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Generate impression based on findings. | History of T4N2c SCC of the head and neck (base of tongue), HBV positive who completed TFHX on in 9/16/11. CHEST:LUNGS AND PLEURA: Scattered areas of microatelectasis and groundglass opacity in the right lower lobe most likely reflect sequelae of aspiration. No pleural fluid or pneumothorax. 10 x 13 x 7 mm groundglass... | 1. No specific evidence of pulmonary metastases.2. Index high right paratracheal lymph node is unchanged in size.3. Right upper lobe ground glass nodule most likely post inflammatory. Three-month CT follow-up recommended to assess for resolution. If the lesion persists on subsequent scan, yearly CTs for a total of 3 ye... |
Generate impression based on findings. | Reason: Pt with hx of HNC; please re-eval and compare to prior sscans History: as above CHEST:LUNGS AND PLEURA: Right upper lobe subsegmental bronchial obstruction mild bronchial wall thickening, and probable mucoid impaction unchanged over several years. Adjacent nodular opacity also unchanged over multiple exams. Sca... | Stable pulmonary abnormalities compatible with aspiration and post radiation changes. No evidence of metastatic disease. |
Generate impression based on findings. | 54 year old female with chest pain. Rule out CAD. Height: 61 in Weight: 104 lbs BSA: 1.43 m^2BMI: 19.7 kg/m^2Calcium Score:LM: 0LAD: 335LCx: 0RCA: 32Total: 366.6, This represents the 99% for this patient's age and gender.(Based on MESA - Multi-Ethnic Study of Atherosclerosis, http://www.mesa-nhlbi.org/Calcium/input.asp... | 1. Multifocal calcification in the LAD and RCA, most prominent at the LAD origin associated with 25% stenosis.2. Coronary artery score is 366.6, This represents the 99%ile for this patient's age and gender.3. Normal ventricular size and shape. |
Generate impression based on findings. | Male 61 years old Reason: Pt with h/o of relapsed CLL on treatment regimen History: Evaluation of disease status. CHEST:LUNGS AND PLEURA: Pleural-based soft tissue density series 5 image 68 1.4 x 1.4 cm. Previously 1.8 x 1.7 cm. No new nodules. No effusions.MEDIASTINUM AND HILA: Small non-pathologic sized mediastinal n... | Decrease in size of index lesions. No new sites of disease. |
Generate impression based on findings. | Clinical question: Rule out intracranial hemorrhage. Signs and symptoms: Headache and weakness. Nonenhanced head CT:There is no evidence of an acute intracranial process CT however is insensitive for detection of acute nonhemorrhagic ischemic stroke.There are patchy foci of cortical and periventricular low-attenuation ... | 1.No acute intracranial process. Please see above comments.2.Age indeterminate small vessel ischemic strokes as detailed. |
Generate impression based on findings. | Grade III follicular NHL status post chemotherapy. Assessment is limited without intravenous contrast administration. Nevertheless, there is no significant interval change in an enlarged left supraclavicular lymph node that demonstrated hypermetabolism on the prior PET, which currently measures 10 x 11 mm, previously a... | 1. No significant interval change in an enlarged left supraclavicular lymph node that demonstrated hypermetabolism on the prior PET, which currently measures 10 x 11 mm. No additional significant cervical lymphadenopathy is identified.2. Diffuse enlargement of the left thyroid lobe, which appears heterogeneous, but not... |
Generate impression based on findings. | Squamous cell cancer of esophagus and head and neck cancer of the larynx status post chemo and radiation. CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema. No pleural fluid or pneumothorax. Unchanged scattered nodular densities, but no suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Mild circumfere... | Continued improvement in the appearance of the esophagus with probable radiation esophagitis in the distal segment. Gastrohepatic ligament lymphadenopathy has also improved. No pulmonary metastases. |
Generate impression based on findings. | 77-year-old male with history of fall and confusion. Head: 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 intact. The visualized paranasal sinuses and mastoid air cells are clear. There is a scleroti... | 1. No evidence of intracranial hemorrhage, mass, or cerebral edema.2. No evidence of cervical spine fracture or spondylolisthesis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 62-year-old female patient with history of abdominal mesh and previous bowel resection present with weight loss, night sweats and left-sided abdominal pain. Evaluate for mass or internal hernia. ABDOMEN:LUNG BASES: Dependent atelectasis in the right lung base.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEE... | 1.No internal hernias or mass identified.2.Sigmoid diverticulosis without diverticulitis.3.Stable hernia repair.4.No significant lymphadenopathy. |
Generate impression based on findings. | Invasive squamous cell carcinoma of the left superior buccal and alveolus status post composite resection of a supraclavicular island flap reconstruction and local flap advancement. There are postoperative findings related to left marginal mandibulectomy, bilateral neck dissection, and flap reconstruction. There is a s... | 1. Interval resection of a left oral cavity mass without definite evidence of residual or recurrent locoregional tumor, although assessment is limited by dental amalgam artifact. No evidence of significant cervical lymphadenopathy.2. A small amount of gas and fluid in the flap may represent an infected collection, alth... |
Generate impression based on findings. | Male, 64 years old, history of esophageal cancer and had a neck cancer, status post chemo and radiation. Extensive postsurgical changes are demonstrated including total laryngectomy, tracheostomy and perhaps myocutaneous flap placement. A voice prosthesis is in place. Extensive additional treatment related findings inc... | No evidence of recurrent disease in the neck. |
Generate impression based on findings. | 44-year-old who has undergone multiple neck surgeries following esophageal perforation by a foreign body. Status post pectoral flap with fevers. Assess for fluid collection, abscess. Sequelae of multiple previous surgeries are demonstrated -- there is a tracheostomy, a right-sided PICC line with its tip inferior to the... | Expected postoperative changes in this patient who recently underwent left pectoral flap and multiple prior surgical procedures following esophageal perforation. No CT evidence of free air or fluid collection/abscess. |
Generate impression based on findings. | 41-year-old female patient with right flank pain and difficulty voiding. Evaluate for right-sided kidney stone. Note that the lack of intravenous contrast limits evaluation of vasculature, lymph nodes, solid and hollow viscera.ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Fatty infiltration... | 1.Punctate calcification near the right ureterovesical junction may represent a phlebolith versus renal calculus. However, given lack of hydronephrosis, hydroureter and perinephric fat stranding, this is unlikely to be the cause of patient's symptomatology.2.Fatty liver. Consider correlation with LFTs.3.Prominent uteru... |
Generate impression based on findings. | Female 62 years old Reason: eval for internal hemorrhage, RP bleed, organ laceration History: LVAD s/p fall with SAH, Ascites, s/p paracentesis with 4.8L bright red blood Exam is not sensitive for detecting lesions in the bowel, solid organs of vasculature due to lack of oral or intravenous contrast. Given those limita... | New, large amount of free intraperitoneal fluid. Stable splenic artery aneurysm. Cholelithiasis. |
Generate impression based on findings. | Female, 97 years old, status post mechanical fall with headache. There is a right parietal subgaleal hematoma with swelling of the overlying scalp. No skull fractures are seen.No acute intracranial hemorrhage, abnormal extra-axial fluid collections, or other posttraumatic abnormalities are detected.Extensive white matt... | 1. Right parietal scalp injury. No acute intracranial findings.2. Extensive, largely small vessel ischemic disease is redemonstrated. |
Generate impression based on findings. | Female 46 years old Reason: Pre-transplant evaluation. Evaluate vessels for transplant. History: Poor palpation of left femoral pulse on exam. Exam is not sensitive for detecting lesions in the bowel, solid organs or blood vessels due to lack of oral or intravenous contrast. Given those limitations, the following obser... | Left lower quadrant mass correlate with surgical history and GYN history. Differential diagnosis includes ovarian neoplasm. Discussed by telephone with Dr. Josephson. Renal osteodystrophy. Chronic medical renal multicystic kidneys.Extensive subcutaneous collaterals anterior chest abdominal and pelvic wall. Correlate fo... |
Generate impression based on findings. | 68-year-old male with increasing bladder pressure and necrotic ostomy, evaluate for progression of bowel infarction and ascites. Additional history of invasive colonic adenocarcinoma obtained from chart. ABDOMEN:LUNG BASES: Pleural effusions and basilar consolidation and atelectasis. Right pleural catheter is noted wit... | 1. Short segment of necrotic appearing colon, just proximal to the diverting colostomy. No free air.2. Extensive hepatic metastases as detailed above.3. Marked abdominal and pelvic ascites.4. Pleural effusions and basilar consolidation and atelectasis. |
Generate impression based on findings. | Female, 60 years old, vertigo. Evaluate for stroke. A smoothly marginated, mildly and homogeneously hyperdense extra-axial mass is present along the right frontal lobe measuring 2.4 x 1.5 cm transaxial. This mass mildly displaces the adjacent middle frontal gyri.Elsewhere in the brain, vague subcortical and periventric... | 1. Extra-axial mass along the right frontal lobe probably represents a meningioma. A more confident diagnosis could be made on MRI. This finding is likely incidental and of doubtful relevance to the patient's present complaint of vertigo. 2. Moderately extensive age indeterminate small vessel ischemic disease is suspec... |
Generate impression based on findings. | Headache and dizziness. 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. Thre is prominent dural calcification along the falx cerebri for age, which is of uncertain significance. The... | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Head and neck cancer, follow-up CHEST:LUNGS AND PLEURA: Scattered stable micronodules which at least one is large and solid with punctate calcifications compatible granulomata. The less specific subcentimeter nodule in the probe posterior right lower lobe (image 74 series 5) is also unchanged containing to measure 6 mm... | Old granulomatous disease exposure without evidence of metastatic disease |
Generate impression based on findings. | Alzheimer disease, admitted for sepsis and AMS. There is unchanged moderate cerebral white matter hypoattenuation that likely represents microangiopathy. There is also a chronic small left PICA territory infarct. There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal ci... | No evidence of acute intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | 47-year-old female patient with acute urinary retention, constipation, abdominal and thigh numbness. ABDOMEN:LUNG BASES: Status post right middle lobe wedge resection. Bilateral lower lobe volume loss with ground-glass opacities, honeycombing and mild fibrosis in the lung bases.LIVER, BILIARY TRACT: Mild hepatomegaly.S... | 1.Inflammatory changes in the urinary bladder wall consistent with cystitis.2.No evidence of bowel obstruction or fecal impaction.3.Chronic lung changes.4.Severe narrowing of the inferior vena cava at the level of the IVC filter. |
Generate impression based on findings. | Male 78 years old Reason: Assess for IBD History: Pt. with multiple interloop abscesses ABDOMEN:LUNG BASES: Previously seen bilateral pleural effusions are resolved. Minimal bibasilar atelectasis. Minimal calcification at the root of the aorta. Presumed central line tip at the junction of the SVC RA.LIVER, BILIARY TRAC... | Previously seen abscess cavities are difficult to identify in the matted loops of diseased bowel in the pelvis. If present, they are certainly smaller or resolved. Given the caliber discrepancy there is probably a low-grade mechanical obstruction.There also diseased loops of distal ileum and the ascending colon with th... |
Generate impression based on findings. | Secondary neuroendocrine tumor of the liver. Malignant carcinoid. Follow-up. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. Multiple right sided nodules are unchanged. A right middle lobe reference nodule is not significantly changed measuring 6 mm (image 37 clinical series 9), compared to 6 mm pre... | 1.Stable pulmonary nodules.2.Multiple hepatic metastases slightly larger. 3.Unchanged cecal mass and adjacent mesenteric soft tissue attenuation. |
Generate impression based on findings. | Female, 64 years old, weakness. Extensive patchy hypoattenuation is demonstrated on both sides of the brain but more extensively and more conspicuously on the right. This hypoattenuation extends to involve the cortex within the superior and middle frontal gyri. The post central gyrus is also extensively affected. The a... | Findings concerning for acute to subacute cortical ischemia involving largely the right frontal lobe and the right post central gyrus but to a lesser degree the left frontal lobe as well. Underlying white matter hypoattenuation is compatible with small vessel ischemic disease of indeterminate age. Further evaluation wi... |
Generate impression based on findings. | 67-year-old female with chest pain and shortness of breath. PULMONARY ARTERIES: Diagnostic quality exam with no evidence of pulmonary embolus.LUNGS AND PLEURA: Innumerable lung nodules throughout both lungs most compatible with metastases. Moderate to large bilateral pleural effusions, right more than left, with associ... | 1.Findings consistent with diffuse metastatic disease, including innumerable lung nodules, hypoattenuating liver lesions, bilateral adrenal nodules, and destructive osseous lesions; given large exophytic mass arising from the left kidney, suspect primary renal neoplasm. Dedicated abdominal and pelvic CT should be consi... |
Generate impression based on findings. | 30 year-old female with chest pain. PULMONARY ARTERIES: Diagnostic quality exam with no evidence of pulmonary embolus.LUNGS AND PLEURA: No consolidation or pleural effusions. Mild scarring/atelectasis in left lung base.MEDIASTINUM AND HILA: No adenopathy. Heart size normal. Pulmonary artery size is normal. No evidence ... | 1.No pulmonary embolus or other acute abnormality to account for symptoms.2.Cholelithiasis. |
Generate impression based on findings. | 25-year-old female patient with history of Crohn's disease, off Remicade for one year presents with abdominal pain and bloody diarrhea. Please evaluate for active inflammatory changes and obstruction. ABDOMEN:LUNG BASES: Subcentimeter pleural scarring in the posterior right lower lobe. Otherwise, no significant abnorma... | 1.Rectal wall thickening and inflammation of perirectal tissue with numerous phlegmon. No drainable fluid collection.2.Perianal fat hyperattenuating foci may be chronic changes from previous fistulas versus active fistulas. |
Generate impression based on findings. | 66-year-old male with squamous cell lung carcinoma with dyspnea of increased frequency. PULMONARY ARTERIES: Mild motion artifact mildly limits evaluation of lung bases. Given this limitation, no evidence of pulmonary embolus.LUNGS AND PLEURA: Interval increase in large right parahilar mass which encases the right lower... | 1.Interval increase in size of large right parahilar lung mass causing postobstructive consolidation of the right lower and middle lobes, as described above.2.Mediastinal and supraclavicular adenopathy, consistent with involvement by tumor.3.No pulmonary embolus. |
Generate impression based on findings. | Clinical question: Hemorrhage or mass. Signs and symptoms: Headache and papilledema. Nonenhanced head CT:There is no detectable acute intracranial process CT however is insensitive for detection of acute non-hemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gr... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Rule out mass. Signs and symptoms: Seizure. Nonenhanced head CT:There is no detectable acute intracranial process.Usual cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is within normal.Calvarium and soft tissues of the scalp, paranasal sinuses, mastoid ... | Unremarkable head CT. |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: CVA. Unenhanced head CT:No detectable acute intracranial process. CT however is insensitive to detection of acute on hemorrhagic ischemia strokes.Mild prominence of the cortical sulci and ventricular system remain similar to prior exam from 2012.Present gray -- white differen... | No acute intracranial process. |
Generate impression based on findings. | Altered mental status. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is a punctate focus of hypoattenuation in the right basal ganglia which may represent a lacunar infarct of indeterminate age. There is also moderate diffuse cerebral white mater hypoattenuation, which is likely relate... | A punctate focus of hypoattenuation in the right basal ganglia which may represent a lacunar infarct of indeterminate age. There is also moderate diffuse cerebral white mater hypoattenuation, which is likely related to microangiopathy. No evidence of intracranial hemorrhage, mass, or cerebral edema. However, non-contra... |
Generate impression based on findings. | 29-year-old female with hematuria and dysuria -- rule-out urinary tract stone. Within the limits of a non-IV contrast enhanced examination which limits ability to evaluate solid parenchymal organs and vascular structures, following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILI... | Normal examination of the abdomen and pelvis -- no findings seen to account for patient's symptomatology. |
Generate impression based on findings. | 50 year-old male with tonsillar cancer and known metastases -- please evaluate for new metastases, infection source. CHEST:LUNGS AND PLEURA: There is been increased in size and number of pulmonary parenchymal metastases. The reference left anterior upper lobe mass (series 5, image 40) has only minimally increased in si... | 1. Worsening pulmonary, parenchymal metastases. 2. Worsening mediastinal lymphadenopathy. 3. Increasing size and number of liver metastases. 4. Increasing size of left pleural effusion. 5. New mesenteric lymphadenopathy. |
Generate impression based on findings. | Right maxillary swelling and right orbital abrasion after fall. There is subcutaneous stranding overlying the right zygoma. There is no evidence of maxillofacial fracture. The paranasal sinuses and mastoid air cells are clear. There is a right lens implant. The orbits are otherwise unremarkable without evidence of retr... | Subcutaneous hematoma overlying the right zygoma, but no evidence of maxillofacial fracture. |
Generate impression based on findings. | 29-year-old female with history of right lower back pain and positive blood on urinalysis. ABDOMEN:LUNG BASES: Mild basilar atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy. No focal hepatic lesions. Diffusely increased liver density may relate to iron overload.SPLEEN: Small, autoinfarcted spleen.PANCREAS:... | 1. No nephrolithiasis, ureteral calculus or hydronephrosis. 2. Diffusely increased hepatic density indicating hemosiderosis. |
Generate impression based on findings. | 39-year-old female with history of pancreatitis, complicated by pseudocyst, status post necrosectomy and multiple drain placements with worsening fever. ABDOMEN:LUNG BASES: Moderate left pleural effusion with adjacent consolidation and atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No signifi... | 1. Marked interval decrease in size of peripancreatic and multiple additional abdominal and pelvic loculated fluid collections as detailed above. Although all the fluid collections are decreased in size we cannot determine whether some communicate or simply abut one another. 2. Left pleural effusion with adjacent atele... |
Generate impression based on findings. | 27-year-old male patient with left costovertebral angle tenderness, left groin pain and left lower quadrant pain. Evaluate for renal stone. Note that lack of intravenous contrast limits evaluation of vasculature, lymph nodes and solid organs.ABDOMEN:LUNG BASES: Trace bibasilar dependent atelectasis. Otherwise, no signi... | 1.Prominence of the left ureter with 3mm punctate calcification in the urinary bladder. Findings are consistent with a passed renal calculus. |
Generate impression based on findings. | Reason: eval for PE History: l sided chest pain PULMONARY ARTERIES: No evidence of a pulmonary embolus.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: Large axillary and subpect... | 1.No evidence of a pulmonary embolus.2.Axillary and subpectoral lymphadenopathy similar in appearance to the prior exam. |
Generate impression based on findings. | Fall. There is no evidence of fracture or significant spondylolisthesis. The vertebral body heights are preserved. There are several subcentimeter lucent foci with prominent trabecula that likely represent intraosseous hemangiomas. There is multilevel degenerative spondylosis with several areas of intravertebral gas, m... | 1. No evidence of cervical spine fracture or spondylolisthesis.2. Multilevel degenerative spondylosis with several areas of intravertebral gas, moderate to severe neural foramen stenosis, and prominent disc-osteophyte complexes. This can be further evaluated via MRI if clinically warranted. |
Generate impression based on findings. | Reason: Pt with ss disease, 2 PEs in past, off coumadin for last 1 year. Now with SOB, tachycardia History: SOB PULMONARY ARTERIES: No evidence of pulmonary embolus.LUNGS AND PLEURA: Mild basilar scarring/atelectasis. Stable probable intrapulmonary lymph node lung the minor fissure.Chronic elevation of the left hemidia... | No evidence of a pulmonary embolus. No acute abnormalities identified. |
Generate impression based on findings. | 70 year-old male with abdominal pain, postop day 6 for right nephrectomy. Lack of IV contrast limits ability to evaluate solid parenchymal organs and vascular structures -- within these limitations, the following observations can be made:ABDOMEN:LUNG BASES: Right pleural effusion and atelectasis. Innumerable lung nodul... | 1. Expected changes of postoperative right nephrectomy with predominantly fluid and small amount of air in surgical bed. 2. Pneumoperitoneum seen in subcutaneous emphysema, most likely relating to recent laparoscopic procedure. 3. Innumerable parenchymal lung nodules or post lung bases, most likely, metastatic disease,... |
Generate impression based on findings. | Left tonsillar pain and swelling. There is enlargement of the left palatine tonsil with extensive surrounding areas of ill-defined hypoattenuation that extend into the soft palate, parapharyngeal space, submandibular space, epiglottis, and arytenoid on the left side. There is associated moderate narrowing of the nasoph... | Findings indicative of left palatine tonsillitis associated with extensive peritonsillar edema and areas that may represent phlegmon or very early abscess formation, but no evidence of a drainable abscess. |
Generate impression based on findings. | 66-year-old male with diabetic ketoacidosis. Extracardiac mass seen on echocardiography. LUNGS AND PLEURA: Small left pleural effusion with associated segmental atelectasis/consolidation in the left base. Minimal dependent atelectasis in the right lung. No right pleural effusion. No suspicious nodules.MEDIASTINUM AND H... | 1.Evaluation of mediastinum is suboptimal given lack of IV contrast, however, no mediastinal or extracardiac mass is identified.2.Small left pleural effusion with associated atelectasis/consolidation and left base.3.Severe atherosclerotic disease. |
Generate impression based on findings. | Clinical question: Tonsillar cancer, rule out metastases. Signs and symptoms: As above. Nonenhanced head CT:Examination demonstrates no evidence of an acute intracranial process CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular sys... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | 73-year-old male patient status post gastric pull up for cancer and diaphragmatic hernia repair presented with shortness of breath. Postop day 5 from hernia repair. Evaluate for reherniation. Note that the lack of oral and intravenous contrast limits evaluation of vasculature, lymph nodes, solid organs and bowel.CHEST:... | 1.No diaphragmatic hernia.2.Extensive amount of intraperitoneal free air and mottled, infiltrating air underneath the left diaphragm. No evidence of oral contrast leak.3.Stable large bilateral pleural effusions with atelectasis. 4.Enteric tube coiled in intrathoracic portion of gastric pull up.5.Extravasation of 30 cc ... |
Generate impression based on findings. | ams s/p multiple falls. pt has a hx of MS. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There are extensive patchy areas of supratentorial and infratentorial white matter hypoattenuation that likely correspond to the reported history of multiple sclerosis. The ventricles and basal cisterns ... | 1. No evidence of acute intracranial hemorrhage, mass, or cerebral edema.2. Extensive patchy areas of supratentorial and infratentorial white matter hypoattenuation likely correspond to the reported history of multiple sclerosis. A brain MRI would be useful for further delineation, if clinically warranted.3. Pansinus o... |
Generate impression based on findings. | 52-year-old male with tachycardia and history of metastatic colorectal carcinoma. PULMONARY ARTERIES: Diagnostic quality exam with no evidence of pulmonary embolus.LUNGS AND PLEURA: Multiple bilateral pulmonary nodules are again noted, some of which appear slightly increased; reference right lower lobe nodule currently... | 1.No pulmonary embolus.2.Minimal increase in size of bilateral lung metastases. No definite new nodules.3.Although there are technical differences compared to prior exam from 10/2013, the reference right hepatic lobe lesion appears increased in size.4.Large amount of ascites fluid. |
Generate impression based on findings. | 57 year-old male with nausea and vomiting, evaluate for bowel obstruction or worsening fluid collections. ABDOMEN:LUNG BASES: No focal hepatic lesions. Pneumobilia is again noted. A biliary stent is unchanged in position, extending to the duodenum. Air is again noted within the gallbladder.LIVER, BILIARY TRACT: No sign... | 1. Mild interval decrease in size of right perinephric/peripancreatic and retroperitoneal fluid collections. No new fluid collections. 2. Persistent moderate right hydronephrosis. |
Generate impression based on findings. | 21-year-old female with abdominal pain, generalized, but greater in the lower quadrant. 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 n... | Normal CT scan of the abdomen and pelvis without findings seen to account for patient's symptomatology. No change since 7/2/13. |
Generate impression based on findings. | Male 58 years old Reason: assess for infection History: pain, immunocompromise BONES, SOFT TISSUES: There is a prominent erosion of the superior lateral femoral head with associated fluid within the joint space. Patchy sclerosis is seen along the margin of the femoral head suggestive of avascular necrosis. There is a s... | 1. Erosion of the femoral head, which may represent atypical infection, pigmented villonodular synovitis or synovial osteochondromatosis. 2. Findings suggestive of avascular necrosis.3. Possible femoral neck fracture of indeterminate age. |
Generate impression based on findings. | 79-year-old male with question of possible stroke. There is no evidence of intracranial hemorrhage, mass or edema. There is no CT evidence of stroke, however CT is suboptimal for evaluation of acute ischemic stroke.There are prominent sulci and mildly enlarged ventricles which are appropriate for the patient's age.The ... | No evidence of intracranial hemorrhage, mass, or stroke, however CT is suboptimal for evaluation of acute ischemic stroke. |
Generate impression based on findings. | 54-year-old male patient with distention, lack of ostomy output and feculent material around tracheostomy. Evaluate for obstruction versus ileus. CHEST:LUNGS AND PLEURA: Bilateral pleural effusions and dependent atelectasis. Atelectasis stable compared to prior examination. Tracheostomy tube in place. Bronchiectasis an... | 1.Debris within the esophagus and stomach with mildly dilated loops of small bowel. No evidence of obstruction. Findings most consistent with ileus.2.Interval decrease in hemoperitoneum with drain in place.3.New subcutaneous necrosis in the left inguinal region. |
Generate impression based on findings. | Clinical question: 28 year old male with T11, new severe headache. Rule out hemorrhage. Signs and symptoms: Headache. Nonenhanced head CT:No detectable acute intracranial process.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation. No evidence of edema, ... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | 49-year-old female with tuberous sclerosis, and generalized epilepsy, follow-up renal angiomyolipoma. ABDOMEN:LUNG BASES: Mild basilar atelectasis and small cysts.LIVER, BILIARY TRACT: Small punctate foci of fat likely representing AML are unchanged.SPLEEN: Unchanged small splenic AML.PANCREAS: No significant abnormali... | No significant interval change in bilateral renal angiomyolipomas with the largest left lower pole lesion measuring 4.5 cm. |
Generate impression based on findings. | 55-year-old male status post tumor resection. There has been interval left occipital craniotomy with resection of the left cerebellar mass. There is significant edema with a small amount of pneumocephalus and acute blood surrounding the surgical cavity, expected postsurgical findings. The fourth ventricle and basal cis... | 1. Expected postsurgical findings status post resection of left cerebellar mass.2. Improvement in effacement of fourth ventricle with slight decrease in hydrocephalus. |
Generate impression based on findings. | Reason: thymoma History: myasthenia LUNGS AND PLEURA: Scarlike abnormality right middle lobe image 49 series 5, the lungs otherwise unremarkable.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.There is no evidence of thymoma or thymic hyperplasia.Severe coronary artery calcifications are present primarily... | 1. No evidence of thymic tissue.2. Severe coronary artery calcification.3. Possible esophageal dysmotility. |
Generate impression based on findings. | HA, found to have papilledema. There is a partially empty sella. There is minimal flattening of the optic discs bilaterally. There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Th... | A partially empty sella and minimal flattening of the optic discs bilaterally may indicate intracranial hypertension. No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Female 62 years old; Reason: MESENTERIC MASS, POSITIVE ON PET BUT STABLE OVER TIME. EVALUATE FOR INTERVAL GROWTH History: COLON CANCER CHEST:LUNGS AND PLEURA: 4-mm right lower lobe peripheral nodule is stable compared to prior exams (series 5 image 56). No additional new pulmonary nodules.MEDIASTINUM AND HILA: No media... | No significant interval change in with stable reference lesions as described above. |
Generate impression based on findings. | Left sided facial swelling from temple to submandibular area. There is mild diffuse enlargement and heterogeneous hyperattenuation of the let parotid gland. There is no evidence of radio-opaque calculi. The right parotid gland and bilateral submandibular gland are unremarkable. There is diffuse stranding of the overlyi... | Diffuse left facial cellulitis with mild swelling of the left parotid gland, which may represent parotitis, and reactive regional lymphadenopathy, but no evidence of abscess. |
Generate impression based on findings. | 33-year-old male with nausea, abdominal pain and vomiting with eating, evaluate for pathology. ABDOMEN: Contrast phase is late arterial rather than portal venous, limiting evaluation of solid organ pathology, likely due to heart dysfunction.LUNG BASES: Right cardiac lead is partially visualized. Cardiomegaly and dilate... | 1. No specific findings to account for the patient's abdominal pain.2. Cardiomegaly with dilated right atrium, IVC, and hepatic veins, suggesting right heart dysfunction. |
Generate impression based on findings. | S/P hemorrhagic stroke. There is right anterior frontal subarachnoid hemorrhage. The right temporal region subarachnoid hemorrhage is no longer conspicuous. There are unchanged scattered areas of cerebral white matter hypoattenuation, which is most pronounced in the bilateral frontal lobes and right cerebellar hemisphe... | 1. Unchanged right frontal subarachnoid hemorrhage.2. Unchanged scattered areas of cerebral white matter hypoattenuation, which is most pronounced in the bilateral frontal lobes and right cerebellar hemisphere. |
Generate impression based on findings. | 52-year-old female with history of left breast cancer and multiple axillary lymph nodes. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: Several large left breast masses are identified. Left axillary adenopathy with the largest lymph nod... | Left breast masses and left axillary lymphadenopathy without additional evidence of metastatic disease. |
Generate impression based on findings. | 29-year-old female with fevers and history of metastatic breast cancer. LUNGS AND PLEURA: Mild interval increase in multiple pulmonary metastases. Reference right lower lobe nodule measures 2.6 x 2 .4 cm, previously measured 2.2 x 2.1 cm (series 4, image 57). Reference left upper lobe nodule measures 2.0 x 2.1 cm, prev... | Mild but definite increase in size of multiple pulmonary metastases and mediastinal lymphadenopathy, without evidence of superimposed infectious process. |
Generate impression based on findings. | Female 38 years old; Reason: evaluate pelvic abscess fluid collection History: known abscess This study is limited due to lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Previously described hypodense lesions in the liver are not seen. Lack of IV contrast limits optimal eval... | Limited study due to lack of intravenous contrast.1. Residual phlegmonous inflammation with no discernable fluid collection. Stable position of the pelvic drain.2. Patient's known liver lesions cannot be evaluated due to lack of IV contrast. |
Generate impression based on findings. | 69-year-old male with history of ischemic stroke. There is continued evolution of the previously seen right parietal lobe stroke which now appears less dense. There is no evidence of increased size or hemorrhagic conversion. There is persistent local mass effect with effacement of the sulci without any midline shift or... | 1.Continued evolution of right parietal lobe stroke without evidence of increase in size or hemorrhagic conversion. 2.Scattered age indeterminate small vessel ischemic disease. |
Generate impression based on findings. | Reason: baseline exam prior to starting systemic oral TKI therapy History: hx of metastatic renal cell cancer LUNGS AND PLEURA: 4-mm nodule in the right middle lobe (series 4 image 67), increased from 2 mm on the previous scan.The differential diagnosis includes metastasis and intrapulmonary lymph node.Other micronodul... | 4 mm nodule in the right middle lobe increased from 2 mm previously, which remains indeterminate for metastasis versus an intrapulmonary lymph node. Further follow up is recommended. |
Generate impression based on findings. | New onset seizure activity. There is extensive periventricular and subcortical low attenuation of white matter remains without evidence of mass effect. There is unchanged moderate diffuse cerebral and cerebellar volume loss. There is no mass-effect or midline shift. There is no acute intracranial hemorrhage. Stable flu... | 1. Extensive cerebral white matter volume loss and hypoattenuation is not significantly changed. However, noncontrast CT is insensitive for early infarct and detection of seizure foci. Brain MRI with contrast may be useful for further investigation.2. No evidence of acute intracranial hemorrhage.3. Interval increase in... |
Generate impression based on findings. | 57 year-old female with CHF, dizziness, and critical aortic stenosis. Evaluate the aortic size in patient being evaluated for aortic valve replacement. LUNGS AND PLEURA: No consolidation or pleural effusions. Scattered calcified and noncalcified bilateral punctate micronodules, likely benign in etiology. No suspicious ... | 1.Upper normal ascending aortic diameter as detailed above. 2.Nonspecific moderately enlarged mediastinal lymph nodes. |
Generate impression based on findings. | Reason: ?evidence of active/progressive sarcoid History: shortness of breath, cough LUNGS AND PLEURA: Stable upper lobe predominant perihilar bronchovascular areas of fibrosis, architectural distortion, traction bronchiectasis.Apical predominant bullae unchanged.No new suspicious pulmonary nodules or masses.Pleural thi... | Unchanged extensive upper lobe predominant perihilar fibrosis, architectural distortion, and traction bronchiectasis in a bronchovascular distribution compatible with known history of sarcoidosis. There is accompanying paraseptal emphysema large apical bullae. No suspicious pulmonary nodules or masses. |
Generate impression based on findings. | 62-year-old male with history of bilateral infarct. The wedge-shaped area of hypodensity in the posterior right medial temporal, right occipital, and left paramedian occipital lobe appears to have lower density. There is no evidence of increase in size or hemorrhagic conversion. There is regional mass effect with persi... | Evolution of PCA-territory stroke involving the right medial temporal, right occipital, and left paramedian occipital lobes without significant increase in size or hemorrhagic conversion. |
Generate impression based on findings. | Reason: ant chest ache, cough on persistent smoker History: as above LUNGS AND PLEURA: A diffuse bilateral groundglass opacity is present with strong and basilar predominance.Multiple small areas of air trapping are present at the lung bases suggestive of small airways disease. These findings are somewhat accentuated b... | Diffuse interstitial lung disease with basilar predominant ground glass opacity and moderate underlying emphysema with areas of focal air trapping.In view of the history of persistent smoking the differential diagnosis includes respiratory bronchiolitis interstitial lung disease (RBILD) and desquamative interstitial pn... |
Generate impression based on findings. | 72-year-old male with history of base of tongue cancer, with productive cough for two months. Evaluate for worsening aspiration. LUNGS AND PLEURA: Stable right apical scarring and small loculated pleural effusion. Scarlike opacity in the anterior aspect of the left upper lobe is unchanged (series 5, image 62).Persisten... | Chronic aspiration without evidence of superimposed infection or metastatic disease. |
Generate impression based on findings. | Critical question: Altered mental status rule out hemorrhage. Signs and symptoms: As above. Unenhanced head CT:There is no detectable acute intracranial process CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes. There are diffuse subcortical and periventricular confluence of low attenuati... | Extensive age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Reason: h/o larynx cancer History: r/o lung mets LUNGS AND PLEURA: No significant abnormality noted. No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Status post tracheostomy and neck dissection with a phonation device in place.CHEST WALL: No significant abnor... | No change, and no evidence of metastases. |
Generate impression based on findings. | Clinical portion coiled in without hemorrhage. Signs and symptoms: Alteration of mental status and right facial droop. Unenhanced head CT:No evidence of acute intracranial process. CT ovaries insensitive for detection of acute nonhemorrhagic ischemic strokes.There are several patchy foci of periventricular and subcorti... | Age indeterminate small vessel ischemic strokes and unremarkable exam otherwise. |
Generate impression based on findings. | Reason: r/o mass History: cough LUNGS AND PLEURA: Right apical scarring is present, possibly radiation reaction as the patient has had a prior right mastectomy and axillary dissection.Otherwise, the lungs are normal in appearance.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy present.A very small amount ... | No significant abnormality. Mild evolution of right apical radiation reaction. |
Generate impression based on findings. | Reason: s/p 3mo after left VATS LUL lobectomy, mediastinal LN dissection for adenocarcinoma (pT1aN0), mediastinal LN dissection (0 nodes postive).Stage 1a NSLC History: 3 mo f/u LUNGS AND PLEURA: Postsurgical changes related to interval left upper lobectomy for lung cancer.Mild focal pleural thickening and left upper m... | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 51-year-old female with gallbladder cancer, restaging CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Right central venous catheter tip at the cavoatrial junction.CHEST WALL: Prominent bilateral axillary lymph nodes are again noted with the reference right node measuring 2.0 x 1.1 cm (ima... | 1. Status post cholecystectomy without evidence of metastatic disease.2. Right chest wall soft tissue collection markedly decreased in size with improvement in axillary adenopathy. |
Generate impression based on findings. | 67-year-old male with history of right upper lobe lung cancer. LUNGS AND PLEURA: Status post right upper lobectomy, with stable linear scarlike opacity in the right apex and in right lower lobe adjacent to right hilum (series 5, image 49). No new or suspicious pulmonary nodules.Stable mild narrowing of the right middle... | Postsurgical changes in the right lung without evidence of recurrence or metastatic disease. |
Generate impression based on findings. | 68 year-old male with pleural mesothelioma status post resection and chemotherapy. LUNGS AND PLEURA: Status post left pneumonectomy with large collection of fluid in the pneumonectomy cavity. Left diaphragmatic, pleural, and pericardial graft material are again noted. No new areas of pleural thickening are appreciated ... | 1.Status post left pneumonectomy with no signs of recurrence. 2.New diffuse bronchiolitis pattern in the right lung suggestive of recurrent microaspiration and/or infection. |
Generate impression based on findings. | Reason: history of R lung cancer s/p palliative RT in 2/2013, History: sob CHEST:LUNGS AND PLEURA: Right middle lobe nodular density (image 123 series 5) is unchanged measuring 7 mm.Right lower lobe nodular and scarlike opacities stable.Postsurgical changes in the right lower lobe redemonstrated.Severe emphysema and br... | Stable right middle lobe nodule No evidence of metastatic disease. |
Generate impression based on findings. | Male 68 years old; Reason: pt with mesothelioma recurrent as of 10/2/13. No therapy yet History: now needs disease evaluation compare to previous scans and comment ABDOMEN:LUNGS BASES: Please refer to CT chest done same day for full evaluationElevation of the left hemidiaphragm, unchanged.LIVER, BILIARY TRACT: No signi... | 1.No new or evident recurrence detected. 2.Please refer to CT chest performed same day for full characterization. |
Generate impression based on findings. | 42 year old female, history of autosomal dominant polycystic kidney disease and nephrolithiasis, evaluate for nephrolithiasis. Examination is limited by the lack of IV and oral contrast in the evaluation of solid organ pathology, vasculature, and bowel. Given these limitations, the following observations are made.ABDOM... | 1. Punctate nonobstructive renal calculi appearing similar to the prior study. No hydronephrosis or hydroureter.2. Innumerable renal and hepatic cysts compatible with the history of autosomal dominant polycystic kidney disease as detailed above.3. Fibroid uterus. |
Generate impression based on findings. | 38 -year-old male with Hodgkin lymphoma -- restaging. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Scattered subcentimeter lymph nodes seen in mediastinum unchanged from 2013 and 2010 examinations without evidence of enlarged lymph nodes.CHEST WALL: Scattered normal sized axillary lymph... | No significant lymphadenopathy seen in the chest, abdomen or pelvis, and without other significant abnormality. The previous referenced left inguinal lymph node remains unchanged in size. |
Generate impression based on findings. | 75-year-old female. Lung cancer screening. LUNGS AND PLEURA: Mild to moderate upper lobe predominant emphysema. Few calcified micronodules are unchanged. No new or suspicious nodules or masses. Mild basilar atelectasis.MEDIASTINUM AND HILA: Moderate atherosclerotic calcifications in aorta and coronary arteries. Heart s... | Emphysema without suspicious lung nodules. |
Generate impression based on findings. | 61-year-old female with left upper quadrant pain -- history of ovarian cancer. CHEST:LUNGS AND PLEURA: New left lower lobe supradiaphragmatic nodule seen measuring 1.3 cm -- in retrospect a small nodule was present measuring 6 mm on 1/17/13. No other infiltrates, nodules, masses or effusions seen.MEDIASTINUM AND HILA: ... | 1. New left lower lobe 1.2-cm nodule, most consistent with metastatic focus. 2. Slight decrease in size and residual low attenuation involving the anterior aspect of left lobe of liver -- this has appearance consistent with postoperative change, but should be followed to ensure this is not peritoneal seeding of tumor. |
Generate impression based on findings. | Female 49 years old; Reason: severe pain History: dIFFUSE PAIN Limited evaluation due to the lack of IV and oral contrast in the evaluation of solid organ pathology, lymphadenopathy and vasculature.ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No si... | 1.No specific findings to account for the patient's pain. |
Generate impression based on findings. | 63-year-old female patient with history of 1.7-cm right renal mass, urothelial versus renal. 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 abno... | 1.No suspicious renal masses or filling defects in the collecting system.2.Three hypoattenuating foci within the left renal cortex are too small to characterize and most likely represent cysts.3.No renal calculi. |
Generate impression based on findings. | Female 80 years old; Reason: Evaluation of left lower quadrant nodularity (?mass) of the abdominal wall and for intraabdominal adenopathy. Ovaries absent on recent pelvic ultrasound. History: Weight loss and night sweats. Palpable abdominal wall mass left lower quadrant mass. ABDOMEN:LUNGS BASES: No nodule or mass dete... | 1.Focal mesenteric nodule/Infiltrative changes in the left lower quadrant anterior mesentery, nonspecific. This can be seen in scarring, however metastatic neoplasm cannot be excluded given lack of prior imaging.2. Cholelithiasis without cholecystitis |
Generate impression based on findings. | 55-year-old male with history of bladder cancer. Status post cystectomy with neobladder reconstruction. Rule out stricture. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL ... | Status cystectomy with neobladder creation without significant interval change or new evidence of metastatic disease. |
Generate impression based on findings. | Reason: COPD, heavy smoking, asbestos exposure History: cough LUNGS AND PLEURA: Multiple micronodules, most compatible with previous infection and intrapulmonary lymph nodes.No suspicious nodules.Mild upper zone centrilobular emphysema and moderate diffuse bronchial thickening compatible with bronchitis.Secretions are ... | Emphysema and bronchitis, with several nonspecific micronodules which are most likely benign.In view of the patient's high risk status follow-up with annual low-dose CT scans would be appropriate. |
Generate impression based on findings. | Reason: 34 male with AML, r/o baseline infiltrate History: AML LUNGS AND PLEURA: Focal air space opacity deep in the left costophrenic sulcus is consistent with localized infection.Several small ground glass nodules are present in the right lung base.MEDIASTINUM AND HILA: Numerous mediastinal lymph nodes are present, b... | 1. Left lung base focal opacity, consistent with infection although a leukemic infiltrate is in the differential diagnosis.2. Marked splenomegaly. |
Generate impression based on findings. | Reason: eval known bilateral lung transplant History: see above LUNGS AND PLEURA: Scarring/discoid atelectasis in the left lower lobe.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Left central venous catheter with its tip in the SVC.No hilar or mediastinal lymphadenopathy.Surgical... | Status post bilateral lung transplant without evidence of acute abnormalities or complications. |
Generate impression based on findings. | Status post sigmoid resection. Presenting with increased leukocytosis ABDOMEN:LUNG BASES: There is a subcentimeter nodule, best seen on image number two, series number 3. Further evaluation with chest CT may be helpful.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREA... | Postsurgical changes in the pelvis. There are two small collections, one neared anastomosis and a second one near the terminal ileum.Significant wall thickening involving the cecal base and distal ileal loops. Etiology is unknown but may be secondary to infection and less likely ischemia.Small amount of free air and fl... |
Generate impression based on findings. | 82-year-old female 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 ... | No specific CT findings to explain patient's acute abdominal pain. No significant change from previous study. |
Generate impression based on findings. | Male 61 years old Reason: abd pain, s/p radical cystectomy and ileal conduit urinary diversion 10/16/13 History: abd pain ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: Diffuse fatty liver. No focal lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: ... | Expected postsurgical changes with small amount of fluid in the pelvis and in the surgical scar. No loculation to suggest abscess, however.Fatty liver. Left adrenal myelolipoma. |
Generate impression based on findings. | History of intranasal polyps and sinusitis. Evaluate for sinus disease after treatment with intranasal steroids. There is an opacified left superior anterior ethmoid air cell adjacent to the basal lamina. The paranasal sinuses and mastoid air cells are otherwise clear. There is mild nasal septal deviation and 4 mm righ... | Opacified left ethmoid air cell, but otherwise clear paranasal sinuses and nasal cavity. |
Generate impression based on findings. | Postop menopausal bleeding. Increased abdominal distention.. ABDOMEN:LUNG BASES: Small pleural effusions.LIVER, BILIARY TRACT: There are multiple hypodense lesions in the liver suspicious for metastatic disease. Index lesion in the right lobe measures 1.1-cm image number 32, series number 3.SPLEEN: No significant abnor... | Extensive peritoneal carcinomatosis and metastatic liver disease.Right-sided hydronephrosis caused by decompression of the pelvic mass.Ill-defined soft tissue mass in the pelvis, which cannot be differentiated from the leiomyomatous uterus. Bilateral adnexal masses cannot be excluded. |
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