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Generate impression based on findings. | 25 year-old female with relapsed AML, graft versus host disease, presenting with diffuse abdominal pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Unchanged right hepatic hypodensity representing a cyst.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: Fluid filled right hemicolon without wall thickening. The distal colon is filled with feces. Interval resolution of ileal wall thickening and mesenteric inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Fluid filled right hemicolon without wall thickening. The distal colon is filled with feces. Interval resolution of ileal wall thickening and mesenteric inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Fluid-filled right hemicolon without wall thickening, which is nonspecific, but may represent enteritis. Interval resolution of small bowel findings suggesting graft-versus-host disease. |
Generate impression based on findings. | 54-year-old female with abdominal pain and distention for one week. Abdominal tenderness. ABDOMEN:LUNG BASES: Emphysematous changes. Catheter tip in right atrium. Scattered nonspecific ground glass opacities diffusely in the lung bases.LIVER, BILIARY TRACT: Extensive solid innumerable mass lesions, most consistent with diffuse metastatic disease replacing the majority of liver parenchyma. Portal veins and hepatic veins appear patent throughout.Gallbladder and biliary tract show no abnormalities.SPLEEN: No significant abnormality noted in splenic parenchyma. Calcified enhancing density in splenic hilum (series 4, image 47) measures 1.8 x 2.7 cm and represents a splenic artery aneurysm.PANCREAS: Atrophy of the body and tail. The pancreas with marked dilatation of the pancreatic duct extending to the head of the pancreas where a hypodense mass is seen measuring approximately 3.0 X 1.8 cm.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Hepatoduodenal ligament, and para-aortic adenopathy is seen. Largest lymph node (series 4, image 60) in the aorta caval space measures 2.1 x 2.2 cm.In vena cava filter in the infrarenal location with expected appearance.BOWEL, MESENTERY: No evidence of bowel obstruction with orally administered contrast traversing through normal-appearing small bowel. Colon is without abnormality and is feces filled. Extensive ascites is present diffusely. Omental masses are seen extensively throughout the abdomen (see series 4, image 85 and image 105).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No evidence of bowel obstruction with orally administered contrast traversing through normal-appearing small bowel. Colon is without abnormality and is feces filled. Extensive ascites is present diffusely. Omental masses are seen extensively throughout the abdomen (see series 4, image 85 and image 105).BONES, SOFT TISSUES: Surgical hardware in the lumbar spine and pelvis. No other focal abnormalities identified. Small left pleural effusion.OTHER: No significant abnormality noted | 1. Extensive liver metastases. 2. Large amount of ascites. 3. Extensive omental metastases. 4. Retroperitoneal lymphadenopathy. 5. Splenic artery aneurysm.Findings discussed with Dr. Abbo at 11:05 AM. |
Generate impression based on findings. | Male, 57 years old, hemiplegia, intraventricular and intracerebral hemorrhage status post fall. No significant change in size or morphology of the right thalamic/basal ganglia hematoma. Stable surrounding parenchyma edema and mass effect. Hemorrhage seen previously layering within the occipital horns is no longer distinctly detectable. Minimal subarachnoid hemorrhage persists in the occipital regions. There has been no significant change in the caliber of the lateral ventricles.Postprocedural change redemonstrated status post removal of a right frontal approach shunt catheter. Small calcific focus along the right frontal lobe tract is redemonstrated. Mild persistent subcutaneous air and fluid at the shunt site. | 1. Stable right basal ganglia/thalamic hematoma. No new hemorrhage.2. Stable ventricular size. |
Generate impression based on findings. | 52-year-old male with bronchiectasis with acute exacerbation. Evaluate for PE. PULMONARY ARTERIES: Diagnostic quality exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Severe basilar predominant bronchiectasis with air-fluid levels, not significantly changed. Increase in subpleural tree in bud opacities, best appreciated in the right upper lobe (series 8, image 46), most compatible with mucoid impaction and bronchiolitis. No consolidation or pleural effusions.MEDIASTINUM AND HILA: No significant change in mediastinal and hilar lymphadenopathy. Heart size normal without pericardial effusion. Persistent mild enlargement of the main pulmonary artery, suggestive of pulmonary arterial hypertension. No significant change in tracheal flattening and increased AP dimension, most likely result of pulmonary disease. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. | 1.No pulmonary embolus.2.No significant change in severe basilar predominant bronchiectasis. While this may be post inflammatory in nature, ciliary dyskinesia and Williams Campbell disease are also in the differential.3.Mild increase in the subpleural tree in bud opacities, most notable in the right upper lobe, consistent with bronchial mucoid impaction and bronchiolitis. |
Generate impression based on findings. | Reason: 32 yo female with chest pain, sob, tachycardia History: 32 yo female with chest pain, sob, tachycardia PULMONARY ARTERIES: Technically adequate examination although with motion abnormalities. Extensive bilateral pulmonary emboli extending from right and left main pulmonary arteries involving and nearly occluding segmental and subsegmental pulmonary arteries. Main pulmonary artery caliber is high-normal.LUNGS AND PLEURA: Few areas of groundglass opacity may represent edema or focal hemorrhage.Ill-defined, linear opacity in the right middle lobe and focal opacity in the right anterior upper lobe may represent infarct. MEDIASTINUM AND HILA: Heart size is normal. Right chamber of the heart larger than the left chamber with associated interventricular septal flattening consistent with degree of right heart strain. No pericardial effusions. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesion in the dome of the liver (series 9, image 148) likely represents a benign cyst. Splenule. | Saddle embolus extending into bilateral segmental and subsegmental pulmonary arteries. |
Generate impression based on findings. | 43-year-old male status post recent panniculectomy ABDOMEN:LUNG BASES: Basilar atelectasis and moderate cardiomegaly.LIVER, BILIARY TRACT: Cholelithiasis. No focal hepatic lesions. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic native kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive postsurgical change of the abdominal wall with two drains and surrounding infiltration of fat as well as a large hyperdense collection likely representing a postoperative hematoma, which measures 20 x 6.8 cm (image 80, series 3). Small foci of gas are noted without loculated fluid collection.OTHER: 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: Moderate degenerative change of the lower lumbar spine with grade 1 anterolisthesis of L4 and L5.OTHER: No significant abnormality noted | Postoperative changes of the abdominal wall with large hematoma and small foci of gas and soft tissue edema but no loculated fluid collections. These findings were discussed with Dr. Leung (pager 2787) at the time of dictation. |
Generate impression based on findings. | 75-year-old female patient with right lower quadrant abdominal pain and low-grade fever. Evaluate for appendicitis versus diverticulitis. ABDOMEN:LUNG BASES: Bilateral atelectasis versus scarring. Cardiac pacemaker in place.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: Extensive colonic diverticulosis. Appendix is visualized and is within normal limits. There is thickening of the wall of the cecum with mucosal enhancement and adjacent fat stranding. There is pericecal fluid and small amount of perihepatic ascites.Bowel is normal in caliber without evidence of obstruction.BONES, SOFT TISSUES: S-shaped scoliosis of the thoracic and lumbar spine. Severe multilevel degenerative changes in the thoracic and lumbar spine. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Exophytic, partially calcified mass extending from the uterus is consistent with a uterine fibroid.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive colonic diverticulosis. Appendix is visualized and is within normal limits. There is concentric thickening of the wall of the cecum with mucosal enhancement and adjacent fat stranding. There is pericecal fluid and small amount of perihepatic ascites.BONES, SOFT TISSUES: S-shaped scoliosis of the thoracic and lumbar spine. Severe multilevel degenerative changes in the thoracic and lumbar spine. Anterolisthesis of L4 on L5. Degenerative changes in the bilateral hips.OTHER: No significant abnormality noted. | 1.Nonspecific inflammation of the cecum with pericecal fluid is most likely secondary to diverticulitis given patient's extensive diverticulosis.2.Degenerative changes in the spine and hips. |
Generate impression based on findings. | Pt with TxN0 SCC treated with CRT 10/8/2010. please re-eval for recurrence Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses demonstrate a mucus retention cyst left maxillary sinus which is stable since prior exam. The mastoid air cells are clear.The parotid and the right submandibular glands appear intact. There is infiltration of the fat plane surrounding the left submandibular gland a finding which has been present since at least June 2010 without any significant change compared to the adjacent left platysma muscle is also thickened suggesting a this could represent scar tissue.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. | 1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy. |
Generate impression based on findings. | Male 50 years old; Reason: GEJ cancer to liver/lung. Evaluate interval change from prior after History: none CHEST:LUNGS AND PLEURA: Index left upper lobe nodule measures 7 x 10mm, previously 8 x 10 mm on image number 69, series number 5, stable in size compared to previous study. Index right upper lobe nodule measures 10 x 10 mm in diameter image number 36, series number 5, also stable in size compared to previous study. Other non referenced subcentimeter nodules have minimally increased in size and conspicuity compared to previous study.MEDIASTINUM AND HILA: Index mediastinal lymph node adjacent to the trachea and now measures 0.9 x 0.6cm previously 1.1 x 0.8 cm image number 24, series number 3, smaller than previous. Other mediastinal lymph nodes are unchanged. Stable wall thickening of the distal esophagus is unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple liver metastases are again noted and are larger and more conspicuous since the previous. Index right hepatic lobe lesion measures 2 x 1.4 cm previously 1.7 x 1 cm image number 94, series number 3. Although difficult to differentiate this lesion from normal liver, the lesion now appears to extend to the liver capsule, which demonstrate progression..Index left lobe lesion measures 10.1 x 5 .7 cm, previously 8.7 x 5.4 cm image number 116, series number 3, significantly increased in size compared to previous study.There is increase in the perihepatic ascites.SPLEEN: Previously mentioned hypodense lesion in the spleen is unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index gastrohepatic lymph node measures 1.9 x 2 cm in previously 1.7 x 2 cm on image number 102, series number 3, not significantly changed from previous study. Index aortic lymph node measures 1.9 x 1cm previously 1.3 x 1 cm image number 126, series number 3, slightly larger. Other retroperitoneal lymph nodes are also stable.BOWEL, MESENTERY: Wall thickening of the proximal stomach and is stable.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: Small amount of ascites.BONES, SOFT TISSUES: Expansile sclerotic lesion in the left iliac wing and left pubic bone unchanged.OTHER: No significant abnormality noted | 1. Interval increase in the size of the referenced and non referenced hepatic lesions. 2. Lung lesions and retroperitoneal lymph nodes are stable to minimally enlarged.3. Stable wall thickening of the stomach and esophagus4. Pelvic expansile/sclerotic bone lesions are stable. |
Generate impression based on findings. | Male, 75 years old, hemorrhagic stroke. Parenchymal hematoma is re-demonstrated involving the left basal ganglia, inferior frontal lobe and insula. There has been no significant interval change in size. Degree of associated mass effect with effacement of the left frontal horn and mild midline shift to the right is not substantially changed. Scattered bilateral subarachnoid hemorrhage also redemonstrated with some degree of redistribution. Intraventricular hemorrhage layering in the occipital horns redemonstrated, probably not significantly changed allowing for redistribution. Ventricular caliber is unchanged. | Stable left basal ganglia hematoma with stable associated mass effect. No definite evidence of new bleeding. Scattered subarachnoid and intraventricular blood is also likely unchanged allowing for redistribution. |
Generate impression based on findings. | 40 year-old female with presumed liver cirrhosis from autoimmune hepatitis, ascites, and elevated CEA 125 -- evaluate morphology of the liver and determine if the patient has ovarian pathology. ABDOMEN:LUNG BASES: Bibasilar atelectasis.LIVER, BILIARY TRACT: Small liver with cirrhotic morphology. Portal vessels appear patent -- hepatic veins could not be visualized which may reflect sclerotic process and delayed phase of enhancement.2.0-cm hypodense mass is seen in the left lobe of liver (series 12, image 31), which would this single phase of contrast is nonspecific. In light of marked cirrhosis, hepatocellular carcinoma is a key consideration. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No adenopathy or retroperitoneal masses are seen.BOWEL, MESENTERY: No significant abnormality noted in the stomach, small bowel or colon. Marked ascites without focal, loculated collection is seen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Normal uterus. Bilateral ovaries are seen of normal size without diagnostic abnormality seen.BLADDER: Foley catheter in a collapsed bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Left inguinal hernia containing only free mesenteric fluid.OTHER: No significant abnormality noted | 1. Cirrhotic liver. 2. Nonspecific 2-cm left lobe liver mass -- recommend either MRI or dedicated multiphase liver CT examination to evaluate enhancement characteristics as hepatocellular carcinoma cannot be excluded. 3. Extensive ascites. 4. left inguinal hernia. 5. Normal-appearing ovaries bilaterally. |
Generate impression based on findings. | 78 year-old female with pulmonary adenocarcinoma and new brain METs, evaluate for progression CHEST:LUNGS AND PLEURA: Cavitary left lower lobe nodule measures 1.9 x 2.6 cm and previously measured 1.9 x 2.4 cm (image 50 series 5).Additional cavitary nodules and right infrahilar mass with distal collapse and consolidation appear similar to the prior study.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy is unchanged with a paratracheal lymph node measuring 2.3 x 0.9 cm (image 36, series 4) and previously measuring 2.4 x 10 cm. Moderate atherosclerotic calcification and noncalcified plaque affects the aorta and its branches. Right hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Splenic lesion is now hypoattenuating, possibly representing treatment effect.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nonspecific left adrenal gland nodule appears unchanged.KIDNEYS, URETERS: Multiple hypodense lesions, likely representing cysts.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcification and noncalcified plaque of the abdominal aorta and its branches.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES:Small ventral hernia containing fat.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: Moderate degenerative disk disease at L5/S1.OTHER: No significant abnormality noted. | Unchanged lung masses and associated lymphadenopathy. Decreased attenuation of the splenic lesion may represent treatment effect. No new metastatic lesions identified. |
Generate impression based on findings. | Pain following MVC. Head: There is no intracranial mass, hemorrhage, hydrocephalus or CT evidence of acute ischemia. The midline is intact. The is a partially visualized soft tissue density within the inferior aspect of the left maxillary sinus likely representing mucous retention cyst. Sinuses and mastoid air cells are otherwise clear. Orbits are unremarkable bilaterally. There are no depressed fractures demonstrated.Cervical spine: There is ossification of the posterior longitudinal ligament at the level of the L4 vertebral body which partially effaces the thecal sac as well as a corticated ossific fragment within the posterior soft tissues at this level which appears nonacute. Vertebral body and intervertebral disk height is maintained. There are no visualized fractures. There is no prevertebral soft tissue swelling and the odontoid is intact. Alignment is normal. | No visualized sequela of trauma. Note of thecal sac effacement at the L4 level by ossified posterior longitudinal ligament. |
Generate impression based on findings. | 36 year old with chest pain and shortness of breath. PULMONARY ARTERIES: Diagnostic quality exam without evidence of pulmonary embolus.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of pulmonary embolus or other significant abnormalities. |
Generate impression based on findings. | 50 year-old female with enlarged lymph nodes. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Heart size normal without pericardial effusion. Scattered small lymph nodes in mediastinal are within normal size limits.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy. No suspicious liver lesions.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodense lesion in left kidney is incompletely evaluated however most compatible with cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications in aorta and its branches. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of lymphadenopathy or other significant abnormality. |
Generate impression based on findings. | 73-year-old male with lung cancer. CHEST:LUNGS AND PLEURA: Right upper lobe mass is difficult to measure, however, is increased in size; currently measuring 6.7 x 5.5 cm, previously measured 5.7 x 3.8 cm (series 5, image 25). Multiple other right upper lobe nodular opacities also appear increased.Increased nodular consolidation in the right lower lobe and right middle lobe. Status post left upper lobectomy. No significant change in complete consolidation in the left base with associated small pleural effusion. Stable loculated fluid in left apex. Stable severe bronchiectasis/cystic change in the left mid lung.MEDIASTINUM AND HILA: No significant change in multiple enlarged mediastinal lymph nodes.CHEST WALL: Stable chronic deformity of left posterior ribs.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal hypodensities, not significantly changed and most compatible with cysts.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.Unchanged calcified soft tissue nodule in the anterior upper abdomen. No new or suspicious lesions.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Interval increase in size of right upper lobe mass and multiple surrounding nodules.2.Interval increase in right middle lobe and right lower lobe consolidation, which may represent spread of tumor.3.No significant change in mediastinal adenopathy.4.Postsurgical changes and consolidation in the left lung, unchanged. |
Generate impression based on findings. | Ovarian carcinoma with pelvic pain CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal nodule; favor benign etiology such as adrenal adenomaKIDNEYS, URETERS: Stable bilateral renal cystsRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post omentectomy.BONES, SOFT TISSUES: Loculated subcutaneous fluid focus; favor benign postoperative collection. No obvious faschial defect.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral oophorectomyBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mildly dilated mid-ileal bowel loops best appreciated on image 163 of series 3.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post omentectomy, hysterotomy, and bilateral nephrectomy. No evidence for recurrent tumor or adenopathy.Mildly dilated mid-ileal bowel loops within the pelvis out of proportion with respect to the distal small bowel. Findings raise the possibility of a mild partial small bowel obstruction secondary to adhesions. |
Generate impression based on findings. | Headache post MVC. Head: There is no intracranial mass or hemorrhage. Ventricles and cisterns demonstrate normal size and morphology. There is no mass effect and the midline is intact. Orbits, paranasal sinuses and mastoid air cells are unremarkable. There are no depressed skull fractures.Cervical spine: There is normal alignment. Vertebral body and intervertebral disk spaces are maintained. There are no fractures and the odontoid is intact. There is no prevertebral soft tissue swelling. | No abnormality demonstrated including fracture or traumatic sequela. |
Generate impression based on findings. | 33-year-old male with pulmonary hypertension. Evaluate for change in groundglass opacities. LUNGS AND PLEURA: No significant change in right upper lobe nodular subpleural opacity, measuring 2.0 x 1.8 cm, previously measured 2.0 x 1.8 cm (series 5, image 36). Scattered apparent ground glass opacities in both upper lobes, right middle lobe, and superior aspects of both lower lobes, not significantly changed and most likely due to mosaic perfusion.Stable scattered lung micronodules and linear scar-like opacities. No pleural effusions.MEDIASTINUM AND HILA: Mildly decreased moderate pericardial effusion. Stable right side predominant cardiac enlargement. Persistent stable enlargement of the main pulmonary artery compatible with pulmonary arterial hypertension.Right central venous catheter terminates in right atrium.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Atrophic kidneys bilaterally. Skeletal findings compatible with renal osteodystrophy. Persistent heterogeneity of hepatic parenchyma, which is inadequately evaluated due to lack of IV contrast, but likely not significantly changed. Trace amount of ascites fluid around the liver is decreased. | 1.Findings compatible with pulmonary arterial hypertension, with marked mosaic perfusion, not significantly changed.2.No significant change in right upper lobe subpleural opacity in, which may represent sequela of pulmonary infarction.3.Mildly decreased moderate pericardial effusion.4.Resolution of right pleural effusion and decreased trace ascites. |
Generate impression based on findings. | 46 year old female with history of ILD and DAD, presents with shortness of breath and cough. LUNGS AND PLEURA: Extensive bilateral ground glass and reticular opacities, with areas of mild honeycombing. Pleural thickening in the anterior aspect of the right lung. Postsurgical changes in the right lung base. No evidence of air trapping on expiratory images.Calcified granuloma in the left upper lobe. Evaluation for nodules is difficult given the background of ground glass and interstitial opacities. No suspicious nodules or masses are identified given this limitation.Moderate upper lobe predominant emphysema.MEDIASTINUM AND HILA: Moderate to severe coronary artery calcifications. Heart size normal without pericardial effusion. Multiple prominent mediastinal lymph nodes, which may be reactive in nature.Calcifications in the right lobe of thyroid gland.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. | 1.Extensive ground glass and reticular interstitial opacities bilaterally with mild honeycombing; findings are consistent with a possible UIP pattern, chronic hypersensitivity pneumonia, as well as prior ARDS/DAD. 2.Emphysema. |
Generate impression based on findings. | 65-year-old male, follow up for therosphere treated HCC. CHEST:LUNGS AND PLEURA: Scattered micronodules, some of which are calcified and likely represent prior granulomatous disease.MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal lymph nodes. Small calcified hilar lymph nodes likely represent prior granulomatous disease. Coronary arterial calcifications. The heart size is normal.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Large right hepatic mass with persistent mosaic attenuation and regions of arterial enhancement measures 10.6 x 8.4 cm and previously measured 11.4 x 8.3 cm (image 30, series 9). Enhancement of the capsule with regions of washout are seen on delayed images. Slightly increased central hypoattenuation is suggestive of some interval necrosis.A second segment 4 mass without arterial enhancement but demonstrating washout and peripheral capsular enhancement on delayed images measures 2.3 x 2.2 cm (image 39, series 3) and previously measured 2.4 x 2.1 cm (image 43 series 12).A 8 x 6 mm arterial enhancing focus in the posterior right hepatic lobe is identified without washout (image 41, series 9), slightly increased in size from the prior study.Cirrhotic liver morphology with mild abdominal ascites as well as gastrosplenic and gastrohepatic collaterals and re-cannulization of the periumbilical vein. The portal and splenic veins are patent. The hepatic artery and hepatic veins are patent.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild abdominal ascites.PELVIS: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: Moderate pelvic ascites. | 1. Large arterially enhancing right hepatic mass with washout consistent with HCC is unchanged in size with slightly increased central hypoattenuation suggesting necrosis.2. Segment 4 mass seen best on the delayed images is also consistent with HCC, unchanged in size. Nonspecific arterially enhancing 8mm focus in the posterior right hepatic lobe without washout does not meet the criteria for HCC, but is slightly larger than on the prior study.3. Cirrhotic morphology with evidence of portal hypertension. |
Generate impression based on findings. | 83-year-old female with history of aspergillus pneumonia. LUNGS AND PLEURA: Improved bilateral consolidation, which was previously seen predominantly in the upper lobes, consistent with resolving infection. Scattered residual opacities are seen in both upper lobes.Mildly increased moderate to large bilateral pleural effusions with overlying basilar consolidation/atelectasis.MEDIASTINUM AND HILA: Multi-nodular goiter. Severe atherosclerotic calcifications affect the aorta and coronary arteries. New moderate pericardial effusion. No pathologically enlarged mediastinal lymph nodes. Heart size within normal limits.CHEST WALL: Diffuse anasarca. Degenerative changes affect the spine and shoulders. Right PICC terminates in the right axillary vein.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. Hypodense lesion in the spleen most compatible with cyst. Haziness of the upper abdominal mesentery compatible with diffuse edema. | 1.Improved upper lobe predominant opacities compatible with resolving infection.2.Increased bilateral pleural effusions, anasarca, and new moderate pericardial fusion, suggestive of volume overload. |
Generate impression based on findings. | 47-year-old male with history of biliary carcinoma, status post resection -- now with nausea, vomiting -- evaluate small bowel obstruction. Right upper quadrant pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Pneumobilia and cholecystectomy is seen, consistent with prior, biliary tract surgery. No space occupying mass lesions are seen in the liver.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: Postsurgical changes without other abnormality seen. No free mesenteric fluid. Administered contrast progresses rapidly through normal-appearing small bowel to right lower quadrant without evidence of obstruction. Colon is feces filled without other abnormality. No evidence of mesenteric metastatic lesions.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: Administered contrast progresses rapidly through normal-appearing small bowel to right lower quadrant without evidence of obstruction. Colon is feces filled without other abnormality. No evidence of mesenteric metastatic lesions.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Postsurgical changes from prior, biliary tract surgery. 2. No evidence of tumor recurrence. 3. No evidence for bowel obstruction. |
Generate impression based on findings. | 71-year-old male with fever, shortness of breath, and status post antibiotic treatment. LUNGS AND PLEURA: New clusters of micronodules and mild ground glass opacity in upper lobes and lingula suspicious for bronchiolitis and/or aspiration. New subsegmental consolidation in lingula with associated bronchial wall thickening also likely due to aspiration and/or bronchiolitis.No significant pleural effusions. No suspicious nodules or masses. Scattered linear opacities are not significantly changed and compatible with scarring.MEDIASTINUM AND HILA: Multiple small mediastinal lymph nodes, which may be reactive in nature. Heart size normal without pericardial effusion. Mild coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypoattenuating lesion in right lobe of the liver, unchanged and most compatible with cyst. Punctate, partially visualized hyperdensity in left kidney compatible with nonobstructing stone and unchanged. | Right upper lobe predominant clusters of micronodules and left lingular subsegmental consolidation suspicious for bronchiolitis and/or aspiration. |
Generate impression based on findings. | Female, 75 years old, history of squamous cell cancer of the oral cavity status post induction. A lobular enhancing tumor is identified within the left upper lip spanning from the skin surface to the buccal mucosa. The lesion measures 4.4 x 2.7 cm in maximal transaxial dimension (image 17 series 6), previously about 2.9 x 1.6 cm. The tumor abuts the anterior maxilla without definite evidence of osseous erosion. In the craniocaudal dimension, tumor involves the entirety of the lip and extends superiorly to the level of the left nasal ala.The above tumor seems to be contiguous with ill-defined mucosal thickening extending inferiorly along the left buccal space to the level of the mandible. There is evidence of osseous erosion of the left mandible extending as far inward as the level of the inner cortex, stable. This region of tumor has decreased in size measuring 3.1 x 1.0 cm (image 26 series 6), previously 3.5 x 2.9 cm. The mandibular teeth have been removed since the prior exam.No pathologically enlarged lymph nodes identified in the neck by CT size criteria. Numerous scattered small lymph nodes are evident bilaterally. There is an enhancing node with the left submandibular space which, although not pathologically enlarged, is larger than all the other neck nodes. It measures 1.1 x 0.9 cm (image 33 series 6), previously 1.4 x 1.1 cm. An adjacent more posterior lymph node is again seen, also slightly smaller than on the prior exam.The remainder of the aerodigestive tract is unremarkable. Salivary glands and the thyroid and free of focal lesions. Cervical vessels are patent. Lung apices are clear. Except as above, no concerning osseous lesions are seen. | 1. Mild expansion in size of tumor involving the left upper lip.2. Tumor seen on the prior examination to involve the left buccal space at the level of the mandible is substantially reduced in size. It is unclear if this change reflects surgical debulking or response to therapy.3. Two small left submandibular lymph nodes are identified which are nevertheless somewhat suspicious due to their enhancement and size relative to other neck nodes. These have become smaller in the interval. |
Generate impression based on findings. | Reason: Pt with TxN0 SCC treated with CRT 10/8/2010. please re-eval for recurrence History: as above CHEST:LUNGS AND PLEURA: Calcified micronodule in the left base unchanged.Mild interval increase in medial right basilar ground glass opacities. New small scar-like nodule in the right peripheral upper lobe.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusions. No mediastinal or hilar lymphadenopathy.CHEST WALL: Mild degenerative changes of the thoracic spine. Sclerotic focus in the right scapula and humeral head are unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypodense lesion adjacent to the caudate lobe is unchanged. Hepatic segment 5 hemangioma is unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodense lesion in the right kidney likely represents a benign renal cyst, unchanged.PANCREAS: Hyperdense lesion in the body of the pancreas measuring 7 mm remains unchanged since 2010. This likely represents a neuroendocrine tumor and does not need dedicated follow-up at this time. No evidence of obstruction.RETROPERITONEUM, LYMPH NODES: Numerous small retroperitoneal lymph nodes appear 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. | No evidence of recurrent or metastatic disease without interval change. |
Generate impression based on findings. | 67-year-old female with history of peritoneal mesothelioma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Unchanged heterogeneous left thyroid nodule. No mediastinal or hilar lymphadenopathy. Central venous catheter tip extends to the SVC. Soft tissue mass at the right cardiophrenic angle measures 4.2 x 2.0 cm and previously measured 4.4 x 2.2 cm (image 77, series 3). Additional adjacent soft tissue nodule is unchanged.CHEST WALL: Right chest wall port.ABDOMEN:LIVER, BILIARY TRACT: Small hepatic hypodensities likely representing cysts, are unchanged. Soft tissue mass near the hepatic vein confluence is also not significantly changed. Cholelithiasis. The hepatic vasculature is patent.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: Multiple small para-aortic lymph nodes are unchanged.BOWEL, MESENTERY: Extensive peritoneal and mesenteric disease is reidentified, increased in size and extent. Reference omental soft tissue mass measures 8.6 x 3.1 cm (image 113, series 3) and previously measured 7.3 x 2.7 cm. There is increased mesenteric infiltration and new small nodule in the left lower quadrant. Thickening of the gastric antrum is again noted.BONES, SOFT TISSUES: Reference abdominal wall soft tissue mass measures 7.2 x 2.5 cm and previously measured 7.0 x 2.3 cm (image 128, series 3).OTHER: Mild abdominal ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Small pelvic lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: Moderate pelvic ascites, increased from the prior study. | Increase in peritoneal and mesenteric disease as detailed above. |
Generate impression based on findings. | Right lower quadrant 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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Status post right inguinal hernia repairOTHER: No significant abnormality noted | Negative for acute, inflammatory, or neoplastic process. |
Generate impression based on findings. | 75-year-old male patient with metastatic prostate cancer status post 15 cycles of investigational therapy. Evaluate for disease. CHEST:LUNGS AND PLEURA: Redemonstrated are multiple bilateral pulmonary nodules without significant interval change. Reference left upper lobe pulmonary nodule measures 0.9 x 0.9 cm (series 5 image 34), stable.MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal lymph nodes, stable.CHEST WALL: Stable left Bochdalek hernia.ABDOMEN:LIVER, BILIARY TRACT: Numerous subcentimeter hypoattenuating foci within the liver are stable compared to prior examination and likely represent benign cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal sinus cyst and right renal cyst are stable compared to prior examination.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral fat containing inguinal hernias. Multiple sclerotic lesions in the L4, L5, S1 and S2 vertebral bodies are stable compared to prior examination. Posterior fixation at L4 through S1 is unchanged compared to prior.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: Multiple sclerotic lesions in the L4, L5, S1 and S2 vertebral bodies are stable compared to prior examination. Posterior fixation at L4 through S1 is unchanged compared to prior.OTHER: No significant abnormality noted. | 1.Appearance and distribution of pulmonary metastases in sclerotic bone lesions stable compared to prior examination. 2.No evidence for development of new metastatic sites. |
Generate impression based on findings. | 62-year-old male status post cystectomy with neobladder formation, evaluate for recurrent or metastatic disease. 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: Status post right nephrectomy. The left kidney appears normal with filling of the collecting system and ureter on delayed images extending to the neobladder without evidence of mass.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the lumbar spine.OTHER: No significant abnormality noted | Status post cystoprostatectomy and right nephrectomy without evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 40 year-old male with suspected fungal pneumonia. History of MDS. LUNGS AND PLEURA: Previously seen right upper lobe nodular opacity is smaller, compatible with resolving infection. Bilateral moderate pleural effusions, increased on the right and stable on the left, with overlying basilar consolidation/atelectasis. The previously seen right base lateral consolidation is likely improved.MEDIASTINUM AND HILA: Heart size normal. Stable small pericardial effusion. No significantly enlarged mediastinal lymph nodes. Left PICC tip terminates in distal SVC. Hypoattenuation of the blood pool consistent with anemia.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. New peripheral, wedge-shaped hypodensities in the spleen. | 1.Improved right upper lobe nodular opacity compatible with resolving infection. Previously seen peripheral consolidation in the right lower lobe also appears improved.2.Moderate bilateral pleural effusions, increased on the right, with overlying basilar atelectasis/consolidation.3.Stable small pericardial effusion.4.New peripheral hypodensities in the spleen, not specific but may represent fungal infection or infarctions. |
Generate impression based on findings. | 54-year-old male history of right lower lobe pulmonary embolus. LUNGS AND PLEURA: Resolution of pleural effusions. Subsegmental atelectasis in the left base. No consolidation, suspicious nodules or masses.Please note that study was not performed according to pulmonary embolus protocol, and evaluation of previously seen embolus is suboptimal. Given limitation, no large, central pulmonary embolus identified.MEDIASTINUM AND HILA: Calcifications in aorta and coronary arteries. Heart size normal without pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: Orthopedic hardware in the spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Resolution of previously seen pleural effusions with no acute intrathoracic abnormality on current exam. Please note that assessment for pulmonary embolus is inadequate given that this was not a PE protocol CT. Given limitation, no large, central embolus is seen. |
Generate impression based on findings. | Reason: 36yoM with DM, HTN here in MICU with pneumomediastinum of unclear etiology. Please eval and compare to previous. Esophagus pathology? Or PTX? History: respiratory failure. Additional history provided by MICU resident: History of vomiting with retching and coughing in days prior to presentation. LUNGS AND PLEURA: Bilateral lower lobe opacities consistent with aspiration pneumonia. Small focal groundglass opacities likely represent additional foci of pneumonia. No pleural effusions. Minimal left apical pneumothorax.MEDIASTINUM AND HILA: ET tube noted. NG tube with tip in the stomach. Heart size is normal. No pericardial effusions. Interval decrease in pneumomediastinum. Focus of air in adjacent to the distal esophagus.CHEST WALL: Low cervical lymphadenopathy. Air tracks through the muscle layers in the anterior neck extending inferiorly.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Residual contrast is noted within the bowel. | 1.Bilateral lower lobe opacities consistent with aspiration pneumonia.2.Interval decrease in extensive pneumomediastinum. Minimal apical pneumothorax.3.The pneumomediastinum most likely is spontaneous, related to coughing, rather than esophageal rupture. |
Generate impression based on findings. | 51-year-old male patient with stage IV colon cancer. Please compare to previous scans and provide an index lesion measurements. CHEST:LUNGS AND PLEURA: Pulmonary micronodule in the right lower lobe is too small to accurately measure and appears larger compared to previous examination (series 4 image 50).MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal lymph nodes, stable.CHEST WALL: Left sided chest port with catheter tip in the superior vena cava.ABDOMEN:LIVER, BILIARY TRACT: Redemonstrated are multiple hypoattenuating lesions within the liver. Index lesion in segment 7 measures 1.6 x 1.6 cm (series 3 image 86), previously 1.4 x 1.4 cm. Index lesion in segment 4 measures 3.9 x 2.4 cm (series 3 image 98), previously 3.1 x 2.3 cm. There is slight interval increase in a hypoattenuating lesion within segment 8 of the liver (series 3 image 100). Other hypoattenuating lesions appear stable.Perihepatic and capsular implants are stable.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: Mild multilevel degenerative changes in the thoracic and lumber spine. OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Left external iliac lymph node measures 9 mm and is stable compared to prior examination (series 3 image 174).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes in the thoracic and lumber spine. There is a new asymmetric soft tissue density in the external iliac region and measures 1.1 x 3.0 cm (series 3 image 182).OTHER: No significant abnormality noted. | 1.Slight interval increase in index hypoattenuating liver lesions with subjective increase in size of nonindex lesions.2.Asymmetric soft tissue density in the extra iliac region, new compared to prior examination.3.Interval increase in right lower lobe pulmonary nodule. |
Generate impression based on findings. | 71-year-old male with esophageal cancer status post chemoradiation CHEST:LUNGS AND PLEURA: Scattered calcified granulomas. No suspicious nodules or masses. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Multiple calcified mediastinal and hilar lymph nodes. No pathologically enlarged lymph nodes. Heart size normal without pericardial effusion. Interval decrease in thickening of distal esophagus, compatible with known esophageal neoplasm.CHEST WALL: Right chest wall port catheter, with tip at SVC/RA junction. Round soft tissue nodule in the midline of upper chest wall, unchanged and most compatible with sebaceous cyst.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy. No suspicious liver lesions.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Interval decrease in distal esophageal wall thickening, compatible with known neoplasm.2.No evidence of metastatic disease. |
Generate impression based on findings. | Reason: h/o HNC, h/o CRT, compare to baseline History: none LUNGS AND PLEURA: Scattered benign appearing micronodules unchanged.There is no evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Calcified left hilar lymph node from healed granulomatous disease.CHEST WALL: Mild degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Vascular calcifications are present, but no obvious metastatic disease. Calcified splenic granulomata are seen. | No evidence of metastatic disease, or other significant abnormality. |
Generate impression based on findings. | Male 62 years old; Reason: ANAL CANCER COMPLETED THEARPY IN AUGUST 2012. ALSO HISTORY OF LYMPHOMA. EVALUATE FOR DISEASE RECURRENCE History: ANAL CANCER CHEST:LUNGS AND PLEURA: No dominant lung lesion. The pleural spaces are clear. The central airways are patent. Few scattered pulmonary granulomata.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: Post operative clips in the left axilla. No recurrent lymphadenopathy.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesion. Hepatic and portal veins are patent. Stable hypodense lesion in segment IVb of the liver which is well marginated and near fluid attenuation and may represent a cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Calcific arthrosclerotic disease of the aorta. There are multiple small retroperitoneal lymph nodes which are stable.BOWEL, MESENTERY: Small bowel is normal in caliber and course. Colon is unremarkable.There is marked enlargement of the mesenteric node (series 3 image 153) measured 2 x 2.0 cm, previously 1.2 x 1.1 cm.There is some haziness of the mesentery, unchanged. .BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Right internal iliac node measures 1.3 x 0 .8 cm, previously 1.5 x 0.7 cm (image 195/series 3).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the lumbar spine. Avascular necrosis of the femoral heads.OTHER: No significant abnormality noted | 1.Enlargement of a mesenteric node as referenced above with stable haziness of the mesentery. 2.Otherwise, stable examination. |
Generate impression based on findings. | 23-year-old female patient with sepsis and history of congenital malformation of the gyne system and had a miscarriage. Evaluate for evidence of abscess or findings suspicious for proximal of conception. 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: Right kidney with superior pole cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Appendix is visualized and within normal limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Foley catheter with balloon inflated in a cavity that appears to be involving the vagina, cervix and inferior uterus that measures 5.3 x 5.3 cm (series 5 image 125), contains fluid density and air. Air may be secondary to instrumentation. Myometrium enhances normally without evidence of necrosis. Trace, nonloculated fluid around the uterus. Bilateral adnexa within normal limits.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: External vagina/perineum with soft tissue scarring.OTHER: No significant abnormality noted. | Collection involving the vagina, cervix and distal uterus consistent with hematocolpos. No other collection or abscess identified.Findings discussed with Dr. Preyess via telephone at 11:20 AM on 11/12/13 by Dr. McCann. |
Generate impression based on findings. | Reason: h/o HNC, s/p induction, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Small benign-appearing nodules along the inferior aspect of the right major fissure are most likely intrapulmonary lymph nodes.There is no specific evidence of pulmonary or pleural metastases. MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.CHEST WALL: Mild to moderate degenerative changes affect 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: 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: Very small Bochdalek hernias are present.Mild degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted. | No sign of metastases or other significant abnormality. |
Generate impression based on findings. | 72-year-old male with head and neck cancer status post chemoradiation. CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema. No consolidation or pleural effusions.Right upper lobe groundglass nodule not significantly changed, measuring 5 to 6 mm (series 4, image 44); however, this is slightly increased since 11/2010. 5-mm left lower lobe nodule also unchanged since 11/2010 (series 4, image 58). No new nodules or masses.MEDIASTINUM AND HILA: No lymphadenopathy. Heart is normal in size without pericardial effusion. Status post CABG. Extensive coronary artery and aortic calcifications. Small hiatal hernia.CHEST WALL: No significant abnormality noted.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: Extensive atherosclerotic calcifications in aorta and its branches. No lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastrostomy tube in place. No significant abnormality.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of metastatic disease.2.Stable ground glass nodule in the right upper lobe suspicious for atypical adenomatous hyperplasia or minimally invasive adenocarcinoma. Continued annual follow-up recommended. |
Generate impression based on findings. | History of bladder cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver. No focal liver lesions. Liver is enlarged. Left lobe is hypertrophied. These findings may be compatible with chronic liver disease. Correlation with liver function tests is recommended.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nodular left adrenal gland, nonspecific.KIDNEYS, URETERS: Nonspecific subcentimeter lesion in the upper pole of the right kidney, too small to accurate characterize with most likely a cyst. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: 2 x 1.3 cm hypodense lesion on image number 112, series number 7 in the left obturator region likely represents a small lymphocele. Follow-up imaging is recommended to exclude a lymph node in that location. | A small lymphocele versus lymph node in the left pelvis. Follow-up imaging is recommended for further evaluation. Postsurgical changes secondary to cystectomy.Fat infiltration of the liver. Hepatomegaly. Correlation with liver function test is recommended to evaluate for chronic liver disease. |
Generate impression based on findings. | Male 23 years old; Reason: History testicular cancer, s/p multiple chemo surgical therapies. assess disease across several scans History: none CHEST:LUNGS AND PLEURA: Multifocal scarring, unchanged. Left upper lobe micronodule unchanged.MEDIASTINUM AND HILA: Stable reference subcarinal lesion best seen on image 52 of series 3 measures 2.3 x 1 .8 cm, previously 2.7 x 1.7 cm. Stable surgical clips in the mediastinum.CHEST WALL: No significant abnormality noted. Left Port-A-Cath unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable left renal cystRETROPERITONEUM, LYMPH NODES: Relatively stable size of several of the previously noted retrocrural and retroperitoneal lymph nodes. The reference conglomerate left periaortic lymph node cluster best seen on image 143 of series 3, now measures 1.4 x 2.2cm previously 2.3 x 1.3 cm.The reference left psoas focus seen on image 134 of series 3, is smaller and now measures 1.2 x 1.1cm previously 1.4 x 1.8 cm.BOWEL, MESENTERY: No significant change in mesenteric adenopathyBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Interval stability in size of reference left external iliac lymph node mass best seen on image 187 of series 3, now measuring 2.7 x 1.3cm previously 2.9 x 1.7 cm. Reference right internal iliac lymph node mass best seen on image 175, series 3 has remained relatively stable, measuring 2.4 x 1.3cm previously 2.3 x 1.5 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable size of several mediastinal, retroperitoneal and eft external iliac referenced lymph nodes. |
Generate impression based on findings. | 61-year-old male with metastatic thyroid cancer. CHEST:LUNGS AND PLEURA: Extensive intrathoracic metastatic disease not significantly changed.Reference left upper lobe nodule measures 4 mm, previously measured 4 mm (series 5, image 23).Reference left lower lobe nodule measures 7 mm, previously measured 7 mm (series 5, image 46).Reference right middle lobe nodule measures 10 mm, previously measured 10 mm (series 5, image 62).No new nodules identified.MEDIASTINUM AND HILA: Postsurgical changes in thyroid bed. No mediastinal or hilar lymphadenopathy. The heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality noted.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: Subcentimeter hypodense lesion arising from right kidney unchanged, most likely representing cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No pathologically enlarged retroperitoneal lymph nodes. Round soft tissue attenuation nodule anterior to right kidney that is nonspecific but unchanged (series 3, image 110).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 metastatic disease. No new sites of disease identified. |
Generate impression based on findings. | 89-year-old male with prostate cancer and history of renal cell carcinoma status post left nephrectomy, with rising PSA, evaluate for progression. ABDOMEN: Lack of IV contrast limits evaluation of solid organ pathology and vasculature.LUNG BASES: Mild basilar atelectasis.LIVER, BILIARY TRACT: Multiple hepatic hypodensities, likely representing cysts. Cholelithiasis without evidence of inflammation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic right kidney with hypodense lesion likely representing a cyst, but not fully characterized on this noncontrast exam. Status post left nephrectomy without evidence of recurrent disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Large mass involving the left prostate with apparent extension into the pelvic side wall posteriorly and superiorly. The left seminal vesicle is not well visualized and likely involved by the mass.BLADDER: Foley catheter in a collapsed bladder with apparent wall thickening.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the thoracic lumbar spine. Nonspecific sclerotic lesion in the left proximal femur may represent a bone island although a metastatic lesion cannot be excluded without prior comparison.OTHER: No significant abnormality noted | 1. Mass involving the left prostate with evidence of local extension as detailed above. No abdominal or pelvic lymphadenopathy. Nonspecific sclerotic lesion in left proximal femur which may represent a bone island, although metastasis cannot be excluded without prior comparison.2. Status-post left nephrectomy without evidence of recurrent disease. |
Generate impression based on findings. | 71-year-old male with COPD and left upper lobe lung nodule. LUNGS AND PLEURA: Increase in size of spiculated left upper lobe nodule abutting the posterior pleura, measuring 11 x 16 mm, previously measured 8 x 11 mm (series 5, image 17).New ill-defined pleural-based nodular opacity in left lower lobe measures 5 mm (series 5, image 77).Stable left lower lobe fat containing nodule, compatible with a hamartoma.Severe emphysema.MEDIASTINUM AND HILA: No pathologically enlarged lymph nodes. Moderate coronary artery calcifications. The heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Again seen are hypodense lesions in the partially visualized left kidney, incompletely evaluated but likely represent cysts. | 1.Increase in size of left upper lobe spiculated nodule, highly suspicious for primary lung neoplasm.2.New nonspecific 5-mm pleural-based nodular opacity in the left lower lobe.3.Severe emphysema. |
Generate impression based on findings. | 46-year-old female, status for abscess or colitis ABDOMEN:LUNG BASES: Right lower lobe atelectasis. Superimposed pneumonia cannot be excluded. Small right-sided pleural effusion. Cardiomegaly.LIVER, BILIARY TRACT: Heart is enlarged and demonstrates heterogeneous enhancement likely secondary to heart failure. Cholelithiasis. Subcentimeter cyst in the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nodular left adrenal gland, unchanged, nonspecific.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval development of diffuse wall thickening involving the entire colon, more prominent on the right side suggestive of colitis. Interval development of mild distention of small bowel loops suggestive of ileus. Large amount of ascites, unchanged. No evidence of abscess.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Please see discussion aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval development of colonic wall thickening suggestive of colitis, involving the entire colon with more prominent on the right side.Interval development of mild to moderate ileus.No evidence of abscess.Right lower lobe atelectasis. Superimposed infection cannot be excluded. |
Generate impression based on findings. | 89-year-old female with squamous cell carcinoma of the gums, status post chemoradiation therapy, reevaluate There are diffuse post therapy changes including mucosal and salivary gland hyperemia as well as induration and reticulation of subcutaneous fat and fascial planes. Significant interval decrease in the size of the patient's previously identified destructive mass in the right oral cavity which invades the right maxillary sinus, buccal space, soft and hard palate and minimally the right masticator space. A small amount of residual enhancing tissue along the anterior aspect of the right maxillary sinus measures 6 x 16 mm (series 12 image 8). Similar to the prior, there is soft tissue density induration and thickening of the subcutaneous tissue of the upper lip.No significant interval change in erosion of the inferior wall of the right maxillary sinus with soft tissue opacification of the inferior aspect of the maxillary sinus. No significant interval change in osseous erosion involving the right maxilla, right hard palate and right pterygoid bone. No lymphadenopathy present by CT size criteria. Reference non-pathologically enlarged right level 1 lymph node measures approximately 4 x 3 mm (series 12 image 19), previously measured 7 x 4 mm.The submandibular glands are free of focal lesions. The parotid glands are free of focal lesions. Small hypoattenuating thyroid nodules. The cervical vasculature remains patent. Bilateral atherosclerotic vascular calcifications at the carotid bifurcations.Partially visualized right chest port catheter. Multilevel degenerative changes of the visualized cervicothoracic spine which are most pronounced at C5-C6 and C6-C7. Similar to the prior, thickening of the ligaments posterior to the dens cause mild spinal stenosis at the cervicomedullary junction. No new osseous lesions are present. The lung apices are clear. Please see dedicated chest CT from today's date for further details.Limited intracranial views are unremarkable. Redemonstration of partial opacification of the right mastoid air cells. | 1. Continued interval decrease in size of the destructive mass in the right oral cavity with residual right maxillary sinus soft tissue opacification.2. No significant interval change in osseous erosions involving the right maxilla, right hard palate and right pterygoid bone.3. No evidence of cervical lymphadenopathy. |
Generate impression based on findings. | Reason: h/o larynx cancer History: r/o chest mets LUNGS AND PLEURA: Severe centrilobular emphysema and hyperlucency in the lateral segment of the right middle lobe, unchanged from the prior exam. Stable mild bronchial wall thickening.No suspicious pulmonary nodules or masses.No interval pleural effusion.MEDIASTINUM AND HILA: Secretions occupy the mid trachea.No interval mediastinal or hilar lymphadenopathy.Severe coronary and aortic calcifications.Redemonstration of esophageal wall thickening and a large hiatal hernia.CHEST WALL: Post surgical changes are noted at the anterior base of the neck, unchanged. Multilevel degenerative changes of the spine and left humeral head.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable left adrenal nodule. Small amount of sludge in the gallbladder. | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: h/o HNC, s/p CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Benign-appearing micronodules unchanged, with no evidence of metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Moderate severe coronary calcifications are seen.A right jugular catheter terminates at the SVC/RA junction level.CHEST WALL: Degenerative abnormalities affect 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: No significant abnormality noted.KIDNEYS, URETERS: There are scattered small renal cystlike hypodensities.PANCREAS: Pancreatic atrophy and ductal dilatation, unchanged. 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 abnormalities affect the lumbar spine.OTHER: Extensive vascular calcifications are present. | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | Male, 73 years old, history of larynx cancer status postsurgery and RT. Postsurgical deformity of the larynx is redemonstrated appearing similar to the prior examination. This includes anatomic distortion, a poorly visualized right vocal cord and aryepiglottic fold, a medialized left vocal cord, and soft tissue hypoattenuation involving the left supraglottic larynx. No evidence of disease recurrence is seen.Soft tissue and tracheal deformity is also evident at the level of the cricoid suggesting prior tracheostomy. This too appears similar to prior. The aerodigestive mucosa is otherwise remarkable only for tonsilliths in the palatine tonsils and a small amount of debris pooling in the posterior trachea.No pathologic adenopathy is detected by size criteria. The salivary glands are free of focal lesions. The surgically divided thyroid is unremarkable. Cervical vessels remain patent. Lung apices are notable for evidence of emphysema and a small right-sided micronodule. No concerning osseous lesions are seen. There is advanced degenerative disk disease at C5-6 with endplate sclerosis and near complete loss of disk height. | Stable postsurgical changes with no evidence of disease recurrence. |
Generate impression based on findings. | 61-year-old female with history of malignant melanoma CHEST:LUNGS AND PLEURA: Left lower lobe mass measures one . Nine by 1.3 cm on image number 84, series number 4, not significantly changed from previous study. Other scattered micronodules are also stable.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Left lobe simple cyst is stable. Other multiple hypodense lesions in the liver are also grossly stable.SPLEEN: Subcentimeter lesion the spleen is stable.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: Leiomyomatous uterus, stable.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant change in the size of the left lower lobe mass. No other significant change from previous study. |
Generate impression based on findings. | Reason: Pt with hx of HX cancer 5 years s/p CRT. please re-eval and compare History: as above CHEST:LUNGS AND PLEURA: Apical emphysema and apical ground glass opacities which may indicate to inspiratory bronchiolitis with interstitial lung disease, unchanged.Scattered benign-appearing micronodules are stable with no specific evidence of pulmonary or pleural metastases.Focal scarring left lung base.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy present.Mild/moderate coronary calcifications are seen.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholecystectomy clips.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. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No sign of metastases or other significant abnormality. No change. |
Generate impression based on findings. | Female, 69 years old, history of left tonsil cancer 5 years ago status post CRT. No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Postsurgical alteration is redemonstrated in the left neck appearing similar to prior exam. No evidence of recurrent disease is seen in the surgical bed.No pathologic adenopathy is detected by size criteria. The left submandibular gland has been resected. The residual salivary glands and the thyroid are free of focal lesions. The left internal jugular vein fails to opacify through most of the neck, a stable finding. Vasculature is otherwise unremarkable. Lung apices are notable for scarring and emphysema. No concerning osseous lesions are detected. Degenerative disease affects the posterior elements of the cervical spine as well as the C6-7 disk space. | 1. Stable treatment related change in the neck with no evidence of recurrent disease.2. No intracranial metastatic disease. |
Generate impression based on findings. | Reason: pt with recurrent lung ca s/p 2 newer cycles of chemo History: now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Residual subpleural scar like opacity in the left lower lobe is not significantly changed, measuring 11 mm in thickness compared to approximately 9 mm previously (series 4 image 72). The long axis and is no longer measurable.There is extensive associated scarring and pleural thickening in the left lower lobe area.No other suspicious nodules.MEDIASTINUM AND HILA: Large necrotic subcarinal lymph node, now 31 mm in short axis, markedly increased from 20 mm previously.Markedly increase in tumor in the area of the left coronary artery distribution involving the pericardium and possibly involving the coronary arteries (series 3, image 61).New moderate pericardial effusion..CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Marked interval increase in the left adrenal metastasis now measuring up to 37 and by 59 mm, increased from 28 x 39 mm previously.Moderately enlarged right adrenal gland also increase compared to previous, compatible with metastatic disease.KIDNEYS, URETERS: Right 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: Multiple enhancing nodules in the subcutaneous fat, the largest of which is located posteriorly (series 3, image 119) OTHER: No significant abnormality noted. | Marked interval progression of subcarinal lymphadenopathy, pericardial metastases and bilateral adrenal metastases. |
Generate impression based on findings. | History of chest ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Index lesion in the right hepatic lobe measures 1.5-cm in diameter image number 16, series number 7. This is unchanged from previous study. Other small hypodense lesions in the liver and fatty infiltration of the liver are also unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 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 | Stable metastatic disease in the liver |
Generate impression based on findings. | Reason: h/o palate cancer History: eval for lung mets LUNGS AND PLEURA: Benign-appearing nodules likely intrapulmonary intrapulmonary lymph nodes are unchanged.Subpleural reticular opacities are suggestive of mild fibrosis but could be dependent atelectasis. There is no evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.CHEST WALL: Mild degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of metastases or other significant abnormality. Stable benign appearing nodules are likely intrapulmonary lymph nodes. |
Generate impression based on findings. | Clinical question: 50 year old with history of AML, Pre-stem cell transplant evaluation. Signs and symptoms: Evaluate. Nonenhanced Maxillofacial CT:There is no evidence of acute or any significant chronic sins disease of the paranasal sinuses.There are patent bilateral osteomeatal units of maxillary sinuses and sphenoethmoidal recesses.Visualized mastoid air cells and the middle ear cavities also remain well pneumatized.Unremarkable images through the orbits. | Unremarkable CT of the maxillofacial region. |
Generate impression based on findings. | Evaluate for signs of possible infection CHEST:LUNGS AND PLEURA: Bilateral large anterior pneumothoraces have resolved. Endotracheal tube is in place. There is a large left-sided hydropneumothorax posteriorly, not significantly changed from pre-study. There is also a right-sided loculated pleural effusion.Consolidation of the right middle and soft lower lobe suspicious for pneumonia. Atelectasis involving the left lower lobe. Superimposed infection cannot be excluded in the left lower lobe.Left-sided drain in the anterior hemithorax is in place.MEDIASTINUM AND HILA: There is small amount of air in the mediastinum. Esophageal stent is noted. There is also small left-sided loculated pleural effusion adjacent to the mediastinum in the upper lobe, basilar image number 18, series number 3. Postsurgical changes about the aorta are again seen.CHEST WALL: Postsurgical changes involving the chest wall.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: Moderate amount of ascites.BONES, SOFT TISSUES: Generalized anasarca.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Moderate amount of ascites and generalized anasarca.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval resolution of bilateral large pneumothoraces. Extensive pneumonia involving the right lung. Loculated left hydropneumothorax and bilateral small loculations of pleural fluid.Postsurgical changes and air in the mediastinum and chest wall.Moderate amount of ascites and generalized anasarca. |
Generate impression based on findings. | Clinical question: Evaluate for focal abnormality. Signs and symptoms: 5 year old with HIV and suspected MDR TB with new lethargy. Nonenhanced head CT:There is no detectable acute intracranial findings.There is normal appearing cortical sulci, ventricular system, CSF spaces, gray - white matter differentiation and maintained midline.There are no prior exams for comparison.Unremarkable images through the orbits.Calvarium is unremarkable.Chronic sinusitis of the ethmoids.Mastoid air cells and the middle ear cavities remain well pneumatized. | Unremarkable exam and without acute intracranial process. |
Generate impression based on findings. | Fever of unknown origin 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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: There is a tissue defect in the lower anterior uterus in the expected location of the C-section scar. Fluid in the uterus extends to the periuterine space. There is small amount of air within the endometrial cavity. Small amount of fluid around the uterus measuring 4.4 x 1.1 cm. there is another pocket of fluid in the pelvis on the left side measuring 5.7 x 4 cm image number 82, series number 3. Smaller right adnexal pockets are also present.In addition there is a loculated collection in the subcutaneous tissues of the pelvis in the midline measuring 11.1 x 2.5 cm. These findings are suggestive of endometritis and possible dehiscence of the uterus at the level of this area this lesion in the lower anterior uterus. Small amount of air in the pelvis is likely to recent surgery.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Loculated pelvic and subcutaneous fluid collections communicating with endometrial cavity through lower uterine anterior defect at the level of the cesarean section incision.These findings were discussed with the clinical team at the time of dictation. |
Generate impression based on findings. | 71-year-old female with history of colon cancer ABDOMEN:LUNG BASES: Small amount of left-sided pleural effusionLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Presumed splenic hemangioma, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Patient's known cancer is noted in the cecum and proximal ascending colon area. In that location there are associated mesenteric lymph nodes. Index lymph node is not increased in size and now measures 1.6 x 1.8 cm on image number 88, series number 4.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval increase in the size of the index metastatic adenopathy adjacent to patient's known right-sided colon cancer.Interval development of small left-sided pleural effusion.Splenic hemangioma is unchanged. |
Generate impression based on findings. | Reason: eval for persistent wheezing and upper abdominal pain, r/o PE History: as above CHEST:LUNGS AND PLEURA: Stable, mild centrilobular emphysema. Mild bronchial wall thickening which has remained stable since 2009.Localized mild groundglass within the anterior aspect of the right upper lobe (series 4 image 27). This is nonspecific and maybe related to small airway inflammation.No pleural effusion or suspicious pulmonary nodule.MEDIASTINUM AND HILA: Small amount of dependent debris occupies the right main bronchus.The heart size remains normal. No interval pericardial effusion.CHEST WALL: Loss of height within several mid thoracic vertebral bodies, stable.No axillary lymphadenopathy. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Fat filled umbilical hernia. | Stable, mild apical centrilobular emphysema. Mild bronchial wall thickening that is unchanged since 2009. A single focus of groundglass in the anterior left upper lobe may be related to small airway inflammation. |
Generate impression based on findings. | Reason: compare previous CT scan 10/8 - with noted new pleural based consolidation. evaluate for interval change. ALso comment on esophageal thickening noted on CT scan 3/2013 History: none LUNGS AND PLEURA: Almost complete interval resolution of a focal area of subpleural consolidation in the left lower lobe, with a small residual scar (series 4 image 37).Almost complete resolution of a previously described focal area of ground glass opacity in the left lower lobe which was presumably secondary to infection (series 5 image 185).Partial resolution of a band of atelectasis in the left upper lobe with a nodular component, now with a small residual scar like opacity (series 4 image 23).New small area of focal pulmonary opacity in the left upper lobe (series 5 image 66) with interstitial thickening which is new since the previous scan, compatible with focal infection. Diffuse severe predominantly centrilobular emphysema.MEDIASTINUM AND HILA: No significant lymphadenopathy and no pericardial effusion.Moderate size hiatal hernia.Mild coronary artery calcification.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Very small hepatic hypodensities, unchanged and likely benign.Left renal exophytic cyst, unchanged. | Marked interval decrease in previously described nodular opacities. A new small area of focal opacity in the left upper lobe is compatible with infection and is not considered suspicious. However, in view of the patient's high risk status further monitoring with annual low-dose CT scans would be appropriate. |
Generate impression based on findings. | h/o pleomorphic adenoma with small malignant component resected 10/2011Signs and Symptoms: none There is an 8 x 16 mm in lymph node present at the right submandibular space which previously measured 12 x 6 mm axial dimensions. This in particular lymph node has a fatty hilum suggesting it is benign. There is a right posterior triangle lymph node measuring 8 x 11 mm axial dimensions at the C2 vertebral level which previously measured 9 x 6 mm. the left jugulodigastric node measures 11 x 7 mm axial dimensions. There is a 7 x 6 mm axial dimensions lymph node present at the right level 2 jugular chain which is stable when compared to prior exam A left-sided submandibular lymph node measures 7 x 8 mm and previously measured the same. These do not meet size criteria for lymphadenopathy Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The eyeball lenses are thin. The paranasal sinuses are clear. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact . There are degenerative changes redemonstrated cervical spine were sent to C5-6 where there is loss of disk space height endplate and uncovertebral osteophytes and a some narrowing of the spinal canal and right neural foramen. | 1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy it since the prior exam some lymph nodes in the right suprahyoid neck are slightly larger but do not meet the size criteria for lymphadenopathy. Please correlate with clinical findings to determine whether closer interval follow up is warranted.2.Degenerative changes are present in the cervical spine. |
Generate impression based on findings. | 70 year-old female status post craniotomy. There has been interval postsurgical changes of a left frontotemporal craniotomy at the same prior surgical site. There is moderate amount of air overlying the left frontal convexity. There is a wedge shape surgical cavity containing some blood products and with surrounding edema in the left middle frontal lobe. The degree of the edema has not significantly changed since prior MRI 11/12/2013. There is no midline shift. The ventricles and cisterns are symmetric. Prominent cisterna magnum is again seen. The gray-white matter differentiation is normal. The paranasal sinuses and mastoid air cells are clear. | Expected postsurgical changes of a left frontotemporal craniotomy. |
Generate impression based on findings. | Reason: Tonsil SCC T3/4N2CM0 s/p resection f/b consolid weekly cisplatin History: as above CHEST:LUNGS AND PLEURA: Biapical scarring consistent with radiation reaction.Unchanged micronodules, presumably benign.Partial resolution of medial right lower lobe focal consolidation likely related to aspiration, with persistent partial right middle lobe atelectasis.No suspicious nodules.MEDIASTINUM AND HILA: Mildly enlarged lower left paratracheal lymph node measuring 8 mm in short axis, unchanged.Previously mildly enlarged right hilar lymph nodes unchanged.CHEST WALL: Bifid right fourth rib, a normal variant.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: 8mm nonspecific cystic lesion in the tail of the pancreas, unchanged.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. | Partial resolution of right lower lobe consolidation compatible with aspiration.No sign of metastases. |
Generate impression based on findings. | Reason: h/o HNC, s/p induction chemo, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Suspicious pulmonary nodule or mass. No pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastases. |
Generate impression based on findings. | 74-year-old male with known pancreatic cancer and gangrenous cholecystitis, evaluate for metastatic disease and resolution of cholecystitis ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Percutaneous cholecystostomy tube is coiled in the gallbladder. The gallbladder is collapsed with minimal adjacent fat stranding. Common bile duct stent with expected pneumobilia, again noted.SPLEEN: No significant abnormality noted.PANCREAS: Dilatation of the pancreatic duct extending to the pancreatic head which is enlarged and hypoenhancing. The SMA, SMV, portal vein, splenic vein, and celiac axis are patent.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcification and plaque of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: The prostate is enlarged.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.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right inguinal hernia.OTHER: No significant abnormality noted | 1.Status post cholecystostomy with collapsed gallbladder without significant right upper quadrant inflammation or evidence of complication.2.Common bile duct stent in appropriate position. Persistent pancreatic ductal dilatation and mildly enlarged pancreatic head. |
Generate impression based on findings. | 69-year-old male with right upper lobe nodule. LUNGS AND PLEURA: 5-mm right apical nodule is unchanged. Several other micronodules in both lungs are also unchanged. No new nodules. No consolidation or pleural effusions.MEDIASTINUM AND HILA: No lymphadenopathy. Heart is normal in size without pericardial effusion. Scattered atherosclerotic calcifications in coronary arteries and aorta.CHEST WALL: Mixed sclerotic/lytic lesion in T1 vertebral body with mild loss of height, unchanged. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Left liver lobe hypodensity unchanged, likely cyst. Pancreatic calcifications again noted. | 1.Stable pulmonary nodules, largest measuring 5 mm and located in right apex. if patient is low risk, no further follow up is recommended. If high risk patient, additional follow-up at 18 to 24 months is recommended.2.Stable lesion in T1 vertebral body. |
Generate impression based on findings. | 74 year old female with history of abdominal aortic aneurysm status post EVAR and right to left femoral-femoral bypass ANGIOGRAPHY:Unchanged mild fusiform ectasia of the suprarenal aorta. Atherosclerotic calcifications creates a 50% narrowing at the origin of the celiac axis. Atherosclerotic calcifications also affect the origin of the superior mesenteric artery without significant luminal narrowing. Revisualized infrarenal aortoiliac stent graft. No evidence of endo- leak. The left common iliac segment of the graft is occluded by an amplatz device. The distal left common iliac and hypogastric arteries are reconstituted via retrograde flow from the femoral bypass graft.The eccentrically oriented and thrombosed aneurysm sac is not significantly changed measuring 3.9 x 6.0 cm (series 10 image 72), previously 4.4 x 6.3 cm.There is a common femoral to common femoral arterial graft. The graft is patent but there is mild anastomotic narrowing at the right iliac. Limited views of the peripheral vasculature distal to the graft show multicentric atherosclerotic disease without significant luminal narrowing.Severe atherosclerotic calcification affects the common, internal, and external iliac arteries bilaterally. ABDOMEN:LUNG BASES: Left basilar scarring and atelectasis. Interlobular septal thickening compatible with pulmonary edema. Bilateral pleural effusions, trace right and small on the left.Moderate cardiomegaly with right atrial enlargement. Reflux of contrast into the hepatic veins and enlargement of the suprahepatic IVC indicating elevated right heart pressures. LIVER, BILIARY TRACT: Numerous well-defined hypodense liver lesions are either too small to characterize or compatible with hepatic cysts. Additional well-defined higher attenuation subcapsular segment 7 fluid collection is unchanged compared to prior.Small dependent gallstone versus adherent biliary sludge. No CT evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Status post right adrenalectomy. The left adrenal gland is unremarkable.KIDNEYS, URETERS: Status post right nephrectomy. There is a small focal fluid collection adjacent to the staple line in the nephrectomy bed that is mildly increased in size from prior and now measures 11 x 11 mm (Series 10 Image 44). This is of uncertain clinical significance, but continued followup is recommended. No definite enhancing soft tissue mass in resection bed.Innumerable hypodense cystic lesions in the left kidney. A complex cystic focus in the mid body of the left kidney has intermediate attenuation and is best appreciated on the coronal series measures 3.2 x 1.4 cm (series 81172 image 54), previously 3.0 by 1.4 cm. The poorly defined nature of the lesion makes evaluation of enhancement difficult, but this is highly suspicious for a contralateral renal cell carcinoma.RETROPERITONEUM, LYMPH NODES: Multiple enlarged retroperitoneal lymph nodes which are not significantly changed from prior. The reference left para-aortic lymph node measures 1.3 x 1.2 cm (series 12 image 41), previously 1.7 x 1.2 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse soft tissue edema.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Large heterogeneous and partially calcified uterus compatible with leiomyomatous disease. Left adnexal multiloculated cystic lesion with thickened enhancing septa highly suspicious for a primary ovarian malignancy.BLADDER: The bladder is collapsed limiting evaluation.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Mild uncomplicated diverticulosis of the sigmoid colon.BONES, SOFT TISSUES: Unchanged well-defined lucent focus in the posterior right iliac bone. Severe degenerative changes affect the lower lumbar spine.OTHER: No significant abnormality noted | 1. Aortoiliac stent graft and femoral-femoral bypass graft without evidence of complication or endo- leak. Abdominal aortic aneurysm sac is not significantly changed compared to prior.2. Postoperative changes from right nephrectomy and adrenalectomy. Mild increase in size of a fluid collection within the nephrectomy bed as described is of uncertain clinical significance, but continued followup is recommended. Unchanged retroperitoneal lymphadenopathy.3. Complex cystic mass lesion in the mid left kidney highly suspicious for a contralateral renal cell carcinoma.4. Complex left adnexal cystic lesion as described. If clinically warranted this can be further evaluated with MRI or ultrasound. |
Generate impression based on findings. | Reason: eval for lung mets History: h/o larynx cancer LUNGS AND PLEURA: Biapical scarring and mild centrilobular/paraseptal emphysema is noted. Scattered areas ofsubpleural reticulation in the lower lobes are not significantly changed from the prior examination. No interval traction bronchiectasis/honeycombing is evident. No suspicious pulmonary nodules.No pleural effusion.MEDIASTINUM AND HILA: Tracheostomy and phonation device again identified. The previously described clustered small superior mediastinal lymph nodes are unchanged. Reference lymph node (series 4 image 29) remained stable at 8 mm. Right cardiophrenic lymph node also unchanged, 8 mm (series 4 image 84).The heart size remains stable. No interval pericardial effusion.CHEST WALL: Stable postsurgical changes at the base of the anterior neck.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified hepatic granuloma. Small pericaval lymph node is unchanged. | No evidence of metastases.Mediastinal lymph nodes unchanged in size. |
Generate impression based on findings. | 75 year-old female with bilateral pleural effusions, mucous plug, pneumonia, and sepsis. LUNGS AND PLEURA: Small bilateral pleural effusions with overlying consolidation/atelectasis in both bases, left more than right; the left base consolidation is increased since 10/20/2013 CT. Lungs are under inflated, with scattered areas of groundglass opacity likely representing subsegmental atelectasis. Stable appearing subpleural linear opacities in the anterior aspect of right middle lobe, most compatible with scarring/post-radiation change.There is a cavitary lesion in left lower lobe with peripheral solid nodular component measuring 9 x 13 mm (series 4, image 44); this is unchanged since 7/2013.MEDIASTINUM AND HILA: Endotracheal tube and NG tube are in place. Two right central venous catheters terminate in right atrium.Stable moderate cardiomegaly. New trace pericardial effusion. Multiple enlarged mediastinal lymph nodes are not significantly changed.CHEST WALL: Stable appearing right upper chest wall fluid collection with multiple surrounding staples, most compatible with postsurgical seroma due to lumpectomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Small amount of ascites fluid around the liver. Postsurgical changes in the anterior abdominal wall. | 1.Small bilateral pleural effusions with overlying basilar atelectasis/consolidation.2.Cavitary lesion with peripheral solid nodular component. This is unchanged since 7/2013, however, suspicious for primary lung neoplasm. Consider follow-up after resolution of basilar consolidation for better evaluation. Nodular component of lesion may be amenable to bronchoscopic biopsy. |
Generate impression based on findings. | 58 years old female metastatic esophageal cancer. As on the prior examination, diffuse stranding through the fascial planes of the anterior neck is seen. Mucosal edema/hyperemia is also demonstrated involving the tongue base, larynx and hypopharynx. These findings are likely related to therapy and have not substantially changed.No focal soft tissue mass or pathologic enhancement is demonstrated within the neck. As before, the esophagus is patulous superiorly, and inferiorly, the lumen is effaced which may reflect other wall thickening or presence of debris.No pathologic adenopathy is detected in the neck by size criteria. The cervical vessels are patent. Atherosclerotic calcification is present at both carotid bifurcations. The right internal jugular vein is normal in caliber at the skull base but tapers to a thin string above the entry of the right chest porta catheter, at which point it no longer opacifies, a stable finding. The salivary glands are free of focal lesions. The left thyroid lobe remains enlarged and heterogeneous. A right upper lobe mass is better assessed on the accompanying dedicated chest CT.The cervical lordosis is reversed. There are bulky anterior osteophytes at C4 through C6. No concerning or focally destructive bony lesions are seen. | Stable treatment-related changes in the neck. No definite evidence of recurrent tumor or adenopathy. |
Generate impression based on findings. | 54-year-old male patient with history of trauma and hematuria. Evaluate for renal injury. 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. No laceration or evidence of trauma.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate multilevel degenerative changes of the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate multilevel degenerative changes of the thoracic and lumbar spine. Degenerative changes appear to be narrowing the spinal canal in the lumbar spine.OTHER: No significant abnormality noted. | 1.No CT evidence of renal trauma.2.Moderate multilevel degenerative changes with narrowing of the spinal canal at the level of the lumbar spine. |
Generate impression based on findings. | 53-year-old female with a 30 year smoking history. Evaluate for lung cancer. LUNGS AND PLEURA: No suspicious nodules or masses. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Large, nodular right lobe of the thyroid extends into the superior mediastinum. No lymphadenopathy. Heart is normal in size without pericardial effusion.CHEST WALL: Mild degenerative changes affect the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No suspicious nodules or masses.2.Large, nodular right thyroid lobe extending into mediastinum. |
Generate impression based on findings. | 41-year-old male with seminoma, evaluate for interval change. CHEST:LUNGS AND PLEURA: Two unchanged micronodules. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN: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: Infrarenal para-aortic lymphadenopathy with the largest lymph node measuring 1.5 x 2.4 cm and previously measuring 1.5 x 2.4 cm (image 128, series 3). Additional shotty small retroperitoneal lymph nodes are identified.Unchanged prominent portal caval lymph node. A prominent anterior pancreatic lymph node is new from the prior study (image 98, series 3).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Unchanged retroperitoneal lymphadenopathy and new prominent peripancreatic lymph node. |
Generate impression based on findings. | 65-year-old female with thyroid cancer status post 16 cycles of investigational oral agent. CHEST:LUNGS AND PLEURA: No significant change in multiple pulmonary nodules. No new nodules identified. No consolidation or pleural effusion.MEDIASTINUM AND HILA: Status post thyroidectomy.Stable mediastinal lymphadenopathy. Reference AP window node measures 9 mm, previously measured 9 mm (series 3, image 33). Reference subcarinal node measures 7 mm, previously measured 8 mm (series 3, image 41).Coronary artery calcifications. Stable mild dilation of left ventricle. No pericardial effusion.CHEST WALL: Stable lucency in T8 vertebral body, likely hemangioma.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis. No suspicious liver lesions.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate hypodense lesions in both kidneys are incompletely evaluated but unchanged and most compatible with benign cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy. Severe atherosclerotic calcifications affect 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 multiple pulmonary nodules and mediastinal lymph nodes. |
Generate impression based on findings. | Reason: rectal cancer restaging History: rectal cancer LUNGS AND PLEURA: Stable paraseptal and centrilobular emphysema. Nonspecific bronchial wall thickening is again identified.There are multiple pulmonary micronodules, many of which are new. The largest is now pleural-based posteriorly at the lower lobe (series 5 image 58), measuring 4 x 4 mm. A second, new reference nodule in the peripheral left upper lobe (series 5 image 49) measures 3 by 5 mm. Post inflammatory etiology remains a consideration; however, due to the increasing number of nodules, short interval follow-up CT is recommended.No interval pleural effusion.MEDIASTINUM AND HILA: Stable left thyroid nodule.Heart size remains stable. No interval pericardial effusion. Minimal mitral annular and aortic valvular calcification. Small mediastinal lymph nodes are stable in size.CHEST WALL: Right port catheter in stable position.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified splenic granulomas. A portion of the right superior renal pole is visualized demonstrating an exophytic cystic lesion, incompletely imaged. Infrarenal abdominal aortic aneurysm measuring 3.1 x 3.1 cm at the inferior field of view. | Multiple pulmonary micronodules, many of which are new. Although postinflammatory etiology they be considered, close interval follow-up to exclude metastases recommended. Stable size of multiple small mediastinal lymph nodes. |
Generate impression based on findings. | 58 year-old female with head and neck cancer. CHEST:LUNGS AND PLEURA: Stable to slightly increased size of multiple pulmonary metastases.Right apical nodule measures 2.6 x 1.9 cm, previously measured 2.3 x 1.8 cm (series 4, image 21).Lingular nodule measures 2.7 x 2 .5 cm, previously measured 2.5 x 2.3 cm (series 4, image 48).Left lower lobe nodule measures 13 mm, previously measured 12 mm (series 4, image 67).No new nodules identified.New mild ground glass opacities in the inferior aspect of right upper lobe and right lower lobe, may be related to bronchiolitis and/or aspiration.MEDIASTINUM AND HILA: Right chest wall port catheter terminates in right atrium. Heart size normal. Stable small pericardial effusion.Reference subcarinal lymph node mildly increased in size, measuring 9 mm, previously measured 7 mm (series 3, image 44). Mild atherosclerotic calcifications affect aorta.No significant change in mid esophageal wall thickening.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Unchanged punctate hypodensity in the right lobe of liver, likely cyst.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The right kidney is absent. Multiple hypodensities in left kidney are unchanged, likely cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications affect the aorta and its branches. Multiple small retroperitoneal lymph nodes are not significantly changed. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastrostomy tube is in place.BONES, SOFT TISSUES: Multiple soft tissue attenuation nodules in the subcutaneous tissues of anterior abdominal wall, likely due to injections.OTHER: No significant abnormality noted. | 1.Stable to slightly increased lung nodules2.Mildly increased size of subcarinal lymph node. |
Generate impression based on findings. | 75-year-old female patient with renal cell carcinoma and GI bleed. Evaluate for possible metastases from RCC and source of GI bleed. ABDOMEN:LUNG BASES: New left sided pleural effusion with associated atelectasis and volume loss. Cystic lesion in the left lower lobe with associated nodule is stable compared to prior examination. Right-sided pleural effusion with persistent atelectasis is stable.LIVER, BILIARY TRACT: Scattered subcentimeter hypoattenuating lesions in the liver parenchyma are too small to characterize and are stable compared to prior examination. Hepatomegaly, measuring 22 cm in craniocaudal dimension.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy.Atrophic left kidney with cysts, stable.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes in the abdominal aorta and iliac arteries.BOWEL, MESENTERY: Dobbhoff tube with tip in the proximal duodenum. Right lower quadrant ileostomy. Interval removal of left lower quadrant abdominal drain. Interval decrease in abdominal fluid with some residual mesenteric fluid. No evidence of small bowel or gastric bleeding.There is high density material within the rectal pouch, which may represent hemorrhage versus previous administration of contrast.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumber spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Absent.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Dobbhoff tube with tip in the proximal duodenum. Right lower quadrant ileostomy. Interval removal of left lower quadrant abdominal drain. Interval decrease in abdominal fluid with some residual mesenteric fluid. No evidence of small bowel or gastric bleeding.There is high density material within the rectal pouch, which may represent hemorrhage versus previous administration of contrast.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumber spine.Bilateral fat filled inguinal hernias.OTHER: No significant abnormality noted. | 1.High-density material within the rectal pouch, new compared to prior examination and may represent blood products.2.Bilateral pleural effusions.3.Stable left renal cysts of varying attenuation.4.No evidence of metastatic renal cell carcinoma. |
Generate impression based on findings. | 76-year-old female with renal cell carcinoma with lymphadenopathy. Decreased appetite. CHEST:LUNGS AND PLEURA: Parenchymal nodules, masses or airspace disease. No pleural effusions.MEDIASTINUM AND HILA: Coronary artery calcification seen again. No abnormal masses or lymphadenopathy seen.CHEST WALL: Reference left supraclavicular lymph node is not significantly changed (series 3, image 10) measuring 1.0 x 0 .9 cm, previously 0.9 x 0.9 cm.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Prior right nephrectomy. Left kidney again shows benign exophytic cyst without other parenchymal abnormality. No evidence of hydronephrosis or significant perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy. Again seen with slight increase in size of the left periaortic. Reference lesion (series 3, image 107) now measures 2.0 x 1.5 cm compared with previous 1.7 x 1.1 cm.. Right periaortic reference node (series 3Com image 114) has slightly increased in size, measuring 2.2 x 1 .7 cm, previously 1.9 x 1.6 cm. No new foci of lymph node enlargement is seen.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse mild bony degenerative changes without focal lesion seen to suggest metastatic disease.OTHER: No significant abnormality noted. | 1. Status post right nephrectomy. 2. Stable left supraclavicular lymph node. 3. Slight increase in abdominal periaortic adenopathy as measured above. 4. No new foci of suspected metastatic disease seen. |
Generate impression based on findings. | GIST restaging CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Stable left thyroid nodule. Stable calcified right hilar lymph nodesCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable segment 8 peripheral resection defect.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: 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 | Stable negative examination. No evidence for acute, inflammatory, or neoplastic process. |
Generate impression based on findings. | 34-year-old female, GIST restaging. CHEST:LUNGS AND PLEURA: Bilateral micronodules. The left lower lobe micronodule is unchanged. There is no comparison for the right upper lobe micronodule.MEDIASTINUM AND HILA: Prominent thymus. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large left upper quadrant mass measures 18.8 x 13.5 cm and previously measured 20.7 x 16.2 cm (image 97, series 3). Marked interval decrease in attenuation with fewer enhancing components and decreased density of the solid component suggests necrosis/treatment effect. Much of the mass now measures near water density. Solid components of the mass measure 26 Hounsfield units and previously measured 54 Hounsfield units. The mass compresses the stomach and splenic flexure.Inferiorly within the mesentery a second necrotic mass with thick wall measures 4.3 x 5.9 cm and previously measured 7.2 x 6.6 cm, decreased in size (image 139, series 3). Prominent mesenteric lymph nodes are not significantly changed.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: An IUD is noted. Interval resolution of right adnexal cyst. A new left simple cyst measures 5.1 x 4.7 cm, likely physiologic.BLADDER: Distended and normal,LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Unchanged pelvic ascites. | 1. Interval decrease in attenuation and size of large left upper quadrant mass, much of which now measures near water density. Solid components now measure 26 Hounsfield units and previously measured 54 Hounsfield units. Decrease in size of necrotic lower abdominal mass. 2. Unchanged mediastinal lymphadenopathy. |
Generate impression based on findings. | Reason: RUL nodule per CXR 11/7/13 History: persistent, productive cough LUNGS AND PLEURA: Mild bronchial wall thickening.Right upper lobe calcified granuloma is again seen without significant change.Right-sided medially located calcified pleural plaque suggestive of prior empyema exposure with overlying atelectasis and pleural thickening (rounded atelectasis) not significantly changed from prior exam.Lingular atelectasis.MEDIASTINUM AND HILA: Multiple calcified and noncalcified hilar and mediastinal lymph nodes appear similar to prior exam. Multiple small retrocrural lymph nodes appear similar to prior exam. Severe coronary artery calcifications. Heart size is normal. No pericardial effusions.CHEST WALL: Degenerative changes to the right glenohumeral joint.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesion in the left lobe of the liver is unchanged. | 1.Right upper lobe there calcified granuloma correlates with a peripheral right upper lobe nodular opacity on recent CXR without interval change.2.Mild bronchial wall thickening.3.Stable right-sided pleural plaque suggestive of prior empyema exposure with overlying atelectasis and pleural thickening. |
Generate impression based on findings. | Colorectal diverticulitis with abscess 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: Interval decrease in size of retroperitoneal lymph nodes. Reference left para-aortic node best seen on image 62 of series 4 now measures 1.4 x 0.6 cm; this is in comparison to 1.8 x 1.1 cm on 9/28/2013.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: Near complete resolution of previously noted acute sigmoid diverticulitis as well as resolution of previously noted intramural abscess. No bowel obstructionBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Near complete resolution of previously noted acute sigmoid diverticulitis as well as resolution of previously noted intramural abscess. No bowel obstruction. |
Generate impression based on findings. | 39-year-old female with inflammatory myofibroblastic tumor, status-post resection and Crizotinib, now s/p cycle 8 of AP26113, reevaluate. Limited intracranial views are unremarkable. The visualized orbits are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear.Similar to the prior, there are partially visualized post surgical changes related to resection of a left anterior chest wall tumor, including removal of the anterior left first, second and third ribs as well as the medial left clavicle and left pectoralis major muscle with mesh myocutaneous flap reconstruction. There is no evidence of residual or recurrent tumor or fluid collections. No evidence of cervical lymphadenopathy by CT size criteria. Atrophic left strap muscles and sternocleidomastoid muscle similar to prior.Reference right level IIa lymph node measures 12 x 5 mm (series 6 image 26), previously measured 5 x 12 mm. Reference left level 3 lymph node measures 5 x 5 mm (series 6 image 36), previously measured 8 x 4 mm.There is no exophytic mass or focal effacement of the aerodigestive tract. The major salivary and thyroid glands are unremarkable. The major cervical vasculature is grossly patent. The cervical spine is unremarkable. | Stable partially imaged postoperative findings in the left anterior chest wall without definite evidence of recurrent tumor or cervical lymphadenopathy. Please see dedicated chest CT for further details. |
Generate impression based on findings. | 68-year-old with mitral disease undergoing evaluation for repair. VESSELS:The thoracic aorta is normal in size. Conventional arch anatomy.Mild atherosclerotic calcification affects the origin of the left main coronary artery. The mitral valve leaflets appears thickened and there is calcification of the posterior valve leaflet. The abdominal aorta is normal in caliber and contour. The origins of the celiac axis, superior mesenteric artery, bilateral renal arteries, and inferior mesenteric artery are widely patent.SINUS OF VALSALVA: 3.6 X 3.5 X 3.6 cmSINOTUBULAR JUNCTION: 3.3 X 3.5 cmASCENDING THORACIC AORTA AT LEVEL OF MAIN PULMONARY ARTERY: 3.7 X 3.8 cmPROXIMAL DESCENDING THORACIC AORTA IMMEDIATELY DISTAL TO THE LEFT SUBCLAVIAN ARTERY: 3.3 X 3.5 cmDESCENDING THORACIC AORTA AT LEVEL OF HIATUS: 2.3 X 2.3 cm INFRARENAL ABDOMINAL AORTA: 1.9 X 1.6 cmRIGHT COMMON ILIAC ARTERY: 11 X 10 mmRIGHT EXTERNAL ILIAC ARTERY: 9.0 X 7.4 mmRIGHT COMMON FEMORAL ARTERY: 6.7 X 6.2 mmLEFT COMMON ILIAC ARTERY: 10 X 10 mmLEFT EXTERNAL ILIAC ARTERY: 9.3 X 7.4 mmLEFT COMMON FEMORAL ARTERY: 8 X 8 mmCHEST:LUNGS AND PLEURA: Scattered pulmonary granulomas and nonspecific micronodules.MEDIASTINUM AND HILA: The heart is normal in size. There is a small focus of loculated anterior pericardial fluid.CHEST WALL: Right internal jugular dialysis catheter with tip at the cavoatrial junction. There is a small filling defect adjacent to the adherent to the distal catheter which may represent thrombus or fibrin sheath (series 14 image 26). ABDOMEN:Evaluation of the bowel is limited by the lack of oral contrast. Evaluation of the abdominal solid organs is limited by the phase of intravenous contrast. The exam was protocoled for evaluation of the arterial system.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: Mildly atrophic kidneys bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Minimal atherosclerotic disease in an otherwise normal angiographic exam with measurements as described. The mitral valve leaflets appear thickened and the posterior leaflet is mildly calcified. |
Generate impression based on findings. | 34-year-old male patient with renal cell carcinoma. Evaluate extent of metastatic disease. CHEST:LUNGS AND PLEURA: Scattered bilateral pulmonary micronodules, stable. Representative nodule in the left lower lobe measures 5 mm (series 5 image 62), stable. Representative nodule in the right upper lobe was not visualized on this examination, which may be secondary to technique.MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal lymph nodes, stable.CHEST WALL: Scattered axillary lymph nodes are stable compared to prior examination.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. Surgical bed is clear.Patient's known enhancing mass within the left renal sinus is stable compared to examinations dating back to 8/16/2012. The lesion measures 2 x 1.6 cm on image number 110, series number 3. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted. | 1.Stable bilateral pulmonary micronodules.2.Stable enhancing left renal mass. Renal cell carcinoma cannot be entirely excluded. |
Generate impression based on findings. | Testicular carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN: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: Stable reference portacaval lymph node best seen on image 110 measuring 2.3 x 1.7 cm. Stable reference pericaval lymph node best seen on image 151 measuring 0.8 x 0.6 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 | Stable examination |
Generate impression based on findings. | 76-year-old male with tachycardia, distended abdomen -- possible intra-abdominal fluid collection. ABDOMEN:LUNG BASES: Bilateral pleural effusions with associated atelectasis again seen without significant change.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: Evidence of prior GI tract surgery with resection of the right colon and proximal transverse colon abdominal perineal resection of the rectum. Again dilated loops of small bowel are diffusely seen in the proximal and mid. Small bowel into the pelvis with distal collapsed bowel indicative of small bowel obstruction. The degree of distention has decreased slightly since 10/29/13.BONES, SOFT TISSUES: No significant abnormality notedOTHER: The prior noted loculated fluid collections have all decreased in size since prior examination. The left pericolic gutter collection extending inferiorly into the pelvis has had interval placement of a percutaneous drainage catheter. Collection is decreased in size and now measures 1.7 x 3.1 cm (series 13, image 123) compared with 5.6 x 6.7 cm previously.Prior noted perihepatic collection (series 14, image 75) is decreased in size and now measures 5.6 by 1.0 cm, previously 8.8 x 2.6 cm.The right paracolic gutter collection has also decreased in size (series 13, image 117), and now measures 1.1 by 2.3 cm, previously 4.0 x 2.6 cm. These collections all still have mildly thickened walls.No new collections are seen in the mesentery are abdomen.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Evidence of prior GI tract surgery with resection of the right colon and proximal transverse colon abdominal perineal resection of the rectum, with left lower quadrant ostomy. Again dilated loops of small bowel are diffusely seen in the proximal and mid. Small bowel into the pelvis with distal collapsed bowel indicative of small bowel obstruction. The degree of distention has decreased slightly since 10/29/13. In the surgical bed from the abdominal perineal resection again seen is a presacral fluid collection (series 13. image 142) measuring 5.9 x 5.0 cm, previously 6.0 x 5.6 cm with a hint of a percutaneous drain.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Multiple loculated fluid collections, all have decreased in size significantly with the exception of the presacral collection which is minimally changed. Two. Persisting drains in these collections are noted above. 2. Persistently dilated loops of small bowel, suggesting bowel obstruction with slight decrease in distention. 3. No change bilateral pleural effusions. |
Generate impression based on findings. | Female, 63 years old, thoracic back pain. Evaluate disks and vertebral body alignment. There is a mild S-shaped scoliosis of the thoracic spine. Vertebral body alignment is otherwise unremarkable.No focally destructive or concerning osseous lesions are seen. There is a small ossific fragment along the anterior/superior margin of the T2 vertebral body which could represent a small ossicle or old fracture. There is mild concavity of the T2 and T3 superior end plates, and there is a Schmorl's node deformity at the superior endplate of T7.Bulky anterior osteophytes are present along the right anterior aspect of the midthoracic vertebral bodies. Moderately advanced facet hypertrophy is evident from T10-11 down. No large posterior disk protrusions or osteophytes are seen. No significant compromise of the bony spinal canal. No significant narrowing of the bony neural foramina with the exception of T2-3 on the right and T10-11 on the left where ligamentous thickening/calcification encroach upon the foramina.Pleural fluid and patchy air space opacification are partially visualized in the right lung. These are new findings when compared to the prior chest CT. Incidental note is made of cholelithiasis within a contracted gallbladder. | 1. Mild scoliosis and mild degenerative changes in the spine. No definite osseous abnormalities to account for the patient's symptoms.2. Right lung abnormalities are detected as above and which may be related to the patient's presenting complaint. Please refer to the dedicated chest CT which will be dictated separately. |
Generate impression based on findings. | Male 53 years old; Reason: Stage IV GI cancer please compare to previous scan and provide index lesion measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: Interval decrease in size of multiple pulmonary nodules. Some nodules demonstrate stable cavitation. Reference left upper lobe nodule measures 1.9 x 0.8 cm (series 4 image 50) previously 2.2 x 0.7 cm. Another reference lesion in the right upper lobe measures 1.6 x 2.0 cm (series 4 image 50) previously 1.9 x 2.3 cm. Other non referenced lesions are subjectively smaller as well.MEDIASTINUM AND HILA: Subcentimeter mediastinal and hilar lymph nodes, not significantly changed.CHEST WALL: Right Port-A-Cath is in stable position with its tip in the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Punctate hypoattenuating foci in the hepatic dome are too small to characterize. No definite evidence of liver metastasis. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: Lesion in the pancreatic tail invading into the spleen is difficult to fully assess. The cystic component of the lesion is markedly smaller, however a soft tissue lesion cannot reliably characterize on this examination.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral subcentimeter hypodense lesions too small to characterize, but unchanged and likely cysts. Punctate nonobstructing renal stones.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy. 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 pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Interval decrease in size of multiple pulmonary nodules, some of which show stable cavitation likely consistent with treatment response.2. Decrease in size of pancreatic tail cystic portion invading the spleen. Soft tissue lesion is not reliably characterized on this examination, an MRI may be more helpful in characterizing lesion. |
Generate impression based on findings. | 63 year-old female with pleuritic chest pain, desaturation. PULMONARY ARTERIES: Suboptimal exam due to under opacification of pulmonary artery branches. Given limitation, no evidence of pulmonary embolus down to the lobar pulmonary artery level. LUNGS AND PLEURA: Small right pleural effusion with partial loculation of fluid laterally and in major fissure. Bilateral basilar consolidation, right more than left.MEDIASTINUM AND HILA: Mildly enlarged mediastinal lymph nodes are not significantly changed. Stable mild cardiomegaly.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis without evidence of cholecystitis. | 1.Suboptimal study for pulmonary embolus given under opacification of pulmonary artery branches. Given limitation, no evidence of pulmonary embolus down to lobar pulmonary artery branches.2.Small bilateral pleural effusions and basilar consolidation, worst in right base, suspicious for pneumonia or aspiration. |
Generate impression based on findings. | Reason: CT for staging of head and neck cancer History: head and neck cancer LUNGS AND PLEURA: Right upper lobe ill-defined scarlike ground glass region image 31 series 5; this was not clearly seen on the prior PET/CT.Scattered benign appearing micronodules are present as well as areas of linear scarring. MEDIASTINUM AND HILA: Aberrant origin of the left vertebral artery, normal appearing.There is no mediastinal or hilar lymphadenopathy.Dense aortic annular and valvular calcifications are seen.Right jugular catheter terminates in the SVC/RA junction region.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No specific evidence of metastases. Above-noted right upper lobe ground glass opacity should be reevaluated by CT in 3 months to assess for resolution, otherwise annual follow-up independent of the patient's head and neck cancer monitoring. |
Generate impression based on findings. | 72 year old female with history of metastatic melanoma CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary metastases are mildly increased in size. Left lingular lesion measures 1.6 x 1.7 cm and previously measured 1.3 x 1.5 cm (image 49, series 9). Postsurgical change of right upper lobectomy and left lower lobe wedge resection. Decrease in size of several clusters of small nodules which may be infectious/inflammatory in etiology.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Unchanged right breast nodule measures 1.1 x 0.9 cm (image 45, series 7) and previously measured 1.2 x 0.8 cm.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Interval increase in size of splenic lesion, which now measures 6.4 x 6.6 cm and previously measured 4.6 x 5.2 cm (image 97, series 7).PANCREAS: Unchanged prominence of the pancreatic duct.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: Streak artifact limits evaluation of the 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: Bilateral hip prosthesis. Right sacral Tarlov cyst.OTHER: No significant abnormality noted. | Interval increase in size of splenic and multiple pulmonary metastases. |
Generate impression based on findings. | 76-year-old male with persistent tachycardia and lower extremity edema. History of anal cancer. PULMONARY ARTERIES: Diagnostic quality exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Bilateral moderate pleural effusions, right more than left, with overlying basilar consolidation/atelectasis.Moderate upper lobe predominance lobular emphysema. Punctate calcified nodule in right upper lobe. Stable ill-defined opacity in the left upper lobe measures approximately 7 mm (series 11, image 74); this may represent scarring. No new nodules.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No mediastinal adenopathy. Subcentimeter hypodense nodule in left thyroid lobe. Left central venous catheter terminates in SVC. Coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small amount of free fluid in the left upper quadrant. | 1.No evidence of pulmonary embolus.2.Moderate bilateral pleural effusions with basilar atelectasis/consolidation.3.Ill-defined nodular opacity in the left upper lobe is unchanged, however, continued annual follow up is recommended. |
Generate impression based on findings. | Reason: 72 y.o. hx of thryoid cancer s/t thyroidectomy. Please check for recurrence. Outside pet scan uploaded in epic. Question of disease inl the chest. History: thyroid cancer LUNGS AND PLEURA: 5-mm nodule in the right upper lobe with a bronchocele extending distally, probably increased compared to previous, though the previous CT scan is not of diagnostic quality.15 mm lobulated soft tissue nodule in the left lower lobe (series 4 image 65) new or at least markedly increased since the previous scan which is impaired by motion artifact.Small focal scar like opacities elsewhere.MEDIASTINUM AND HILA: Status post thyroidectomy with surgical clips in the thyroid bed. Nonspecific mildly enlarged lymph nodes in this area are not significantly changed. Markedly enlarged prevascular lymph node (series 3 image 37) measuring 16 mm in short axis, increased from 13 mm previously.Moderately enlarged lymph node in the area of the AP window also increased.Moderate coronary artery calcification.Mildly enlarged distal paraesophageal lymph nodes.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Small nonspecific gastroesophageal lymph nodes are present. | New 15 mm nodule in the left lower lobe and increased prevascular mediastinal lymph node, both highly suspicious for metastatic disease. An additional small right upper lobe nodule with associated bronchocele may also represent a metastasis. |
Generate impression based on findings. | Female, 81 years old, dizziness, near syncope after trauma. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. Likely dystrophic ocular calcifications are noted.The bones of the calvarium and skull base are intact. | No acute intracranial abnormality. |
Generate impression based on findings. | 24-year-old female with history of hematuria and bladder neoplasm 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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: The uterus is retroverted and retroflexed. Cervix is enlarged. The cervix abuts and possibly invades the bladder. There is small amount of air in the bladder, etiology is unknown.BLADDER: Soft tissue mass posterior to the bladder likely invading the bladder.LYMPH NODES: Bilateral inguinal adenopathy. Index writing of the lymph node measures 1.4 cm in image number 121, series number 7.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Possible mass in the cervix invading the bladder. MRI is recommended for further evaluation. Paragraph bilateral inguinal adenopathy suspicious for metastatic disease. |
Generate impression based on findings. | Reason: assess for PE History: R sided pleuritic pain PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits. LUNGS AND PLEURA: Bibasilar, right greater than left, atelectasis. Mild medial left and right basilar scarring with pleural effusion.MEDIASTINUM AND HILA: Moderate cardiomegaly. No evidence of right heart strain. No pericardial effusions. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolism.2.Right greater than left basilar atelectasis and scarring. |
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