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Generate impression based on findings. | 59 year-old female with large B cell NHL. There has been interval decrease in size of the ill-defined superficial left parotid lesion, which now measures 11 x 8 mm, previously 18 x 14 mm. The predominant lesion in the inferior aspect of the gland measures 17 x 15 mm. The right parotid and submandibular glands are unremarkable and there is otherwise no significant cervical lymphadenopathy. There is an unchanged 6 mm hypoattenuating right thyroid nodule. The carotid arteries and jugular veins are patent. There are multiple dental caries and periodontal lucencies. There is unchanged multilevel degenerative spondylosis. Limited view of the chest is unremarkable. | Interval decrease in size of the left parotid lesion, which now measures 11 x 8 mm, previously 18 x 14 mm. |
Generate impression based on findings. | 77-year-old male, intubated, evaluate for pneumonia versus edema. CHEST:LUNGS AND PLEURA: Interval decrease in left pleural effusion and reexpansion of the left lower lung with persistent basilar atelectasis and consolidation. Left upper lobe resection cavity with air fluid level. Small right pleural effusion and adjacent atelectasis. MEDIASTINUM AND HILA: Endotracheal tube. Extensive atherosclerotic calcification of the aorta. Two enteric tubes are noted. Leftward mediastinal shift.CHEST WALL:Postsurgical changes of the left thorax.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: Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Enteric tubes extend into the stomach and distal duodenum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Ill-defined density within the bladder may represent debris or mass. A catheter is noted.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal tube.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Interval reexpansion of the left lower lobe with persistent basilar atelectasis and consolidation and small pleural effusions. Left upper lobe resection cavity with air-fluid level.2. Ill-defined density in the bladder, which represent debris, but a mass cannot be excluded on this noncontrast exam. |
Generate impression based on findings. | 73-year-old male with seminoma, stage I, follow suspicious looking periaortic lymph nodes. CHEST:LUNGS AND PLEURA: Apical scarring. Small calcified nodule is compatible with prior granulomatous disease.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes compatible with prior granulomatous disease.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple unchanged hypoattenuating hepatic lesions, likely representing cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: 6-mm nodule adjacent to the right psoas muscle (image 145, series 3) corresponds to the FDG avid lesion seen on prior PET exam. No lymphadenopathy by CT criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate degenerative changes of the lumbar spine with grade 1 retrolisthesis of L4 on L5 and L3 on L4. 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 changes of the lumbar spine with grade 1 retrolisthesis of L4 on L5 and L3 on L4. 6-mm nodule adjacent to the right psoas muscle (image 145, series 3) corresponds to the FDG avid lesion seen on prior PET exam.OTHER: No significant abnormality noted | No lymphadenopathy by CT criteria. Subcentimeter nodule adjacent to the right psoas muscle corresponds to the FDG avid lesion seen on prior PET/CT. |
Generate impression based on findings. | 83 year-old female with vision loss. There is patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and prominent, representing volume loss. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. Moderate small vessel ischemic disease of indeterminate age. Brain volume loss. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. |
Generate impression based on findings. | Male 58 years old; Reason: Adenoid cystic cancer of submandibular gland compare to last Ct \T\ measure RML lesion History: post 3 cycles of therapy. CHEST:LUNGS AND PLEURA: Numerous pulmonary nodules consistent with metastases, stable in size and number. Index lesion in the right middle lobe measures 2.5-cm, unchanged (series 5, image 56). Mild dependent changes in the right lung. MEDIASTINUM AND HILA: Small left cervical lymph nodes are unchanged. Normal heart size. No pericardial fluid. Stable thickening of the anterior wall of the distal bronchus intermedius and the right middle lobe bronchus .CHEST WALL: Right chest wall intramuscular lipoma.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Partially enhancing lesion in the right hepatic lobe (3/112) not appreciably changed in size.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. | Stable pulmonary metastases. No new lesions. |
Generate impression based on findings. | Female 63 years old; Reason: lung ca, on tarceva, left adrenx cyst, pls c/w previous study and evaluate dz status. History: lung ca CHEST:LUNGS AND PLEURA: Bilateral lower lobe confluent disease is seen again with a diffuse ground glass appearance in the right lung base and more solid aggregation of nodules with some ground glass components in the left base. The distribution appears to have increased compared to 9/11/13 examination. With the diffuse conglomerate nature of these, discrete measurements and comparison measurements are difficult to achieve. Measuring the right base groundglass lesion reveals an aggregate dimension of 6.5 x 3 .8 cm, previously 4.3 x 3.1 (series 4, Image 151).Left upper lobe is free of consolidation or nodules. Right upper lobe (series 4 image 80) nodule measuring 0.9 x 0.9cm previously 0.8 x 0.8 cm.No pleural abnormality seen.MEDIASTINUM AND HILA: No abnormally enlarged lymph nodes seen and no change since prior examination..CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No lesions identified with normal vessels seen. Status post cholecystectomy with no biliary tract abnormality seen..SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Soft tissue nodule mesentery adjacent to the ventral aspect. The pancreatic tail is slightly smaller and less prominent in appearance than 9/11/13. This remains of uncertain etiology..BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Left adnexal cystic lesion complex in nature is again seen, unchanged in size, measuring 3.6 x 2.7 cm, previously 2.5 x 3.6 Cm (series 401 image 170).BLADDER: No significant abnormality noted.LYMPH NODES: No enlarged lymph nodes seen..BOWEL, MESENTERY: No significant abnormality noted. No free fluid seen in the mesentery. Small and large bowel in the pelvis appear normal.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Subtle increase in the appearance to basilar confluent lung nodules and groundglass opacities with more solid appearing masses. 2. Subtle increase in size of isolated right upper lobe lung nodule since 9/11/13. 3. Stable size complex left adnexal cyst. Ultrasound of the pelvis advised for full characterization. 4. Stable appearance to the mesenteric nodules seen anterior to tail of pancreas since 9/11/13 |
Generate impression based on findings. | Non-Hodgkin's transformed follicular lymphoma status post chemo radiation and radical excision of pelvic mass. Allo-sib SCT 2006. Recent cellulitis and left hip infection. CHEST:LUNGS AND PLEURA: Multiple calcified micronodules most suggestive of granulomas. Mosaic attenuation of the lung parenchyma is unchanged compared to recent previous but has become more pronounced since 2010; as the vasculature appears symmetric in unaffected areas, this is most likely due to small airways disease. No pleural fluid or new pulmonary nodules. 8mm triangular subpleural nodule in the right lower lobe (12/59) has a location and appearance most consistent with a subpleural lymph node, unchanged.MEDIASTINUM AND HILA: Mild left paratracheal lymphadenopathy. Index lymph node measures 11 x 14 mm unchanged compared to recent previous (10/14). Several small prevascular lymph nodes are not significantly changed. Main pulmonary artery is enlarged, compatible with pulmonary hypertension. Scattered small posterior mediastinal/prevertebral lymph nodes are unchanged. Normal heart size. No pericardial effusion.CHEST WALL: Right PICC tip in the SVC. No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stones and sludge in the dependent portion of the gallbladder.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral cystic renal lesions, some of which are too small to characterize, unchanged compared to recent exam of 9/12/13. Areas of previously described internal complexity are not appreciated on this examination due to the phase of contrast enhancement.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: In the anterior subcutaneous tissues on the left, there are several nodular soft tissue lesions unchanged compared to recent previous. There is a small subcentimeter subcutaneous nodule in the right lower back.OTHER: No significant abnormality noted. | No change in subcutaneous nodules or mild mediastinal lymphadenopathy. |
Generate impression based on findings. | Dizziness, pulsatile tinnitus, hyperacusis, otalgia, and fullness in right ear. On the right, there is dehiscence of the superior semicircular canal along an approximately 4 mm length. The inner ear structures are otherwise unremarkable. The facial nerve describes a normal course. The ossicular chain is intact. The middle ear and mastoid air cells are well-pneumatized and clear. The external auditory canal is patent. There is a right cheek excrescence that measures up to 2 mm in thickness.On the left, inner ear structures are unremarkable. The facial nerve describes a normal course. The ossicular chain is intact. The middle ear and mastoid air cells are well-pneumatized and clear. The external auditory canal is patent. There is a right cheek excrescence that measures up to 2 mm in thickness.The imaged intracranial structures are grossly unremarkable. There is no abnormal enhancement. | Right superior semicircular canal dehiscence. |
Generate impression based on findings. | 70 year-old female with history of thyroid cancer CHEST:LUNGS AND PLEURA: Index left lower lobe mass measures 1.8 by one .6 cm on image number 77, series number 12, stable from previous study. However some of the other lung nodules have minimally increased in size compared to previous study. An index right lower lobe lung nodule now measures 1.2 x 1.2 cm on image number 56 on series number 12. This nodule was measuring 9 x 10 mm on image number 56 on series number 5 on the previous study.No new nodules.MEDIASTINUM AND HILA: Index tracheoesophageal groove nodule now measures two by 1.6-cm image number 8, series number 10, slightly increased compared to previous study. Small bilateral hilar and bronchopulmonary lymph nodes are unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Nonspecific cystic lesion is unchanged in the tail of the pancreas. Pancreas looks atrophic.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right nephrectomy, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Increase in some of the metastatic lung nodules. Minimal interval increase in the size of the tracheal esophageal groove mass. |
Generate impression based on findings. | Histoplasmosis, follow-up. Cough LUNGS AND PLEURA: Postsurgical changes with a partial right middle lobectomy with residual surgical clips in the right lower hilar region and volume loss. Interval removal of the previously described mass. Scattered in a largely calcified granulomata. No suspicious nodules or masses. No effusions.MEDIASTINUM AND HILA: No lymphadenopathy. Specifically the reference right hilar lymph node is difficult to measure given the lack of contrast, however it measures approximately 10 mm (image 48 series 3), previously 19 mm.The cardiac and pericardium are within limits.CHEST WALL: Mild strandy in the lateral right chest wall, compatible with prior surgery and probable surgical scarring.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Partial right middle lobectomy with removal of the suspected neoplasm. No evidence of recurrence or findings suggest residual metastatic disease |
Generate impression based on findings. | Sinusitis. There are bubbly secretions within the bilateral maxillary sinuses. There is also retention cyst formation within the left maxillary sinus. There is opacification of the bilateral infundibula. There is mild opacification of the left anterior ethmoid air cells. There are small air fluid levels within the bilateral sphenoid sinuses, as well as additional bubbly secretions within the right sphenoid sinus. The frontal sinuses are clear. The nasal cavity is clear. The mastoid air cells are clear. The imaged intracranial structures and orbits are grossly unremarkable. | Findings suggestive of acute sinusitis. |
Generate impression based on findings. | History of tuberous sclerosis This study is limited due to lack of IV contrast.CHEST:LUNGS AND PLEURA: Multiple small cystic lesions in both lungs consistent with lymphangioleiomyomatosis in a patient with known history of tuberous sclerosis. No lung nodules.MEDIASTINUM AND HILA: No significant abnormality noted.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: There is a 2.8 by 2.3 cm soft tissue density mass in the anterior portion of the lower pole of the left kidney on image number 115, series number 3. This lesion does not contain any fat density. This may represent a lipid poor angiomyolipoma, however, a renal cell carcinoma cannot be excluded. Subcentimeter angiomyolipoma image number 102, series number 3 the midpole of the left kidney and image number 107, series number 3..No focal lesions are are seen within the right kidney within the limitations of a noncontrast study.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Nonspecific sclerotic lesion involving the left iliac bone adjacent to the left sacroiliac joint.OTHER: No significant abnormality noted. | Limited study due to lack of IV contrast. Patient refused IV access.Lung findings consistent with lymphangioleiomyomatosis.Left lower pole mass which may represent a lipid poor tuberous sclerosis. However renal cell carcinoma cannot be excluded. Small angiomyolipomas within the left kidney. |
Generate impression based on findings. | Female 86 years old; Reason: 86 year old female with History: nightsweats The evaluation of solid organ pathology and lymphadenopathy is limited by the lack of IV contrast. CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged. Stable 8mm pleural-based nodule in the right lower lobe on image 64 of series 5 a is unchanged. No new nodules are masses are identified. No pleural effusions. The central airways are clear.MEDIASTINUM AND HILA: Extensive mediastinal adenopathy is again seen with multiple new enlarged lymph nodes. Reference precarinal lymph node on image 34 of series 4 measures 3 x 1 to 1.8 cm, previously 2.6 x 1 .5 cm.CHEST WALL: Interval increase in size and number of bilateral axillary and subpectoral lymph nodes. Reference right axillary lymph node on image 24 of series 4 measures 4.6 x 2 .7 cm, previously 3.8 x 2.7 cm a. Additional reference left axillary lesion on image 50 of series 4 measures 2.5 X 2 .5 cm, previously measuring 2.5 x 2.5 cm.ABDOMEN:LIVER, BILIARY TRACT: Hepatic granulomas.SPLEEN: Splenic granulomas.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: There is been significant interval in increase in size of confluent retroperitoneal and mesenteric adenopathy.Reference aortocaval node measures although difficult to assess, measures 9.1 x 5.2cm previoulsy 7.8 x 4.5cm (series 4 image 105).BOWEL, MESENTERY: Interval increase in size of extensive confluent mesenteric and retroperitoneal adenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Interval increase in significant mass effect along the sides of the bladder wall secondary to pelvic adenopathy.LYMPH NODES: Extensive lymphadenopathy in all chains which has increased in size and number. Index right common iliac node now measures 9.2 x 4.6cm previously 7.8 x 4.2 cm (image 138, series 4).BOWEL, MESENTERY: Mesenteric adenopathy.BONES, SOFT TISSUES: Right hip prosthesis with adjacent lytic lesion, unchanged. No new osseous lesions are detected.OTHER: No significant abnormality noted. | Significant interval increase in size and number of lymphadenopathy in the visualized chest, abdomen, and pelvis as discussed above. |
Generate impression based on findings. | Clinical question: New onset of seizures. Signs and symptoms : New onset of seizure. Nonenhanced head CT:Less than optimal quality study due to portable technique. There is no convincing evidence of any acute new findings since prior exam. Previously noted subarachnoid hemorrhage is significantly less conspicuous.The cortical sulci and ventricular system as well as the CSF spaces remain unchanged since prior exam. Midline is maintained. Consider MRI if clinical concern persist.Unremarkable calvarium and soft tissues of the scalp, orbits.Complete opacification of bilateral mastoid air cells and partially of the middle ear cavities which could be due to intubation. Minimal fluid level within the right maxillary sinus is also noted. | No convincing evidence of any acute new findings on this portable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Seizure. Signs and symptoms: Seizure. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical show sarcoma ventricular system normal CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp, paranasal sinuses and mastoid air cells and partially visualized orbits. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Evaluate for bleed or other intracranial process. Signs and symptoms: AMS and pinpoint pupils. Nonenhanced head CT:No evidence of acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells.Small loculated soft tissues within bilateral external auditory canals representing secretions/wax. | No acute intracranial process. |
Generate impression based on findings. | Clinical question : Vertigo and weakness. Signs and symptoms: As above. Unenhanced head CT:Examination demonstrates ectopia of cerebellar tonsils approximately 6 mm below the foramen magnum. There is resultant effacement of the subarachnoid space. There is no convincing evidence of any cerebellar tonsillar deformity.No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation are otherwise.Unremarkable calvarium and soft tissues of the scalp.On paranasal sinuses and mastoid air cells as well as bilateral middle ear cavities are well pneumatized.Unremarkable images through the orbits. | 1.6-mm ectopia of cerebellar tonsils with effacement of subarachnoid space. Recommend follow-up with MRI exam.2.Unremarkable nonenhanced head CT otherwise. |
Generate impression based on findings. | 74-year-old male patient status post cystectomy with ileal conduit present with possible enteric contents from abdominal wound. Please assess for enterocutaneous fistula/anastomotic leak. ABDOMEN:LUNG BASES: Bilateral dependent atelectasis.LIVER, BILIARY TRACT: Multiple hypoattenuating lesions in liver, stable compared to prior examination. Dominant lesion is in segment 5. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Calcification within the left urine when stable compared to prior examination and may be secondary to prior hemorrhage.KIDNEYS, URETERS: Atrophic right kidney. Left kidney with cortical thinning, appropriate for age. Mild ectasia of the left ureter may be secondary to post surgical changes.RETROPERITONEUM, LYMPH NODES: IVC filter in place below the level of the renal veins.BOWEL, MESENTERY: Ileal conduit in the right lower abdomen. There is an enteric cutaneous fistula between a loop of small bowel and the ventral abdominal wound and pelvis (series 3 image 120) with excretion of oral contrast. The loop of small bowel that communicates with the ventral wound is remote from the the loop used for the ileal conduit. Small amount of free abdominal ascites tracking into the mesentery without evidence of phlegmon or abscess formation. No pneumoperitoneum or pneumatosis. Subcutaneous air adjacent to the ventral wound may be postsurgical.Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status post proctectomy.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ileal conduit in the right lower abdomen. There is an enteric cutaneous fistula between a loop of small bowel and the ventral abdominal wound and pelvis (series 3 image 120) with excretion of oral contrast. The loop of small bowel that communicates with the ventral wound is remote from the the loop used for the ileal conduit. Small amount of free abdominal ascites tracking into the mesentery without evidence of phlegmon or abscess formation. No pneumoperitoneum or pneumatosis. Subcutaneous air adjacent to the ventral wound may be postsurgical.Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Fluid-filled left inguinal canal. Multilevel degenerative changes in the thoracic and lumbar spine.OTHER: Drain in the bladder bed and exits anteriorly in the left hemipelvis. | 1.Fistulous communication between the small bowel and ventral wound at the level of the pelvis. No pneumoperitoneum or abscess formation.2.Trace free ascites.3.Postsurgical changes from cystoprostatectomy with drain in place. |
Generate impression based on findings. | Reason: r/o pe History: sob, cp, h/o PE PULMONARY ARTERIES: Limited examination due to body habitus and motion. Within these limitations, no evidence of pulmonary embolism down to the lobar arteries.LUNGS AND PLEURA: Severe motion artifact. No significant abnormalities noted.MEDIASTINUM AND HILA: No pericardial effusions. Moderately enlarged superior mediastinal lymphadenopathy, unchanged since 2012 and presumably benign.CHEST WALL: Degenerative changes to the lower thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic steatosis. | Limited examination with no large embolus down to the lobar arteries. |
Generate impression based on findings. | 48-year-old female with left flank pain, hematuria, and nausea. Rule out kidney stone. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatomegaly, unchanged. Lack of IV contrast limits ability to evaluate solid parenchymal organs. Gallbladder and biliary tract are no diagnostic abnormalities.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate left renal calyceal nonobstructing calculus, unchanged. No new calcifications seen. No hydronephrosis or hydroureter is seen. No perinephric fluid collections are seen.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 | 1. Punctate left nonobstructing renal calyceal calculus, unchanged. No evidence for urinary tract obstruction. 2. Hepatomegaly. |
Generate impression based on findings. | Male 58 years old; Reason: PMH of non Hodgkin's/ transformed follicular lymphoma s/p chemo/radiation and radical excision of L lat pelvic mass 5/2013 s/p allo-sib SCT 2006 and recent cellulitis and L hip infection requiring drain History: Transformed follicular Lymphoma. Please measure masses in hip and pelvis and compare to prior scan. Again seen are two large subcutaneous masses along the anterior soft tissues of the 5 which are again increased in size compared to recent previous examination from 9/12/2013. The larger more lateral mass measures up to 12.0 x 11.0-cm (series 11394, image 275), previously 8.9 x 9.3 cm in the axial dimension. There is some central necrosis visible. Again seen is mild reticulation of the soft tissues more superficial to this lesion. The drain appears unchanged without visible drainable fluid collection.The second smaller more anteromedial mass measures up to 5.9 x 6.3 cm (series 11394, image 334), previously measuring 4.6 x 5.1 cm. Again seen is the large iliac mass which has increased in size measuring 5.1 x 7.4 cm (series 11394, image 117), previously measuring 4.9 x 5.0 cm in axial dimension. There is now 180 degree encasement of the external iliac artery.The bones of the left hip are within normal limits without evidence of fracture per | 1.Continued interval increase in size of the soft tissue masses along the anterior thigh and left iliac region compared to previous exam on 9/12/2013 and is again highly suspicious for progression of malignancy given the patient's history of transformed follicular lymphoma.2.Interval complete resolution of the previous fluid collection along lateral thigh status post drain placement. |
Generate impression based on findings. | 12-year-old male with abdominal pain, diarrhea, leukocytosis. ABDOMEN:LUNG BASES: No focal air space opacities or pleural effusions are present.LIVER, BILIARY TRACT: The liver is normal in attenuation and size. The gallbladder is distended. There is no biliary ductal dilatation.SPLEEN: The spleen is normal in size and attenuation. Two small accessory spleens are present. PANCREAS: The pancreas is normal in size and attenuation.ADRENAL GLANDS: The adrenal glands are symmetric in size and attenuation.KIDNEYS, URETERS: The kidneys are normal in size and attenuation with preserved corticomedullary differentiation. There is no hydronephrosis.RETROPERITONEUM, LYMPH NODES: There is no retroperitoneal lymphadenopathy.BOWEL, MESENTERY: The small bowel is normal in caliber without wall thickening.BONES, SOFT TISSUES: No focal osseous lesions identified.OTHER: No free intraperitoneal air is present. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is displaced inferiorly by the distended bowel. It is partially distended.LYMPH NODES: Bilateral prominent inguinal lymph nodes are present. BOWEL, MESENTERY: There is marked enlargement of the sigmoid colon and rectosigmoid with associated wall thickening and pericolic fluid. The sigmoid colon measures up to 8.0 cm in diameter. There is mild wall thickening of the distal descending colon. The proximal descending colon, ascending colon, and transverse colon appear within normal limits. Desiccated stool is noted in the dilated sigmoid and rectum.No enhancing fluid collections are present to suggest abscess.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Colitis of the rectosigmoid, sigmoid, and distal descending colon as described. Differential considerations include infectious and inflammatory etiologies. |
Generate impression based on findings. | Female 60 years old; Reason: NV with ab TTP, mostly in LUQ and epigastrium History: as aove The exam is not sensitive for detecting lesions in the solid organs are vasculature due to lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNGS BASES: Scarring right lung base redemonstrated. No effusions.LIVER, BILIARY TRACT: No evidence of fatty liver. No definite focal lesions. Cholecystectomy clips. No obvious biliary dilatation.SPLEEN: Normal size. Accessory spleen noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Some asymmetry in the right kidney probably related to some scarring and cortical loss in the anterior aspect of the lower pole.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications. Focal mild anterior bulge of the proximal abdominal aorta see sagittal image 64. More distally there is frank asymmetric aneurysm of the distal abdominal aorta with some tortuosity. The aneurysm is best measured on coronal image 58 where it measures only 2.4-cm in diameter but is distinct bulge relative to the normal caliber aorta proximal to it which measures 1.7 cm diameter.BOWEL, MESENTERY: Scattered colonic diverticulosis. No evidence of inflammatory process. No fat stranding, free or loculated fluid or bowel wall thickening.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: Colonic diverticulosis. No evidence of diverticulitis. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No specific findings to explain left upper quadrant pain.2.Small abdominal aortic aneurysm. Other findings as abov |
Generate impression based on findings. | 64-year-old female, evaluate renal mass. ABDOMEN: Exam limited in evaluation of solid organ pathology by the lack of IV contrastLUNG 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: Evaluation is limited due to lack of IV contrast. Hypodense right renal lesions, some too small to characterize, likely represent cysts seen on prior ultrasound. Hyperdense left renal lesions, the largest well circumscribed lesion which measures 1.6 x 1.7 cm (image 48, series 3), most likely represent complex cysts.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: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: Degenerative changes of the thoracolumbar spine. | Although incompletely evaluated without IV contrast, the dominant well circumscribed hyperdense left renal lesion has a high probability of representing a benign complex cyst. |
Generate impression based on findings. | Reason: pe? History: shortness of breath PULMONARY ARTERIES: Technically adequate examination. No evidence of pulmonary embolism. Main pulmonary artery caliber is high normal.LUNGS AND PLEURA: Mild centrilobular emphysema unchanged. Mild bronchial wall thickening is again noted and unchanged since 2009.Poorly defined area of mild groundglass opacity in contrast to the left upper lobe (series 10, image 36) remains unchanged and most likely inflammatory.MEDIASTINUM AND HILA: Heart size is normal. No pleural effusions. No significant mediastinal or hilar lymphadenopathy.Mildly prominent right and left hilar lymphadenopathy appears unchanged from prior exam.CHEST WALL: Mild degenerative changes to the left glenohumeral joint. Moderate degenerative disk disease and multiple age indeterminate compression deformities in the thoracic spine. Asymmetric nodular soft tissue density in the right breast, present since 2009.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolism.2.Stable mild central lobular emphysema.3.Mild bronchial wall thickening is again noted and unchanged since 2009, compatible with bronchitis or asthma.4.Asymmetric nodular soft tissue density in the right breast which has been present since 2009 is indeterminate. Correlation with mammography is recommended. |
Generate impression based on findings. | 84-year-old female postoperative day 5 status post sigmoidectomy with leukocytosis, nausea, and emesis. ABDOMEN:LUNG BASES: Bilateral pleural effusions with adjacent atelectasis and consolidation, partially visualized. Cardiomegaly.LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: Prominence of the pancreatic duct.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Superior pole left renal cyst is unchanged. Multiple subcentimeterhypoattenuating lesions in the left renal cortex are too small to characterize and arestable compared to prior examination. Hypoattenuating right renal lesions too small tocharacterize, unchanged. Renal cortical scarring is again noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse dilatation of fluid-filled small bowel with relatively decreased caliber of distal ileal loops, raising the possibility of partial obstruction. Moderate ascites. No loculated abdominal fluid collections. Postsurgical changes in the right lower quadrant. Left lower quadrant colostomyBONES, SOFT TISSUES: A drain extends to small residual phlegmonous collection in the left lower quadrant abdominal wall. Degenerative changes of the thoracolumbar spine.OTHER: Mild abdominal ascites. Anasarca.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diffuse dilatation of fluid-filled small bowel with relatively decreased caliber of distal ileal loops, raising the possibility of partial obstruction. Moderate ascites. No loculated abdominal fluid collections. Postsurgical changes in the right lower quadrant. Left lower quadrant colostomy.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. Right ventral hernia containing loops of small bowel.OTHER: Pelvic ascites. Anasarca. | 1. Status post sigmoidectomy with fluid-filled, distended small bowel loops and decreased caliber distal ileum suggesting partial obstruction. No loculated abdominal or pelvic fluid collections or evidence of perforation.2. Small residual left lower quadrant subcutaneous phlegmonous collection containing drain.3. Abdominal and pelvic ascites, bilateral pleural effusions and anasarca. |
Generate impression based on findings. | 61-year-old male with spiking temperatures --? Source of infection. CHEST:LUNGS AND PLEURA: Evolving changes are seen in the lung parenchyma with slightly decreased. Groundglass opacification and confluence density in the prior noted. Apical infiltrate, slightly increased airspace consolidation in the right lung base and new diffuse left basilar nodular opacities and peribronchial thickening. Peribronchial thickening is increased in the right lung bases well. Aspiration/infection is a likely etiology.Decreased right pleural effusion -- no left pleural effusion seen.MEDIASTINUM AND HILA: Tracheostomy tube in expected position. No significant masses or fluid collections are seen. Slightly prominent lymph nodes are unchanged in size or appearance./distribution. Coronary artery calcification again noted.CHEST WALL: No significant abnormality notedABDOMEN: Within the limits of a non-IV contrast-enhanced examination which limits a blue evaluate solid organs, vascular structures, following observations can be made:LIVER, BILIARY TRACT: Transplant liver appears unchanged. Lack of IV contrast limits ability to evaluate vascular structures or liver parenchyma. Status post cholecystectomy -- biliary stent unchanged in position with no evidence of intrahepatic biliary duct dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate left renal nonobstructing calyceal calculus. No other abnormalities seen, although evaluation is limited due to lack of IV contrast.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Percutaneous gastrostomy tube unchanged in position and in expected location. Small intestine tube through gastrostomy tube is seen with tip of tube at the ligament of Treitz. High density contrast administered rapidly progresses through normal appearing small and large bowel, without evidence of intrinsic abnormality or obstruction.Increase in the diffuse ascites without loculation to suggest abscess.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: High density contrast administered rapidly progresses through normal appearing small and large bowel, without evidence of intrinsic abnormality or obstruction.Increase in the diffuse ascites without loculation to suggest abscess.BONES, SOFT TISSUES: Diffuse subcutaneous edema.OTHER: No significant abnormality noted | 1. Transplant liver, unchanged in appearance. 2. Increasing diffuse ascites without loculation. 3. Evolving parenchymal lung infiltrates, but with increasing peribronchial thickening and nodular changes at both lung bases, most consistent with aspiration/infection. |
Generate impression based on findings. | 48-year-old female patient with history of pancreatic cancer. Restaging. ABDOMEN:LUNG BASES: New large right pleural effusion with associated atelectasis and volume loss. New small left pleural effusion with associated atelectasis.LIVER, BILIARY TRACT: Expected pneumobilia. Mild intrahepatic biliary ductal dilatation. Metallic stent in the distal common bile duct, stable. Segment 5 hypoattenuating lesion seen on prior examination is smaller on this exam, likely due to technique. Otherwise, multiple hypoattenuating lesions in the liver are stable compared to prior examination.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic head mass measures 4.2 x 3.1 cm (series 3 image 72), previously 3.2 x 3.2 cm. Redemonstration of pancreatic duct dilatation within the body and tail. Interval increase in portosplenic confluence thrombosis. Increased tumoral encasement is seen posteriorly around the celiac trunk. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval placement of metal duodenal stent. Diffuse abdominal varices.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Large amount of diffuse abdominal ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Large amount of diffuse abdominal ascites. | 1.Interval increase in the pancreatic head mass, large amount of diffuse abdominal ascites and interval increase in vascular compromise, consistent with disease progression.2.New bilateral pleural effusions. |
Generate impression based on findings. | 73-year-old male with abdominal pain, rule out diverticulitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Bilateral hepatic hypodensities, likely representing cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypodensities, too small to characterize but likely representing cysts.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: A 6.4 x 6.7 cm phlegmonous collection with marked infiltration of the mesenteric fat and foci of extraluminal gas involving a proximal segment of small bowel adjacent to a suture line indicates localized perforation. A maturing loculated fluid collection containing foci of gas measures 2.3 x 4.9 cm (image 79, series 3). There is adjacent small bowel wall thickening and dilatation. Small bowel diverticula are noted proximal and adjacent to the phlegmonous collection. Mesenteric lymphadenopathy is likely reactive in etiology.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: A 6.4 x 6.7 cm phlegmonous collection with marked infiltration of the mesenteric fat and foci of extraluminal gas involving a proximal segment of small bowel adjacent to a suture line indicates localized perforation. A maturing loculated fluid collection containing foci of gas measures 2.3 x 4.9 cm (image 79, series 3). There is adjacent small bowel wall thickening and dilatation. Small bowel diverticula are noted proximal and adjacent to the phlegmonous collection. Mesenteric lymphadenopathy is likely reactive in etiology.BONES, SOFT TISSUES: Left inguinal hernia.OTHER: No significant abnormality noted | Phlegmonous collection adjacent to the proximal small bowel with associated diverticulosis, consistent with perforated small bowel diverticulitis with maturing fluid collection as detailed above. |
Generate impression based on findings. | Reason: aml pre treatment History: aml LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Low attenuation of the circulating blood pool is consistent with anemia.There is no significant mediastinal or hilar lymphadenopathy.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. | No significant abnormality. |
Generate impression based on findings. | 52 year old female with esophageal varices and neck swelling. Evaluate for SVC syndrome. CHEST:LUNGS AND PLEURA: Bilateral basilar scarring and subsegmental atelectasis. No consolidation or pleural effusions. Bilateral lung nodules noted; the largest located in the right lower lobe measures 4 mm (series 4, image 66); no further CT followup recommended at this time.MEDIASTINUM AND HILA: There is a large thrombus occluding lumen of superior vena cava which extends into the left brachiocephalic vein and azygous vein. No evidence of compressing mass or lesion. Remaining vasculature remains patent. Several foci of gas are seen in the left internal jugular vein, which may be related to recent procedure.Multiple enlarged lymph nodes are seen in the lower neck, left more than right, and upper mediastinum. Multiple esophageal varices noted.Heart is normal in size without pericardial effusion.CHEST WALL: Multiple chest wall collaterals vessels. Multiple prominent axillary lymph nodes bilaterally.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Kidneys are atrophic bilaterally. Punctate hypodensity in left kidney most compatible with cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple small retroperitoneal lymph nodes.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.Large thrombus occluding the lumen of the superior vena cava, with extension of thrombus into the azygos and left brachiocephalic veins. Associated numerous collateral vessels are seen in the chest wall and esophagus.2.Several foci of gas in left internal jugular vein, which may be related to recent instrumentation.3.Multiple enlarged cervical and mediastinal lymph nodes. |
Generate impression based on findings. | 69-year-old male with acutely elevated bilirubin and jaundice -- evaluate for biliary mass/abscess. CHEST:LUNGS AND PLEURA: Left pleural effusion minimally changed from prior with increasing bibasilar atelectasis. MEDIASTINUM AND HILA: Pacemaker and associated wires, unchanged in position or appearance. Changes from LVAD unchanged with cardiomegaly.CHEST WALL: Postoperative changes.ABDOMEN: Within the limits of a non-IV contrast enhanced examination limiting evaluation of solid parenchymal organs and vascular structures, the following observations can be made:LIVER, BILIARY TRACT: Liver parenchyma appears homogeneous and without focal lesion. Gallbladder again shows gallstones without other complication. No intrahepatic or extrahepatic biliary duct dilatation is seen.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No change with large right renal cyst and no other abnormality. Lack of IV contrast limits ability to evaluate parenchyma.RETROPERITONEUM, LYMPH NODES: Abdominal aortic aneurysm will with internal aorto biiliac stent seen, unchanged with external sac diameter measuring 5.2 x 5.0 cm (series 4, image 143) unchanged.BOWEL, MESENTERY: Stomach, small bowel, and colon. All appear normal, with no evidence of obstruction, and colon, filled with feces. Prior noted right sided colon wall thickening has resolved. Small amount of free mesenteric fluid is seen without loculation. Small anterior ventral hernia containing only mesenteric fat.BONES, SOFT TISSUES: Diffuse degenerative changes in the lumbar spine again seen.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 noted in small bowel. Colon is feces filled throughout with sigmoid diverticular changes without complication. Small amount of ascites again seen in the dependent pelvis without loculation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Left pleural effusion and bibasilar atelectasis with minimal change. 2. Left ventricular assist device and cardiomegaly unchanged. 3. Gallstones without complication. 4. Aortic aneurysm with internal stent, unchanged. 5. No evidence for biliary obstruction. |
Generate impression based on findings. | Reason: evaluate for signs of PE vs infection History: 58yo F with recurrent lymphomatoid granulomatosis of the lung with fevers, dyspnea, and hypoxia. PULMONARY ARTERIES: Technically adequate examination. No evidence of pulmonary embolism.LUNGS AND PLEURA: Interval increase in left upper lobe consolidation with surrounding groundglass opacities. Small reference nodule in the left upper lobe is no longer visualized due to increased upper lobe consolidation.New small left pleural effusion with overlying atelectasis.. Previously noted left lower lobe subpleural nodule is not visualized due to pleural effusion. MEDIASTINUM AND HILA: Confluent mediastinal and suprahilar lymphadenopathy, increased from prior exam, encasing the left upper lobe pulmonary artery. Small pericardial effusion. Heart size is normal.CHEST WALL: Calcified left lobe thyroid nodule. Interval increase in right lower cervical lymphadenopathy.Collapse of the left humeral head likely secondary to avascular necrosis, unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable calcified granulomas in the left parenchyma. Intrahepatic and extrahepatic biliary ductal dilatation not significantly changed from prior exam. Mild increase in retrocrural lymphadenopathy. Prominent porta hepatis and para-aortic lymph nodes unchanged. Probable splenule anterior to spleen. | Interval increase in left upper lobe consolidation with surrounding groundglass opacities consistent with history of lymphomatoid granulomatosis of the lung. |
Generate impression based on findings. | 80 year-old male with colon cancer, liver METs and hemidiaphragmatic mass. CHEST:LUNGS AND PLEURA: Large lung volumes and scattered micronodules some of which are calcified and likely represent prior granulomatous disease.Right pleural-based mass abutting the diaphragm measures 4.4 x 6.4 cm (image 87, series 3)MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. The heart size is normal.CHEST WALL: Age indeterminant T8 vertebral body compression fractureABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic metastases are identified. One right hepatic metastasis measures 2.2 x 2.1 cm (image 93, series 3). Several additional hypoattenuating lesions likely represent cysts.Large right pleural-based mass extends along the right hepatic contour (image 99, series 3).SPLEEN: Splenic granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Marked right hydronephrosis. A nephroureteral catheter extends from the right renal pelvis to the bladder. Soft tissue masses encase the distal right ureter, measuring up to 2.4 x 1.9 cm (image 138, series 3).RETROPERITONEUM, LYMPH NODES: Retroperitoneal masses involving the distal right ureter as detailed above.BOWEL, MESENTERY: Multiple mesenteric/omental masses are identified. One in the left lower quadrant with coarse internal calcification involves the left rectus sheath and measures 2.2 x 3.9 cm (image 152, series 3). Status post right hemicolectomy. Large stool burden. BONES, SOFT TISSUES: A heterogeneously enhancing mass involves the soft tissues of the right lower quadrant abdominal wall.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple mesenteric/omental masses are identified. One in the left lower quadrant with coarse internal calcification involves the left rectus sheath and measures 2.2 x 3.9 cm (image 152, series 3). Status post right hemicolectomy. Large stool burden. BONES, SOFT TISSUES: Marked degenerative changes of the lumbar spine and pelvis with apparent fusion of the SI joint on the left with reactive sclerosis involving the ileum.OTHER: No significant abnormality noted | 1. Status post right hemicolectomy with hepatic, pleural and abdominal and pelvic metastatic lesions involving the mesentery, retroperitoneum, and abdominal wall.2. Right nephroureteral catheter with marked right hydronephrosis and tumor encasing the distal ureter. |
Generate impression based on findings. | 60 year-old female with left upper lung nodule and shortness of breath. LUNGS AND PLEURA: Left upper lobe nodule slightly increased in size, measuring 15 mm, previously measured 13 mm (series 7, image 23). No new nodules identified.Severe emphysema. No consolidation or pleural effusions.MEDIASTINUM AND HILA: No pathologically enlarged mediastinal nodes. Heart is normal in size without pericardial effusion. Mild coronary artery calcifications. Moderate aortic valve calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. Partially visualized left kidney is atrophic. | Slightly increased size of left upper lobe nodule, which was hypermetabolic on recent PET/CT and highly suspicious for primary lung neoplasm. |
Generate impression based on findings. | 64 year-old female with lightheadedness. There are scattered patchy hypodensities in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. Minimal small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. |
Generate impression based on findings. | Metastatic papillary cell cancer. Head: There is no evidence of abnormal intracranial enhancement, hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The osseous structures are unremarkable. Neck: There are postoperative findings related to total thyroidectomy and right neck dissection. There has been interval increase in size of the enhancing mass within the right tracheoesophageal groove, which now measures 23 AP x 17 RL x 23 SI mm, previously 15 AP x 19 RL x 19 SI mm. The mass appears to infiltrate the adjacent right strap muscles. The mass also abuts the right common carotid artery without evidence of encasement. There is otherwise no evidence of significant cervical lymphadenopathy. The airways are patent. The major salivary glands appear unchanged. The osseous structures are unremarkable, aside from chronic degenerative spondylosis. The imaged portions of the lungs are unremarkable. unremarkable. | 1. Continued interval increase in size of the recurrent papillary thyroid carcinoma within the right tracheoesophageal groove, which now measures up to 23 mm, previously 19 mm.2. No evidence of intracranial metastases. |
Generate impression based on findings. | 65-year-old male with thyroid cancer. CHEST:LUNGS AND PLEURA: Bilateral apical scarring and bronchiectasis is unchanged.Reference right lower lobe pleural-based nodule is unchanged, currently 7 mm, previously measured 7 mm. Remaining punctate micronodules are also unchanged. New ill-defined opacities in the right lower lobe are nonspecific but may be related to aspiration or inflammatory process (series 4, images 50 and 56). Mild septal thickening in the right lower lobe with most compatible with mild edema.No new suspicious nodules.MEDIASTINUM AND HILA: Increase in size of mediastinal and hilar lymphadenopathy; reference partially necrotic subcarinal node measures 2.2 cm in short axis, previously measured 2.1 cm (series 3, image 54).Heart is normal in size without pericardial effusion. Moderate coronary artery calcifications.CHEST WALL: Multiple osseous metastases, mildly increased in size (series 3, image 70).ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Innumerable hepatic metastases are likely not significantly changed given variation in timing of contrast bolus compared to prior study; reference right lobe lesion measures 3.6 x 2.5 cm, previously measured 3.5 x 2.3 cm (series 3, image 104).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: Multiple osseous metastases are increased in size; this is best appreciated in the increased soft tissue component of T9, L1, L5 lesions (series 3, image 70, 117, 160).OTHER: No significant abnormality noted. | 1.No significant change in pulmonary metastases.2.Increased size of mediastinal lymphadenopathy.3.Increased size of osseous diastases.4.Innumerable hepatic metastases, likely not significantly changed.5.New ill-defined opacities in the right lower lung lobe, which may be related to aspiration or inflammatory process. |
Generate impression based on findings. | Clinical question: Evaluate for size of hemorrhage. Signs and symptoms: Right lower extremity weakness and dysphasia. Nonenhanced head CT:A tiny focus of increased density in the right paramedian pons shows no convincing evidence of interval change.There is no detectable new findings since prior exam, CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Grossly stable extensive periventricular/subcortical low-attenuation white matter, ex vacuo dilatation of right lateral ventricle since prior exam. Midline is maintained. | 1.No evidence of new finding since prior exam.2.Stable tiny focus of increased density in the right paramedian pons.3.Grossly stable findings of age indeterminate small vessel ischemic strokes and ex vacuo dilatation of right lateral ventricle. |
Generate impression based on findings. | Clinical question: Continued monitoring of any acute changes. Signs and symptoms: Intracranial hemorrhage. Nonenhanced head CT:Acute hematoma in the left basal ganglia is again noted identified. Multiple measurements on axial, sagittal and coronal projections demonstrate no evidence of interval change in the size of hematoma. It measures maximum of 47 mm in AP axis and 30-mm in transverse. Its associated mass effect on the left frontal horn and trace rightward midline shift is identified the prior study.Acute blood in the dependent portion of bilateral occipital horns are again noted without change. Scattered subarachnoid hemorrhage in the left hemisphere and to a lesser degree on the right as well remains very similar to prior exam.Lateral ventricles are slightly prominent however stable since multiple prior exams. | 1.No evidence of acute new finding since prior exam.2.Stable acute hypertensive dissecting hematoma in the left basal ganglia and its associated mass effect and trace rightward midline shift.3.Stable residual acute blood in the dependent portion of occipital horns and scattered subarachnoid hemorrhage (left > right).4.Stable mildly prominent supratentorial ventricular system since prior exam. |
Generate impression based on findings. | 58-year-old male patient with history of renal cell cancer and thyroid cancer status post thyroidectomy. Evaluate for disease progression of RCC. Note that the lack of intravenous contrast limits evaluation of vasculature, lymph nodes and solid viscera.CHEST:LUNGS AND PLEURA: Multiple subcentimeter, bilateral nodules and micronodules. Subjectively, some nodules are less prominent compared to prior. Right lower lobe superior segment reference lesion is no longer visualized and previously measured 9 x 12 mm. Reference right lower lobe reference nodule measures 4 mm (series 4 image 72), stable.MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes, stable. Reference pretracheal node measures 3.2 x 1.8 cm (series 3 image 46), previously 1.8 x 3.4 cm. Reference right hilar node measures 4.2 x 3.3 cm (series 3 image 52), previously 3.4 x 4.0 cm.CHEST WALL: Status post thyroidectomy. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Diffusely hypoattenuating liver parenchyma, consistent with fatty infiltration.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Status post left adrenalectomy.KIDNEYS, URETERS: Status post left nephrectomy. Right kidney without any significant abnormalities on this noncontrast examination.RETROPERITONEUM, LYMPH NODES: Minimal atherosclerotic changes in the abdominal aorta and iliac arteries. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate, stable.BLADDER: No significant abnormality noted.LYMPH NODES: Interval decrease in right normal lymph node that currently measures 1.9 X 0.7 cm (series 3 image 122), previously 2.0 x 0.9 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted. | 1.Stable to mildly improved pulmonary nodules.2.Decreased right inguinal lymphadenopathy.3.Stable mediastinal lymphadenopathy. |
Generate impression based on findings. | CLL. Assessment is limited due to lack of intravenous contrast. There has been overall interval increase in size numerous, bilateral, multilevel enlarged cervical lymph nodes. For example, a left level 5 lymph node measures 10 x 13 mm (image 93, series 4), previously 9 x 12 mm, a right level 1B lymph node measures 14 x 17 mm (image 101, series 4), a left parotid lymph node measures 7 x 8 mm (image 31, series 4), previously 5 x 5 mm, and a right parotid lymph node measures 15 x 15 mm (image 69, series 4), previously 6 x 7 mm. There is also extensive, but partially imaged upper mediastinal and axillary lymphadenopathy. The Waldeyer ring structures are unremarkable and the airways are patent. There are postsurgical findings suggestive of prior thyroidectomy. The major salivary glands appear unchanged. There is no lytic or blastic lesions. The partially imaged intracranial structures appear unchanged. | Overall interval increase in size of the extensive cervical lymphadenopathy related to CLL. Extensive, but partially imaged upper mediastinal and axillary lymphadenopathy. Please refer to the separate body CT report for additional details. |
Generate impression based on findings. | 58-year-old male with diffuse generalized abdominal pain. On chemotherapy for glioblastoma multiforme. ABDOMEN:LUNG BASES: Bibasilar air space consolidationLIVER, BILIARY TRACT: Scattered, benign cysts in the liver. No other parenchymal abnormality seen. Gallbladder and biliary tract appear normal. Vascular structures appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral benign renal cysts -- no other abnormalitiesRETROPERITONEUM, 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: Scattered sigmoid diverticula changes without complication. No other abnormalities.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Bibasilar airspace consolidation -- aspiration/infection likely etiologies. 2. No abnormality seen in the abdomen to account for patient's symptomatology. |
Generate impression based on findings. | Male 73 years old; Reason: history metastatic renal cancer, assess for progression. CHEST:LUNGS AND PLEURA: Moderate left and small right pleural effusions are noted, similar to prior. There is persistent overlying left lower lobe atelectasis. Numerous pulmonary nodules are similar to prior perhaps minimally increased in size. Right upper lobe surgical changes are again noted.Index right lower lobe mass measures two .6 by 1.6-cm on image number 59, series number 4, minimally increased from previous study. Index right upper lobe nodule measures 1.1-cm image number 44, series number 4, minimally increasing size compared to previous study.MEDIASTINUM AND HILA: Heart size is normal with trace pericardial effusion, with coronary artery calcifications versus stents. Left para-aortic node measures 3.2 x 2.5 cm, similar or slightly larger than prior, best seen on image 76 series 3. Remaining mediastinal adenopathy is also minimally increased in size. Aortic atherosclerotic calcifications are noted.CHEST WALL: ICD is noted.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Numerous hypodense hepatic lesions compatible with cysts are unchanged. Cholelithiasis is noted. No biliary dilation is noted.SPLEEN: 3.3 x 2.3 cm rounded isodense lesion is noted along the posterior aspect of the spleen, similar to prior.PANCREAS: No significant abnormality notedADRENAL GLANDS: Interval development of a left adrenal mass measuring 4.5 x 1.7 cm on image number 115, series number 3.KIDNEYS, URETERS: Status post left nephrectomy. Unchanged hypodense right renal lesions are incompletely evaluated.RETROPERITONEUM, LYMPH NODES: Just medial to the spleen, there is a 3.3 x 2.1 cm transaxial by 2.5-cm craniocaudal dimension ovoid lesion which is larger than prior, seen on image 116 series 3.BOWEL, MESENTERY: Mild diverticulosis is noted. Enteric contrast has progressed to the cecum.BONES, SOFT TISSUES: Lumbar degenerative changes are noted.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate is enlarged.BLADDER: Bladder is decompressed.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There is an enlarging destructive lytic mass within the greater trochanter of the right femur measuring 2.8 x 2.7 cm best seen on image 197 series 3, with soft tissue extension, measuring 4.9 centers craniocaudal dimension on coronal image 60 series 80268. Additional degenerative changes are noted.OTHER: Left inguinal fat-containing hernia is noted. Left superficial pelvic lipoma is noted. | The study is limited due to lack of IV contrast.1.Interval minimal increase in the size of the pulmonary nodules and mediastinal adenopathy2.enlarging right femur. Metastatic lesion.3.New left adrenal mass, suspicious for metastatic disease.4.Other findings are stable from prior study.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | PTC treated with total thyroidectomy and resection left recurrent laryngeal nerve and Montgomery implant placed. The patient then developed an increasing mass in the right paratracheal region that caused intermittent VC weakness. The mass was resected, but there airway obstruction developed resulting in a tracheostomy. There are stable postoperative findings related to total thyroidectomy and left vocal cord prosthesis insertion. There has been interval increase in size of the infiltrative, heterogeneously enhancing mass within the right thyroidectomy bed, which now measures 25 AP x 34 RL x 33 SI mm, previously 17 AP x 21 RL x 30 SI mm. The mass encases the right common carotid artery with associated mild narrowing of the vessel. The mass also abuts and mildly narrows the right internal jugular vein. In addition, there is extension of the mass into the party wall with associated thickening of the esophageal wall. There is perhaps mild narrowing of the airway at the level of the tracheostomy. There has been interval increase in size of a right level 4 lymph node, which now measures 10 x 8 mm, previously 6 x 7 mm. There are numerous lung metastases and upper mediastinal, which have increased in size, although these are not completely characterized in this scan. There is also apparent increase in an incompletely imaged size of a left fifth rib metastases. The previously intracranial metastases are not included in the field of view of this scan. The major salivary glands are unchanged. The imaged paranasal sinuses and mastoid air cells are clear. | 1. Interval increase in size of the infiltrative recurrent tumor that encases the right common carotid artery within the right thyroidectomy bed, which now measures up to 34 mm, previously up to 30 mm, and increase in size of right level 4 lymphadenopathy, measuring up to 10 mm, previously 7 mm. 2. Interval increase in size of numerous lung, upper mediastinal, and partially imaged left fifth rib metastases. Refer to the separate body CT report for additional details. |
Generate impression based on findings. | 70 year-old female with stage III non-small cell lung cancer status post neoadjuvant chemoradiation. CHEST:LUNGS AND PLEURA: Interval decrease in size of right upper lobe spiculated nodule, currently measuring 10 x 15 mm, previously measured 15 x 20 mm (series 4, image 24).Mild scarring/atelectasis in the right base, unchanged. Ill-defined opacity along anterior aspect of right upper lobe also unchanged, which may also represent scarring (series 4, image 44).Previously noted groundglass opacity adjacent to cyst in the right lower lobe unchanged (series 4, image 52).No new nodules. Moderate emphysema.MEDIASTINUM AND HILA: Interval decrease in mediastinal lymphadenopathy; reference pretracheal node measures 17 mm, previously measured 25 mm (series 3, image 34). The heart is normal in size without pericardial effusion.CHEST WALL: Degenerative changes in the spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Several hepatic hypodensities are unchanged, most compatible with benign cysts. No new or suspicious lesions. Diffuse steatosis. 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 right upper lobe lesion and mediastinal adenopathy.2.Stable indeterminate right lower lobe ground-glass opacity associated with cyst; continued follow-up recommended. |
Generate impression based on findings. | 45-year-old female patient with pain. Evaluate for hernia. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis.LIVER, BILIARY TRACT: Status-post cholecystectomy and roux limb. Pneumobilia.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: Status post Roux-en-Y hepatojejunostomy. Interval resolution of pancolitis.BONES, SOFT TISSUES: Multilevel degeneration in the thoracic and lumber spine. Interval closure of midline ventral anterior abdominal wall wound with fibrous scar. There is no breakdown in the rectus sheath. No herniating bowel. Ventral mesh in place.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Right adnexal cyst, likely physiologic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post Roux-en-Y hepatojejunostomy. Interval resolution of pancolitis.BONES, SOFT TISSUES: Multilevel degeneration in the thoracic and lumber spine. Interval closure of midline ventral anterior abdominal wall wound with fibrous scar. There is no breakdown in the rectus sheath. No herniating bowel. Ventral mesh in place.OTHER: No significant abnormality noted | 1.Interval closure of midline ventral wound without evidence of bowel herniation.2.Interval resolution of pancolitis. |
Generate impression based on findings. | 68-year-old male with cough. Evaluate for pneumonitis. CHEST:LUNGS AND PLEURA: Spiculated, perihilar right upper lobe mass measures 3.5 x 3.6 cm, previously 3.1 x 3.3 cm (series 4, image 31). Paramediastinal right lower lobe mass does not appear significantly changed, measuring 2.0 x 5.0 cm (series 4, image 49). Innumerable lung metastases, many which are centrally cavitary. No superimposed consolidation or groundglass opacities to suggest acute abnormality such as pneumonitis.MEDIASTINUM AND HILA: Multiple enlarged mediastinal and hilar lymph nodes; for reference, AP window node measures 8 mm, unchanged (series 3, image 32).Heart is normal in size without pericardial effusion. Mild coronary artery calcifications.CHEST WALL: Lucent lesion in left aspect of T4 vertebral body is unchanged, and has appearance most suggestive of hemangioma (series 3, image 28).ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Punctate hypodensities in left lobe are too small to characterize but unchanged since prior exam (series 3, image 70, 75).SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral subcentimeter hypodensities 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.No gross abnormalities noted.BONES, SOFT TISSUES: Partially visualized round, sclerotic focus in left ilium is nonspecific but likely unchanged since prior exam (series 3, image 143).OTHER: No significant abnormality noted. | 1.Mild increase in size of right upper lobe, perihilar mass, consistent with primary lung neoplasm.2.Innumerable lung metastases and mediastinal lymphadenopathy.3.No evidence of superimposed, acute lung process to suggest pneumonitis.4.Nonspecific sclerotic focus in left ilium is not completely visualized but likely unchanged since prior exam. |
Generate impression based on findings. | 43-year-old female patient with history of possible chronic pancreatitis. Evaluate for pancreatic malignancy. ABDOMEN:LUNG BASES: Minimal right upper lobe scarring.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Focus of coarse calcifications within the pancreatic head. No mass identified, pancreatic ductal dilatation or parenchymal atrophy.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: Limbus vertebra of the L4 vertebral body.OTHER: No significant abnormality noted | Focus of coarse calcifications in the head of the pancreas without findings suggestive of mass lesion. |
Generate impression based on findings. | Testicular carcinoma 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: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 | Negative examination; no evidence for acute, inflammatory, or neoplastic process. No metastatic process. |
Generate impression based on findings. | 69 year-old female with thyroid cancer. LUNGS AND PLEURA: Innumerable pulmonary metastases not significantly changed. Reference left upper lobe lesion measures 12 x 12 mm, previously measured 12 x 12 mm (series 4, image 24). Reference left lower lobe lesion measures 8 x 9 mm, previously measured 8 x 9 mm (series 4, image 64).MEDIASTINUM AND HILA: Again noted tumor in right thyroid bed.Tracheostomy in place.Multiple enlarged mediastinal and hilar lymph nodes not significantly changed. Reference right hilar conglomerate of nodes unchanged, measuring 16 mm, previously measured 16 mm (series 3, image 39). Reference subcarinal node measures 10 mm, previously measured 10 mm (series 3, image 39).Mild coronary artery calcifications. The heart is normal size without pericardial effusion.CHEST WALL: Left fifth rib metastatic lesion is increased in size (series 3, image 35); currently measures 2.8 x 4.0 cm, previously measured 2.6 x 3.1 cm. Status post T12 laminectomy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Left hepatic lobe lesion not significantly changed. Chronic intra-and extrahepatic biliary ductal dilation and pancreatic duct dilation unchanged. | 1.No significant change in extensive pulmonary metastatic disease and mediastinal lymphadenopathy.2.Increase in size of left fifth rib lesion.3.Left hepatic lobe lesion suspicious for metastasis, not significantly changed.4.Right thyroid bed mass; please see dedicated neck CT report for neck findings. |
Generate impression based on findings. | 63-year-old male with history of pancreatic cancer status post radiation therapy and chemotherapy with abdominal pain. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Marked atherosclerotic calcifications of the coronary arteries, aortic valve and aorta. Unchanged mildly prominent mediastinal lymph nodes. Status post CABG. Central catheter tip extends to the IVC.CHEST WALL: Status post median sternotomy. Left chest wall port.ABDOMEN:LIVER, BILIARY TRACT: Scattered hypoattenuating lesions too small to characterize, but likely representing cysts.SPLEEN: No significant abnormality notedPANCREAS: Hypoattenuating pancreatic mass measures 5.5 x 4.1 cm and previously measured 5.2 x 4 cm (image 107, series 3). Several fiducial markers are again noted. Tumor encases the celiac axis and abuts the SMA. There is stable occlusion of the splenic vein with gastrohepatic collaterals.ADRENAL GLANDS: Mild unchanged nodularity of left adrenal gland.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: 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: 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 | Pancreatic mass encasing the celiac axis with thrombosis of the splenic vein, not significantly changed from the prior exam. No new lesions. |
Generate impression based on findings. | Colon carcinoma CHEST:LUNGS AND PLEURA: Stable left lung scarring.MEDIASTINUM 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: No significant change in subtle soft tissue infiltration involving the fat surrounding the celiac and portacaval regionBOWEL, 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. | Nasal congestion. There is mild mucosal thickening within the bilateral maxillary sinuses, as well as partial opacification of the infundibula. There is mild opacification of the ethmoid sinuses. The sphenoid and frontal sinuses are clear. There is pneumatization of the left anterior clinoid process. The imaged intracranial structures are grossly unremarkable. The nasal cavity is clear. There is mild nasal septal deviation with a rightward spur. The ethmoid roofs are nearly symmetric and intact. The lamina papyracea are intact and the orbital contents are grossly unremarkable. The carotid grooves and optic canals are covered by bone. | Mild paranasal sinus opacification in a sporadic pattern. |
Generate impression based on findings. | Female 19 years old Reason: fracture 1st left rib History: Need thoracic outlet CT to eval 1st rib There is a nondisplaced transverse fracture of the mid/distal left first rib with sclerosis along the fracture line margins. There is soft tissue density surrounding the fracture. These findings are suggestive of nonunion. | Left first rib fracture with findings suggestive of nonunion. |
Generate impression based on findings. | Three year old female with history of prior neutropenia, now resolved. Evaluate for interval change of small wedge-shaped area of low attenuation in the right apex. LUNGS AND PLEURA: Interval resolution of the previously identified wedge-shaped area of hypointensity in the right apex. No new pulmonary air space opacities or pleural effusions are identified.There is decreased attenuation of the right upper lobe, best seen on the MINIP sequence, which is suggestive of air trapping. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is present. A right central venous catheter is present with its tip at the junction of the right innominate vein and SVC.The heart size is normal. No pericardial effusion is present. CHEST WALL: Scattered small axillary lymph nodes are noted. UPPER ABDOMEN: The visualized liver, superior kidneys, and spleen appear within normal limits. | 1. Low attenuation of the right upper lobe suggestive of air-trapping. The previously identified wedge shaped area of low attenuation in the right apex is not present on this examination and may have represented a more focal region of air-trapping in the right apex. 2. No evidence of pulmonary infection as clinically questioned. |
Generate impression based on findings. | 76-year-old female with increasing oxygen requirement. History of COPD, right heart failure with pulmonary hypertension. LUNGS AND PLEURA: Moderate centrilobular emphysema.Small right pleural effusion. Mild basilar scarring/atelectasis bilaterally. Several micronodules bilaterally, unchanged and likely benign in nature.MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes, not significantly changed. Severe cardiomegaly, predominantly affecting right atrium and right ventricle. Severe calcifications affect coronary arteries, aortic arch, and the aortic valve. Large main pulmonary artery measures 3.6 cm in diameter, unchanged (series 3, image 39).CHEST WALL: Increased moderate anterior compression deformity of L1 vertebral body (sagittal series image 60).UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Small amount of ascites fluid around the liver. Multiple enlarged lymph nodes in upper retroperitoneum, increased since 2011. | 1.Small right pleural effusion most compatible with CHF.2.Right sided predominant cardiomegaly and pulmonary artery enlargement, compatible with pulmonary arterial hypertension.3.Compression deformity of L1 vertebral body. 4.Emphysema. |
Generate impression based on findings. | 58 year-old female with metastatic colorectal cancer, restaging. CHEST:LUNGS AND PLEURA: Multiple bilateral large pulmonary masses appear sightly smaller in size, many of which have undergone interval central necrosis/cavitation. Reference left lower lobe mass measures 4.9 x 3.2 cm and previously measured 5.2 x 3.3 cm (image 61, series 4).MEDIASTINUM AND HILA: Central venous catheter extends to the SVC. Calcified mediastinal and hilar lymph nodes are unchanged. CHEST WALL: Right chest wall port.ABDOMEN:LIVER, BILIARY TRACT:Cholelithiasis without evidence of cholecystitis. Previously identified ill-defined hypoattenuating lesion is no longer well visualized.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: Right lower quadrant ileostomy. The colon is collapsed with diffuse submucosal fat deposition, indicating prior inflammation.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: Right lower quadrant ileostomy. The colon is collapsed with diffuse submucosal fat deposition, indicating prior inflammation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple bilateral pulmonary metastases many of which appear smaller and have undergone central cavitation/necrosis. No new metastatic lesions. |
Generate impression based on findings. | 49 year-old female with metastatic breast cancer, known adenopathy, liver METs and pleural effusion. CHEST:LUNGS AND PLEURA: Moderate right pleural effusion and adjacent atelectasis.MEDIASTINUM AND HILA: A cystic appearing supraclavicular mass measures 3.0 x 3.3 cm (image 14, series 3) and measures fluid density which would be unusual for breast cancer metastasis. Without prior imaging the significance of this lesion remains uncertain. Mediastinal lymphadenopathy measuring up to 1.5 x1.7 cm (image 34, series 3).CHEST WALL: Left axillary lymphadenopathy measures 2.0 x 1.4 cm (image 34, series 3). Lytic lesion of a right posterior thoracic rib and sclerotic lesions of the vertebral bodies, suspicious for metastatic disease.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. No focal hepatic lesions. Prominence of the common bile duct.SPLEEN: Small splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland mass measures 1.6 x 2.3 cm (image 106, series 3).KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: An enlarged right periaortic node measures 1.6 x 1.4 cm (image 121, series 3) and is worrisome for metastasis. No other abnormalities identified.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scattered sclerotic lesions of the vertebral bodies, likely representing metastatic disease.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: Grade 2 anterolisthesis of L5 on S1. OTHER: No significant abnormality noted. | 1. Axillary and mediastinal lymphadenopathy as well as cystic appearing right supraclavicular lesion.2. Moderate right pleural effusion.3. Left adrenal metastasis and retroperitoneal adenopathy.4. Lytic and sclerotic osseous lesions likely representing metastatic disease, correlate with bone scan which is more sensitive for extent of metastatic disease. |
Generate impression based on findings. | 76-year-old male patient with history of right adrenal mass. ABDOMEN:LUNG BASES: Two pulmonary nodules in the right lower lobe (series 5 image 19 and 47), largest of which measures 4 mm.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal mass is low-attenuation on noncontrast and demonstrates washout on delayed images, consistent with benign adrenal adenoma.Left adrenal gland is slightly nodular and thickened with low attenuation.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes in the abdomen aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine. Right iliac bone island.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine. Right iliac bone island.OTHER: No significant abnormality noted. | 1.Right adrenal adenoma.2.Left adrenal gland slightly nodular and low density but without discrete measurable mass.3.Two nonspecific 4 mm left lower lobe lung nodules.4.Enlarged prostate. |
Generate impression based on findings. | 43-year-old male patient with history of sarcoma. Evaluate disease. CHEST:LUNGS AND PLEURA: Scattered bilateral pulmonary micronodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Segment 7 hypoattenuating liver lesion is no longer visualized and previously measured 0.3 x 0.6 cm.Segment two hypoattenuating lesion measures 1.0 x 1.0 cm (series 3 image 94), 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: Colonic diverticulosis without evidence of diverticulitis. Status post right hemi-colectomy.BONES, SOFT TISSUES: 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: Colonic diverticulosis without evidence of diverticulitis. Status post right hemi-colectomy.BONES, SOFT TISSUES: Soft tissue in the region of the right inguinal canal measures 2.6 x 1.7 cm (series 3 image 193), previously 2.0 x 2.6 cm. Multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted. | 1.Interval resolution of segment 7 hypoattenuating liver lesion.2.Interval decrease in right soft tissue inguinal lesion.3.No new lesions identified.4.Scattered pulmonary micronodules, stable. |
Generate impression based on findings. | Bladder carcinoma status post cystectomy 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: Stable left renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomyBLADDER: Unremarkable neobladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination without evidence for acute, inflammatory, or metastatic process. |
Generate impression based on findings. | T cell lymphoma CHEST:LUNGS AND PLEURA: Stable micronodules.MEDIASTINUM AND HILA: Stable subcentimeter right thyroid nodulesCHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable bilobar cystsSPLEEN: Stable low attenuation fociPANCREAS: 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: Uterus atrophic or absentBLADDER: 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. | Stable examination. No new adenopathy. |
Generate impression based on findings. | Reason: severe uncontrolled asthma, bronchitis History: cough, shortness of breath, wheezing LUNGS AND PLEURA: Although there is a slight increase in linear scarlike opacities in the dependent portion of the lungs, there has been no other change.Lower lung zone predominant bronchiectasis is present, and there is mild bronchial wall thickening in some areas of the lungs.Benign-appearing micronodules are present. MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Mild bronchiectasis, and pulmonary scarring, but no other significant abnormality. |
Generate impression based on findings. | Lymphoma CHEST:LUNGS AND PLEURA: Interval resolution of multifocal patchy right upper and middle lobe opacities. Stable bilateral apical posterior scarring with bronchiectasis.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Stable low attenuation focus within the pancreatic body best seen on image 11 of series 3 measuring 0.7 x 0.6 cm.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable bilateral renal cysts. Stable nonobstructing subcentimeter bilateral nephrolithiasisRETROPERITONEUM, 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 | Interval resolution of patchy right upper and middle lobe lung opacities. Otherwise stable examination. No new adenopathy. |
Generate impression based on findings. | Left lower quadrant pain This study is limited due to lack of IV contrast.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: No significant abnormality notedOTHER: No significant abnormality noted | Limited study due to lack of IV contrast. No CT findings to explain patient's left lower quadrant pain. |
Generate impression based on findings. | 50 year-old female with history of breast cancer status post reconstruction. CHEST:LUNGS AND PLEURA: Punctate micronodule in left lung base measures 4 mm (series 5, image 79), probably benign. No other nodules or masses identified. No consolidation or pleural effusions.MEDIASTINUM AND HILA: No pathologically enlarged lymph nodes. The heart is normal in size without pericardial effusion.CHEST WALL: Status post right mastectomy and breast implant placement.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple well-defined densities in liver, many of which are too small to characterize, but most likely represent benign cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter punctate hypodensities in both kidneys too small to characterize but most likely represent benign cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No pathologically enlarged retroperitoneal lymph nodes.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.Punctate micronodule measuring 4 mm in left lower lobe; most likely benign in nature.2.Multiple hypodensities in the liver, many of which are too small to characterize but most likely represent benign cysts. |
Generate impression based on findings. | 62 year-old female with breast cancer status post 9 cycles of Eribulin. CHEST:LUNGS AND PLEURA: Stable appearing post radiation change in left lateral lung and anterior right upper lobe. Linear opacities in the left base most compatible scarring and subsegmental atelectasis. New trace left pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA: No significant change in multiple enlarged mediastinal lymph nodes. Port catheter tip in right atrium. Stable moderate cardiomegaly.CHEST WALL: Extensive postsurgical changes in left lateral chest wall.Confluent supraclavicular mass is not significantly changed, measuring 3.9 cm on coronal series image 59, previously measured 3.8 cm. Soft tissue nodule in left lateral chest wall also appears similar, measuring 15 mm, previously measured 15 mm (series 3, image 63).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: Renal cysts again 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.No significant change in left supraclavicular mass.2.No significant change in mediastinal adenopathy.3.New trace left pleural effusion. |
Generate impression based on findings. | Clinical question: AML pre-treatment. Signs and symptoms: AML. Nonenhanced head CT:Examination demonstrate no evidence of acute intracranial process.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable images through the orbits and partially visualized paranasal sinuses and mastoid air cells. Maxillofacial CT:Examination demonstrates a retention cyst in the inferior right maxillary sinus a measuring at 20 times 17-mm on coronal reformatted images.Minute mucosal thickening in the dependent portion of left maxillary sinus is present. All other paranasal sinuses are well pneumatized and without evidence of acute or chronic sinus disease.Unremarkable images through the nasal cavity.Patent bilateral ostiomeatal units of maxillary sinuses and sphenoethmoidal recesses of the sphenoid sinus.All mastoid air cells and bilateral middle ear cavities remain well pneumatized and unremarkable.Unremarkable images through the orbits. | 1.Negative nonenhanced head CT.2.CT of the maxillofacial region demonstrate a small retention cyst in the right maxillary sinus and minute mucosal thickening in the dependent portion of left maxillary sinus. Unremarkable exam otherwise as detailed above. |
Generate impression based on findings. | Stem cell transplant for neuroblastoma and throat pain. There is no evidence of abscess or mass lesion in the neck. The Waldeyer ring structures are unremarkable. The airways are patent. There is no significant cervical lymphadenopathy. The major salivary gland and thyroid are unremarkable. There is a right internal jugular venous catheter. The major cervical vessels are patent. There is mild bilateral maxillary sinus opacification. The imaged intracranial structures and orbits are grossly unremarkable. Refer to the separate chest CT report for findings in the lungs. | No evidence of abscess. |
Generate impression based on findings. | 5 days of headache. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are stable in size and configuration with mild cerebral volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There are partially imaged dental caries and periodontal disease. | No evidence of intracranial hemorrhage, mass, or cerebral edema. However, non-contrast CT is not sensitive for the detection of acute infarct and MRI may be warranted if clinically indicated and there are no contraindications. |
Generate impression based on findings. | Clinical question: Interval progression of previous CVA. Signs and symptoms: Previous CVA, gait problem. Nonenhanced head CT:No detectable acute intracranial process CT however is insensitive for early detection of acute nonhemorrhagic ischemic stroke.There is interval evolution of previously noted subacute ischemic stroke in the left posterior parietal to chronic phase.Grossly stable minimal subcortical and periventricular low attenuation of white matter representing age indeterminate small vessel ischemic strokes.Unremarkable cortical sulci and ventricular system and maintained midline.The visualization of heavy large vessel intracranial vascular calcification all vertebral basilar and bilateral cavernous/supraclinoid internal carotids. Unremarkable calvarium and soft tissues of the scalp.The visualization of bony thickening of right maxillary sinus without interval change and likely result of chronic long-standing sinus disease. The paranasal sinuses however remain well pneumatized and interval improvement since prior exam.Bilateral mastoid air cells and middle ear cavities remain well pneumatized. | 1.No detectable acute new findings since prior exam.2.Interval evolution of subacute left parietal stroke to chronic changes.3.Grossly stable mild age indeterminate small vessel ischemic strokes |
Generate impression based on findings. | T2N2b left tonsil squamous cell carcinoma treated with concurrent chemoradiation completed in 1/2011. Head: There is no evidence of abnormal intracranial enhancement or mass lesions. There is unchanged moderate patchy cerebral white matter hypoatenation. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The osseous structures are unremarkable.Neck: There are stable post-treatment findings in the left oropharynx, without evidence of locoregional tumor recurrence. There is no significant cervical lymphadenopathy. The thyroid and major salivary glands are unchanged.unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The imaged portions of the lungs are clear. | 1. No evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. 2. No evidence of intracranial metastases. |
Generate impression based on findings. | Total stage IV carcinoid syndrome ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Previously mentioned subcentimeter focus enhancing at the arterial phase in the left lobe liver is unchanged, nonspecific. No other focal lesions in the liver.SPLEEN: Previously mentioned hypodense nonspecific lesion in the spleen measures 2 cm, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral innumerable hypodense lesions in both kidneys, grossly unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Calcified mesentery mass measures 4.3 by 3.5-cm on image number 99, series number 7, not significantly changed.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. |
Generate impression based on findings. | Clinical information Reason: s/p Right VATS, lobe History: please evaluate and compare to previous CT for changes LUNGS AND PLEURA: Volume loss on the right compatible with previous lobectomy.Multiple nonspecific micronodules compatible with previous infection and intrapulmonary lymph nodes, unchanged.No suspicious nodules.MEDIASTINUM AND HILA: Asymmetric thyroid enlargement, unchanged.No significant lymphadenopathy.CHEST WALL: Left axillary lymphadenopathy, unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. 10-mm hepatic hypodensity (series 3 image 83) not visible previously but most compatible with a cyst.Status post cholecystectomy. Large right renal exophytic cysts. | No sign of recurrent disease. |
Generate impression based on findings. | Reason: evaluate cardiopulmonary status, compare to previous chest CT, evaluate for any changes in nonspecific nodule, evaluate for coronary calcifications History: Right upper lobe nodule nonspecific, patient active on the liver transplant waiting list, ETOH cirrhosis LUNGS AND PLEURA: Moderately large right pleural effusion with associated compressive atelectasis in the right lower lobe, new since the previous scan.Interval decrease in a previously described right upper lobe nodule along the major fissure, now measuring 6 mm compared to 13 mm previously.Resolution of subsegmental atelectasis in the superior segment of the left lower lobe.MEDIASTINUM AND HILA: Numerous mildly enlarged lymph nodes in the supraclavicular regions and upper mediastinum, unchanged.A previously described cystic lesion in the left cardiophrenic angle area has resolved and may have represented extension of ascites into a small Morgagni hernia.CHEST WALL: Degenerative disease in the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cirrhosis with splenomegaly, collateral vessels and a small amount of ascites. | New right pleural effusion but almost complete resolution of a previously described lung nodule which is presumably benign. |
Generate impression based on findings. | 59-year-old female with history of heart is lymphoma CHEST:LUNGS AND PLEURA: Atelectasis in the lung bases, unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right axillary Ortolani enlarged lymph nodes, slightly smaller compared to previous study. An index node measures 1.2 x 1.2 cm image number 10, series number 5. This node was, measuring 1.8 x 1 .1 cm, image number 22, series number 3.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: 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: Index right inguinal lymph node is also smaller now measuring 9 mm in diameter image number 186 on series number 5.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval decrease in the size of the right axillary and inguinal lymph nodes. |
Generate impression based on findings. | 67-year-old female with history of pancreas cancer 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: Pneumobilia and metallic stent, unchanged.SPLEEN: Unremarkable.PANCREAS: 2.6 by 2-cm hypodense mass in the pancreatic head, not significantly changed from previous study, best seen on image number 109, series number 3. Pancreatic ductal dilatation is unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small thrombus in the infrarenal IVC, extending to the right common iliac vein is again noted. Small thrombus is also noted in the right external iliac and common femoral veins.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple hypodense lesions in the subcutaneous tissues of the anterior abdominal wall, likely representing injection sitesOTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Presumed leiomyoma in the uterus is unchanged.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 from prior study. |
Generate impression based on findings. | Malignant melanoma 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: Bilateral renal stones. No evidence of hydronephrosis. Bilateral small cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Bilateral renal stones. No evidence of metastatic disease in the chest, abdomen, and pelvis. |
Generate impression based on findings. | Non-Hodgkin lymphoma CHEST:LUNGS AND PLEURA: Small left calcified lower lobe is unchanged. MEDIASTINUM 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: Small soft tissue nodule adjacent to the pancreatic measures 1.3 x 1 .5 cm, image number 85, series number 4, not significantly changed from previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. |
Generate impression based on findings. | Obstructive sleep apnea, status post adenoidectomy. There is micrognathia and mandibular retrognathia with approximately 20 mm of overjet, although accurate measurement is difficult due to the open bite configuration of the jaw. There is mild glossoptosis. There is partial obstruction of the oropharyngeal airway at the level of the uvula. Otherwise, the adenoids and tonsils are not particularly enlarged. For example, the adenoids measure up to 13 mm in the anteroposterior dimension in the midline. There is a diffuse, symmetric expanded appearance of the upper maxillofacial skeleton and frontal calvarium, without focal lesions or ground-glass appearance. The paranasal sinuses and mastoid air cells are clear. There is volume loss in the bilateral temporal lobe, which is incompletely characterized. | 1. Micrognathia and mandibular retrognathia with partial obstruction of the oropharyngeal airway at the level of the uvula. 2. The diffuse, symmetric expanded appearance of the upper maxillofacial skeleton and frontal calvarium may be attributable to cerebral palsy and microcephaly. |
Generate impression based on findings. | 50 year-old female with headache. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. There are frothy materials in the left maxillary sinus. The paranasal sinuses and mastoid air cells are otherwise clear. | 1. No acute intracranial abnormality. 2. Frothy materials in the left maxillary sinus are suggestive of acute sinusitis. |
Generate impression based on findings. | 41 year-old female with rhinorrhea and sinus symptoms. The orbits are unremarkable. Limited view of the intracranial structure is unremarkable. There is partial opacification of the right mastoid air cells, and the left are clear. There are foamy materials in the bilateral maxillary sinuses. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. There is minimal mucosal thickening in the sphenoid sinuses. The frontal sinuses, frontal-ethmoid recesses, and anterior/posterior ethmoids. The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable. | Foamy materials in the bilateral maxillary sinuses are suggestive of acute sinusitis. |
Generate impression based on findings. | 67-year-old male with history of lymphoma CHEST:LUNGS AND PLEURA: Bilateral mosaic attenuation of the lungs, not significantly changed from previous study. This is nonspecific and may indicate atypical pneumonia or drug reaction. Small right-sided pleural effusion, not significantly changed from the study.MEDIASTINUM AND HILA: Index mediastinal enlarged lymph node is increased in size and now measures 2.9 by 1.3 cm in image number 34, series number 4. Enlargement of the main pulmonary arteries, unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hepato- Megaly is unchanged. Cholelithiasis, unchanged.SPLEEN: Splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index gastrohepatic node, now measures two by 1.4-cm on image number 97, series number 4, minimally increased in size comparedBOWEL, 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 | Minimal interval increase in the size of the mediastinal and index upper abdominal lymph node. No other significant change from previous study. |
Generate impression based on findings. | 64-year-old male with history of non-Hodgkin lymphoma CHEST:LUNGS AND PLEURA: Right lower lobe. Subcentimeter nodule is unchanged, measuring 7 mm on image number 67, series number 5.MEDIASTINUM 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: Stable right adrenal nodule consistent with adenoma.KIDNEYS, URETERS: Right renal cysts, unchanged.RETROPERITONEUM, LYMPH NODES: Stable endovascular graft repair. Maximal AP diameter of the aneurysm measures 4.1 cm, not significantly changed from previous study.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 | Right lower lobe. Subcentimeter nodule, unchanged. Stable changes secondary to endovascular graft repair. |
Generate impression based on findings. | 42 year-old female, pretransplant evaluation This study is limited due to lack of IV contrastABDOMEN: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: Atrophic kidneys consistent with patient known history of endstage renal disease. Right renal hypodense lesion, likely representing cyst however, incompletely characterized due to lack of IV contrast. Right nephrolithiasis.RETROPERITONEUM, LYMPH NODES: Coarse atherosclerotic calcifications involving the aorta and proximal bilateral common iliac arteries. Left common femoral vein catheter with its tip extending to the level of the intrahepatic IVC.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 | Coarse atherosclerotic calcifications involving the abdominal aorta and its major branches and bilateral common iliac arteries. |
Generate impression based on findings. | 76 year old female with right flank pain radiating to the groin Limited study due to lack of IV contrast.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: Mild hepatomegaly.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Fluid density right renal hypodense lesion, incompletely characterized due to lack of intravenous contrast.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Limited study due to lack of IV contrast. No CT findings to explain patient's right flank pain radiating to the groin. |
Generate impression based on findings. | Evaluate for atherosclerotic calcifications before transplant This study is limited due to lack of IV contrastABDOMEN:LUNG BASES: Small pericardial effusionLIVER, BILIARY TRACT: Hypodense lesion in the right lobe of the liver, likely representing cysts. Lack of IV contrast limits optimal evaluation of this lesion.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: There is a left adrenal mass measuring two by 2 cm or image number 39, series number 3. The lesion measures 20 Hounsfield unit.KIDNEYS, URETERS: Right kidney is enlarged, with numerous hypodense lesions of various size, and density. Lack of IV contrast limits evaluation of the right kidney or any enhancing lesion. Left kidney is not visualized.RETROPERITONEUM, LYMPH NODES: Moderate of prostatic calcifications involving the abdominal aorta, its major branches, and proximal iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Transplanted kidney in the left iliac fossa.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: Bladder wall is thickened, likely secondary to enlarged prostate.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Limited study due to lack of IV contrast. Left adrenal mass measuring 20 Hounsfield units. This lesion is not compatible with a typical adenoma by CT criteria. Further evaluation with MRI may be helpful.Enlarged right kidney with multiple hypodense lesions of various size and density. Lack of IV contrast limits optimal evaluation of the right kidney for focal lesions. |
Generate impression based on findings. | 42 year-old female with chest radiograph concerning for interstitial lung disease. Weight loss, joint pain, night sweats. LUNGS AND PLEURA: Multiple bilateral ill-defined nodular opacities predominantly in upper and mid lung zones, which appear to be in perilymphatic distribution. No evidence of fibrosis, honeycombing, ground glass opacities, or air trapping. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Multiple enlarged mediastinal and hilar lymph nodes. Heart is normal in size, without pericardial effusion. Slightly enlarged main pulmonary artery measures 3.1 cm in diameter, suggestive of pulmonary arterial hypertension. Enlarged thyroid gland.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Heterogeneous texture of the liver parenchyma, suspicious for innumerable subcentimeter hepatic nodules. Splenomegaly. | Innumerable ill-defined nodular opacities predominately in the upper and mid lung zones, suspected to represent pulmonary sarcoidosis given associated mediastinal lymphadenopathy. Innumerable subcentimeter hypodensities in the liver and splenomegaly may also represent involvement by sarcoidosis. |
Generate impression based on findings. | Reason: Pt with hx of HNC s/p CRT 2011. please re-eval and compare to prior scans History: as above CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal. No pericardial effusion. Moderate atherosclerotic calcifications of the aorta and coronary arteries.CHEST WALL: Mild degenerative disease to the thoracic spine unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Punctate calcification within the gallbladder likely represents cholelithiasis unchanged. No evidence of cholecystitis. No suspicious focal liver lesions.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Small hypodense lesion within the pancreas is stable since 1/16/2012 and may represent a side branch IPMN.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sclerotic foci in the right humeral head and left eighth rib unchanged.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | 79-year-old female with lung cancer status post surgery and chemo radiation. Follow-up left apical nodule. LUNGS AND PLEURA: Left hemithorax volume loss and paramediastinal scarring not significantly changed. Interval decrease in previously seen scattered ground glass opacities in the left lung, which may have been due to radiation. Scattered nodular and ill-defined ground glass opacities continue to be present in both lungs and are unchanged. Previously seen right apex nodule unchanged, measuring 5 mm, previously measured 5 mm (series 5, image 58). No new suspicious nodules or masses.MEDIASTINUM AND HILA: Large thyroid gland. No significant lymphadenopathy. Small hiatal hernia. Severe coronary artery calcifications. 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. No significant abnormality noted. | 1.Stable 5-mm right apical nodule.2.Interval decrease in predominantly left lung ground glass opacities, which may have been due to radiation.3.Multiple scattered ground glass nodules appear unchanged; continued follow-up is recommended. |
Generate impression based on findings. | 54-year-old female with new polymyositis in setting of long-standing rheumatoid arthritis and bronchiectasis. Evaluate for interstitial lung disease. LUNGS AND PLEURA: Stable moderate paraseptal emphysema. No evidence of groundglass opacities, honeycombing, or fibrosis to indicate interstitial lung disease. Mosaic attenuation is again seen on expiratory images, not significantly changed and likely due to mild air trapping.Stable mild bronchiectasis and bronchial wall thickening bilaterally. Stable calcified and noncalcified bilateral micronodules, likely benign in nature. No new or suspicious nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Stable paraseptal emphysema and mild bronchiectasis. No evidence of interstitial lung disease. |
Generate impression based on findings. | Reason: lung ca, s/p resection, no adjuv chemo. Pls c/w previous study to evaluate dz status. History: lung ca LUNGS AND PLEURA: Status right lower lobectomy. Mild right basilar scarring at the surgical site. Small calcified and noncalcified micronodules in the posterior left lower lobe and right upper lobe likely representing granulomas are unchanged. Mild left basilar atelectasis.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes compatible with prior granulomatous disease. Heart size is normal. No pericardial effusion. Mild atherosclerotic calcifications of the coronary arteries.CHEST WALL: Hypodense nodules with in bilateral thyroid lobes unchanged. Osteoporosis and degenerative disease of the thoracic spine unchanged. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. Left hemidiaphragm eventration. Splenic and hepatic granulomata. Probable splenule adjacent to spleen. | Stable examination without evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Chest pain. History of lobar emphysema and asthma. LUNGS AND PLEURA: Congenital emphysema centered at the superior segment of the right lower lobe, with subsegmental atelectasis. Right middle lobe bronchiectasis. Few scattered ground opacities in the right lower lobe likely represent a small amount of aspiration. Previously seen right basilar atelectasis is improved. No focal air space opacities or pleural effusions.MEDIASTINUM AND HILA: Mild leftward deviation of the mediastinum. Prominent right hilar lymph node, measuring 1.0 cm in short axis. No mediastinal lymphadenopathy. Normal sized heart without pericardial effusion.CHEST WALL: Prominent axillary lymph nodes. Upper thoracic dextroscoliosis and lower thoracic levoscoliosis.UPPER ABDOMEN: No significant abnormality noted. | 1. Congenital right lower lobe emphysema2. Right middle lobe bronchiectasis.3. Mildly prominent hilar and axillary lymph nodes.2. Peribronchial thickening likely representing asthma. |
Generate impression based on findings. | 66 year old female with history of rheumatoid arthritis on methotrexate. Compare ground glass opacities. LUNGS AND PLEURA: Bilateral peripheral honeycombing not significantly changed. Significant interval improvement in previously seen bilateral groundglass opacities.Previously measured right lower lobe nodule appears smaller, measuring 6 mm, previously measured 9 mm (series 5, image 46). Multiple other calcified and noncalcified micronodules not significantly changed, likely benign in nature. No new nodules.No consolidation or pleural effusions.MEDIASTINUM AND HILA: Interval decrease in mediastinal lymphadenopathy; previously measured subcarinal node currently measures 8 mm in short axis, previously measured 12 mm (series 3, image 39). Trace pericardial effusion unchanged. Hiatal hernia unchanged.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.Significant improvement in previously seen bilateral ground glass opacities, which may have represented acute exacerbation of interstitial lung disease or superimposed edema. 2.Bilateral honeycombing compatible with UIP-like pattern interstitial lung disease not significantly changed, likely secondary to known rheumatoid arthritis.3.Apparent decreased size in right lower lobe nodule, currently measuring 6 mm. This has been stable since 2008 and is most likely benign. No further CT follow-up for this nodule recommended. |
Generate impression based on findings. | 47 year-old female with facial pain and pressure. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. The patient is status post extraction of the left first maxillary molar. There is minimal mucosal thickening in the adjacent maxillary sinus. There is no evidence of acute sinusitis, oroantral fistula or abscess. Otherwise, the frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, sphenoid sinuses, and maxillary sinuses are well developed and clear. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable. | Status post extraction of the left first maxillary molar. There is minimal mucosal thickening in the adjacent maxillary sinus. There is no evidence of acute sinusitis, oroantral fistula or abscess. |
Generate impression based on findings. | Reason: f/u of lung nodule; current smoker History: f/u of lung nodule; current smoker LUNGS AND PLEURA: Progressive growth of right apical nodule that is partially solid with a peripheral ground glass component. The solid component measures 8 mm (series 5, image 46) previously measuring 6 mm. The total dimension, including the groundglass component, measures 14 mm (series 5, image 46).Multiple small poorly defined groundglass nodules and opacities within bilaterally.Interval increase of groundglass and reticular opacities in a basilar and subpleural distribution. There is no honeycombing. Interval increase in the peripheral left upper lobe groundglass opacity. No pleural effusions.MEDIASTINUM AND HILA: Residual thymic tissue, unchanged. Moderate to severe atherosclerotic calcification of the aortic arch and minor atherosclerotic calcification of the coronary arteries. Mild cardiomegaly. No pleural effusions. Mildly mediastinal and hilar lymphadenopathy, unchanged.CHEST WALL: Multinodular enlargement of the thyroid gland, unchanged. Left inferolateral breast nodule is unchanged in size and appearance. Calcified focus in the breast. Sclerotic foci in the lateral left fifth and seventh rib unchanged. Sclerotic focus at the costovertebral junction of T10 rib.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesion in the right hepatic lobe is difficult to characterize but appears larger compared to prior exam. Mild retrocrural lymphadenopathy unchanged. | 1.Progressive increase in size of partially solid right apical nodule highly suspicious for primary adenocarcinoma.2.Interval increase in predominantly basilar groundglass and reticular opacities compatible with NSIP. |
Generate impression based on findings. | 40 year-old male with abdominal pain, rule out obstruction. 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: Status post colectomy with ileorectal anastomosis. Distended fluid filled rectum with patent anastomosis. The small bowel is normal caliber. Multiple prominent mesenteric lymph nodes, likely from chronic inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Status post colectomy with ileorectal anastomosis. Distended fluid filled rectum with patent anastomosis. The small bowel is normal caliber. Multiple prominent mesenteric lymph nodes, likely from chronic inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Status post colectomy with ileorectal anastomosis without evidence of obstruction. Large mesenteric lymph nodes indicate chronic inflammation. |
Generate impression based on findings. | 13-year-old male with concern for bronchiectasis on x-ray. Evaluate for pulmonary pathology. LUNGS AND PLEURA: There is peribronchial thickening and large lung volumes compatible with reactive airways disease. Clustered ill-defined ground glass opacities are noted in the right middle lobe which are suggestive of aspiration.Mild right basilar atelectasis/scarring is present.No pleural effusions are present.There is no bronchiectasis as clinically questioned.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy. A PDA ligation clip is noted.The heart size is within normal limits. There is no pericardial effusion present.CHEST WALL: No significant abnormality notedUPPER ABDOMEN: The visualized portions of the liver, spleen, pancreas, and kidneys appear within normal limits. | 1.Reactive airways disease/bronchiolitis pattern with clustered hazy right middle lobe opacities suggestive of aspiration.2.No evidence of bronchiectasis as clinically questioned. |
Generate impression based on findings. | Neuroblastoma. End of therapy. CHEST:LUNGS AND PLEURA: Minimal dependent subsegmental atelectasis. No distinct nodules seen. No focal air space opacities or pleural effusions.MEDIASTINUM AND HILA: The previously seen midline supraclavicular mass has been resected. No mediastinal or hilar lymphadenopathy. Normal sized heart without pericardial effusion.CHEST WALL: No axillary lymphadenopathy. Interval removal of the left central venous catheter.ABDOMEN:LIVER, BILIARY TRACT: Normal enhancement of the liver, without focal lesions. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: Normal in appearance.PANCREAS: Normal in appearance.ADRENAL GLANDS: The right adrenal gland is surgically absent and there are surgical clips in the resection bed. Again seen is the nodular soft tissue density superior to the resection bed. The lesion appears unchanged, measuring 8 x 5 mm (series 3 image 50), previously 7 x 5 mm. The left adrenal gland is normal in appearance.KIDNEYS, URETERS: The kidneys are normal in size and enhancement, without evidence of hydronephrosis. No mass lesions are seen.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Normal appearing loops of bowel. No mesenteric stranding or free fluid.BONES, SOFT TISSUES: No osseous or soft tissue abnormality.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Mild nonspecific bowel wall thickening at the sigmoid colon. BONES, SOFT TISSUES: Lucent lesion in medial right ilium compatible with prior bone marrow biopsy. No osseous or soft tissue abnormality otherwise. | 1. Stable nodular soft tissue adjacent to the right adrenal resection bed. 2. Mild nonspecific bowel wall thickening of the sigmoid colon. |
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