | Reason: Dx Breast Cancer History: Evaluate disease s/p 3 months on faslodex CHEST:LUNGS AND PLEURA: 5-mm nodule in the right major fissure which may represent an intrapulmonary lymph node.An additional smaller nodule is present in the minor fissure (series 7 image 42).Approximately 5 mm subpleural or pleural nodule at the posterior right hemidiaphragm (series 7 image 69).A previous large pleural effusion and multiple pleural metastases have resolved.MEDIASTINUM AND HILA: Enlargement and calcification of the right lobe of the thyroid gland, unchanged.No significant lymphadenopathy.Moderately severe coronary artery calcification.CHEST WALL: Partially calcified mass in the right breast measuring 32 mm in diameter.Enlarged lymph node in the right axilla measuring 11 mm in short axis diameter, markedly decreased compared to the previous scan.Sclerosis in the inferior portion of the sternum consistent with healed metastasis.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Calcification in the gallbladder wall suggestive of adenomyosis.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: Nonspecific subcentimeter lymph nodes in the porta hepatis area.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Multiple small nonspecific lymph nodes in the mesentery.BONES, SOFT TISSUES: Degenerative disease in the spine.OTHER: No significant abnormality noted. | Marked interval improvement in metastatic disease since the previous scan. Very small nonspecific pulmonary and pleural nodules remain in addition to a right breast mass and enlarged right axillary lymph node. |
Generate impression based on findings. | Male 64 years old; Reason: cholangiocarcinoma History: cholangiocarcinoma restaging CHEST:LUNGS AND PLEURA: Right upper lobe subcentimeter pulmonary nodule is grossly unchanged from the prior exam (image 39, series 5).MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: There is repositioning of the Port-A-Cath, with its tip in the cavoatrial junction. ABDOMEN:LIVER, BILIARY TRACT: The hypoattenuating lesion within the left lobe of the liver is much larger, and now measures 6.8 x 8.0 cm (series 2 image 95) previously 6.4 X 5.1 cm (image 91, series 3). The satellite not index lesions are also more conspicuous and larger compared to previous. The left portal vein is not opacified which is unchanged in the prior exam. The right portal vein is patent.The left hepatic vein and left hepatic artery are attenuated comment not well visualized on this examination.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple subcentimeter densities in the kidneys are too small to characterize and unchanged from the prior exam.RETROPERITONEUM, LYMPH NODES: The index porta hepatis lymph node measures 2.9 x 2.9 cm (image 104, series 3), previously 1.9 x 2.2 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. The hepatic lesion and index lymph node appear larger when compared to the prior exam. Interval increase in size and conspicuity of the non reference satellite lesions.2. Interval repositioning of the Port-A-Cath with the tip in the cavoatrial junction. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.