Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Solitary pedunculated bony density lesion contiguous with the wall of the right external auditory canal (EAC) at the junction between the cartilaginous and bony portions of the EAC. Partial opacification, likely ceruminous secretions, within the EAC, and a small amount of non-specific fluid in the middle ear cleft.There is also abnormal bone density as a feature of acute myeloid leukaemia. The left temporal bone, including the EAC, is unremarkable.Polypoid mucosal thickening arising from the floor of the left maxillary antrum. Evidence of right maxillary acute sinusitis.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Extensive inflammatory change in the right iliac fossa is present involving the caecum, terminal ileum and appendix. The appending is dilated (9mm) and hyperemic. The mucosa near the tip of the appendix is not visualised with apparent defect of the mucosa as it enters a poorly circumscribed non-walled-off fluid collection measuring ~3cm in diameter.There is a moderate length segment of terminal ileum just upstream of the ileo-caecal valve that demonstrates wall thickening, mural stratification and surrounding stranding. There is also free fluid tracking within the adjacent mesentery as well as subcentimetre mesenteric lymph nodes more centrally. No free intraperitoneal gas. Small volume free fluid also tracks inferiorly into the pouch of Douglas.No upstream small bowel dilatation. No focal hepatic lesion identified. No portal venous gas identified. The kidneys, gallbladder, adrenals, pancreas and spleen are unremarkable. Circumaortic left renal vein noted.Conclusion:Extensive right iliac fossa inflammation, with close relationship to an abnormal appendix suggesting that appendicitis, despite age of the patient, is the likely diagnosis. Defect of the mucosa at the tip of the appendix adjacent to a fluid collection is suspicious for perforation.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: The left carotid branch arising from the aortic arch is relatively small in calibre, measuring 5 mm in diameter. At the level of bifurcation, the left internal carotid artery is not seen, suggestive of congenital absence, which is supported by an absent carotid canal. Other differentials include chronic thrombosis. Collateralisation from the left PCOM supplies the MCA territory and its branches. Incidental finding is noted of an intracranial aneurysm at the bifurcation of the left MCA, measuring 4 mm in size. The vessels of the Circle of Willis are all patent and well opacified.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: The oesophagus is grossly dilated with thin-walled, filled with fluid/food debris with bird beak sign at the gastro-oesophageal junction.No mediastinal or hilar lymphadenopathy seen.Both lungs are clear (lung window not shown).A mildly enlarged liver is noted (incidental finding).


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Thin-walled lung cysts and enlargement of the left submandibular gland noted.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Fluid-filled esophagus.Small spleen (85 mL).Mildly hyperenhancing gallbladder wall.Diffuse mucosal hyperenhancement and submucosal edema of the large and small bowel. Peripancreatic fluid.Small ascites. Flattened IVC. Small aorta (infrarenal AP diameter 1.0 cm).Right acetabular and pelvic ring fractures with soft tissue/muscular injury of the upper thigh. Delayed images: persistent mucosal hyperenhancement of the bowel, persistent nephrograms.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Multiple and extensive lacerations involving the right liver lobe. In segment 7 active arterial bleeding contained within liver parenchyma is depicted - a pooling of extravasated contrast material is particularly well seen in the delayed phase.A moderate amount of hemorrhagic fluid around the liver, spleen, both paracolic gutters and in the minor pelvis - signs of haemoperitoneum.Laceration in the upper portion of the right kidney; there is no active bleeding or involvement of the collecting system; subcapsular haematoma surrounding the upper pole of the kidney.Multiple lacerations in the spleen; there is no active bleeding within the spleen.Extensive lung contusions in the right lower lobe, some sites of pulmonary haemorrhage and multiple haematopneumatocele and pneumatocele; a few, less extensive compared to the right side, areas of contusions are seen also in the left lower lobe.Several bone fractures including sacral bone, left superior public rami, 12th right rib and spinous and left inferior facet of L5.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Left ischial skin ulcer. Soft tissue air in the scrotum and perineum. Scrotal edema. Reactive inguinal adenopathy.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There is a triple non-thrombosed saccular aneurysm of the splenic artery, the proximal one (18 x16 mm) shows a calcified wall. The two other aneurysms measure (12 x 6 mm) and (9 x 7 mm). Double right renal artery is noted.small simple hepatic cysts noted in the segments, IV, V, and VI.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Anterior position of the pulmonary artery relative to the aorta indicating prior arterial switch procedure. There is asymmetric narrowing of the right main pulmonary artery compared to the left. The right ventricle is diminished in size relative to the left ventricle. There are numerous large (>2mm) right-sided aorto-pulmonary collateral arteries arising from: right subclavian artery (origin not in field of view), right internal mammary artery, left common carotid artery, right internal mammary artery, right coronary artery, left circumflex coronary artery, and right inferior phrenic artery (origin not in field of view). In addition, there are numerous small (<1mm) and medium (1-2mm) collateral arteries arising from vertebral and intercostal arteries, as well as likely the right superior epigastric artery. Two Amplatzer vascular plugs are present in the prevertebral region at and slightly above the level of the aortic arch from prior collateral embolization.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Right below the renal arteries root, there is a suggestive aspect of contrast progression interruption. Aneurysmal dilation from the downstream segment to the iliac bifurcation with 10 x 5.2 x 4.6cm.The aneurysmatic segment, where the aorto-aortic interposition tube graft is localized, shows an heterogeneous density with some predominantly peripheral calcifications.Distally there is contrast opacification in the distal segment of the primitive iliac arteries and proximal femoral vessels.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Three intraperitoneal structures in left abdomen with near-identical density: infradiaphragmatic, lateral to left kidney with linear peripheral calcifications (largest one, measuring 4.0 cm across), and between loop of jejunum and abdominal wall. Several tiny foci of same density in left peritoneum, several of which are located between the left kidney and the descending colon.Fatty liver. Tiny hypodense focus in segment III, too small to characterize. To summarize: Splenules in left peritoneum, some of which are only several mm in diameter.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Spleen enlarged, heterogeneous with multiple hypoattenuating foci sparse by the parenchyma. Lymph nodes increased in number and size at perigastric, pancreatic and periaortic level.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Distended fluid-filled large bowel and distal ileal loops with an irregular circumferential thickening at the rectosigmoid junction with luminal narrowing, infiltration of the perirectosigmoid fat and presence of regional enlarged lymph nodes. There is a small air collection with peripheral enhancement adjacent to the rectosigmoid stricture suggestive a focal perforation (less likely to be sigmoid diverticulum). Focal fatty infiltration of the segment IVa of the liver is noted (confirmed by ultrasound).


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Extravasation of contrast within the mid sigmoid colon, with pooling on the portal venous phase. Extensive colonic diverticular disease. The remainder of the colon is unremarkable aside from some faecal colonic loading. Incidental duodenal diverticulum.Liver, spleen, adrenal glands, pancreas are normal. Cholelithiasis. Multiple bilateral non-obstructive renal stones. Multiple simple renal cortical cysts. Prostatomegaly. Left ureterocele or bladder diverticulum with calcification, which may be in the wall or may represent a dependent stone. No free fluid or free gas.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: The right external iliac vein is narrow in favor of chronic recanalized thrombosis. The left external and common iliac veins are patent but the left common iliac vein is compressed while passing posterior to the right common iliac artery suggestive of May Thurner syndrome. A longitudinal web-like linear filling defect is seen, within the IVC lumen adherent to its anterior wall in favor of chronic recanalized thrombosis. Multiple abdominal wall collaterals are seen, secondary to chronic IVC and the right external iliac vein thrombosis. Chronic thrombosis of the right hepatic vein is also evident with small intra-hepatic venous collaterals in the right liver lobe. Large collateral mimics the right hepatic vein.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: A left retro-areolar breast mass lesion is seen inseparable and invading the underlying chest muscle wall with intramuscular (pectoralis major muscle) metastasis.Enlarged left axillary and subpectoral lymph nodes.Pulmonary metastatic nodules are seen vary in the size, the largest is noted in the lingula.Multiple enlarged mediastinal and bilateral hilar lymphadenopathies as are seen, the largest prevascular and left hilar. Right-sided gynecomastia is noted. No significant right axillary lymph nodes.No pleural effusion.The liver is enlarged in size with innumerable variable-sized lesions disseminated in all segments of the liver, the largest in the segment VIII. The liver surface is nodular. No intrahepatic biliary ducts dilatation.Multiple periaortic enlarged lymph nodes especially at the celiac group.GB, CBD, portal vein, pancreas, spleen, adrenals, kidneys and opacified bowel loops are unremarkable.No significant mesenteric, pelvic or inguinal lymph nodes.Prostate, seminal vesicles and urinary bladder are unremarkable. No ascites.Multiple destructive bony metastases are seen in the bones scan.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: No acute pathology. Typical findings of intestinal malrotation: SMA right of SMV, 3rd portion of the duodenum never crosses midline, small bowel on in right abdomen, colon in mid-left abdomen, cecum/IC valve in pelvis. Appendix starts in pelvis and courses into the right lower quadrant.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There is an irregular fracture line with sclerotic bands and trabecular disorganization in the right sacral ala, lateral to the sacral foramina, parallelling the sacroiliac joint with ventral cortical disruption. A small adjacent bone fragment is seen anteriorly. Similar, but more subtle findings are seen in the left sacral ala at the S2 level, with buckling of the anterior cortex of the S2 vertebral body. The appearances are suggestive of sacral insufficiency fractures, likely healing/subacute given the sclerosis.See key images below.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Thickening and irregularity are seen at splenic flexure of the colon with slightly surrounding fat stranding in favor of tumoral lesion. Loss of hustration is also visible at distal colon in a known patient with ulcerative colitis.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Early filling of the right superior orbital vein, the vein between the orbit and the cavernous appears narrowed. Also early filling venous structures inferiorly. Asymmetric opacification of the right cavernous sinus. No ICA dissection identified. Relative proptosis of the right eye with left enophthalmos.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There is a very large mass which is largely fills the abdomen and pelvis. It is predominantly cystic with numerous septations. No discrete nodularity or solid enhancing soft tissue component is identified. There are slight prominence of the right adnexal veins which appear to lead into the posterior aspect of the mass, indicating that it comes from the right ovary. The left ovary can be seen separate from the mass, following the relatively diminutive left adnexal vein into the left lower quadrant. There is a small amount of free fluid within the pelvis.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Air is present in the gallbladder, which has a hyperemic, swollen wall in close contact with the wall of the proximal duodenum, with suspected fistula. Fluid can be seen both around the gallbladder and the proximal duodenum. Dilated small intestine can be followed to the distal part of ileum, where an oval mass, i.e. impacted gallstone is found. Distally from the gallstone, the diameter of the intestine is normal in size.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There are two liver lesions showing incomplete peripheral nodular enhancement on the arterial phase, and filling progressively on the portal venous and delayed phase imaging. Findings are consistent with 2 large cavernous hemangiomas of the liver.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There are two main morphologically different findings: hypodense, irregular sclerotic lined lesions in sacral bone, both iliac bones and the left femur multiple GGO lesions in the shaft/distal metaphysis of the left femur In addition, there are multiple sharply demarcated cystoid lesions of variable size without significant enhancement in muscles in the following locations: anterior and lateral muscle group left thigh (the largest single 77x65mm in the axial plane) m. iliopsoas sin. gluteal area + m. piriformis dx. All these findings are consistent with intramuscular myxoid lesions and fibrous dysplasia.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Extra-axial mass with hyperdense crescent posteroinferiorly suggestive of blood.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: A moderate amount of free abdominal and pelvic high-density fluid indicating haemoperitoneum.Pneumobilia and intra-abdominal free air, mainly in the right upper quadrant, outlining the falciform ligament (falciform ligament sign) and the fissure for the ligamentum teres (ligamentum teres sign), as well as periportal free gas sign, suggesting duodenal injury. Proximal small bowel wall thickening and enhancing, indicating shock bowel.No evidence of hepatic, splenic or pancreatic injury.Normal appearing kidneys and urinary bladder.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There is a twist involving the sigmoid colon and it's mesentery, identified most clearly by following the swirling vessels. The apex of the sigmoid points to the left upper quadrant. There is also gaseous distension of the remaining large bowel. Long standing left hemidiaphragmatic paralysis.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Large heterogeneous mass filling the majority of the pelvis, displacing the uterus and ovaries anteriorly. Based on sagittal reformats it appears to be arising from the posterior lower uterine segment, from which its blood supply arises.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Incidentally noted retro-esophageal aberrant right subclvaian artery. Right thyroid nodule is also noted.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Large well defined hypodense lesion seen in segment VI showing peripheral puddles of arterial enhancement with centripetal filling and nearly homogenizing with liver parenchyma in delayed scan. Focal outpouching seen arising from the medial wall of gall bladder. No gall stones or features of bile stasis.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Well-placed endotracheal tube and nasogastric tube. Right femoral arterial line. Foley catheter in urinary bladder. Dissection of the aorta beginning at the aortic root (Stanford A). The LMCA is supplied by the true lumen, whereas the RCA appears to be supplied by the false lumen.    All three arteries emanating from the aortic arch are supplied by both the true and the false lumina. Other arteries supplied by both lumens: both CCAs, left ICA, both ECAs, SMA, left RA, left CIA. Arteries supplied by the true lumen: right SA, right ICA celiac trunk, right RA, right CIA.      Arteries supplied by the false lumen: IMA.        The pulmonary trunk is narrow, the left atrium is flattened and there is blood pooling with dependent layering in the IVC and the right hepatic vein - signs of cardiogenic shock 1.          Small pericardial effusion. RLL atelectasis with air bronchogram, Minute amount of right pleural effusion and moderate amount on the left.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Small hyperdense splenial nodule (1cm) in the right paramedian location, protruding into the adjacent ventricular lumen with no enhancement on postcontrast images.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Tomographic images confirm the pelvic position of the kidney graft and its lack of vascularization. The images without enhancement show the hyperdensity of the venous vascular structures of the transplanted kidney. In the angiographic phase, an abrupt stop is shown in the graft artery at the proximal level. In the venous phase, no improvement has yet been observed with contrast.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Circumferential thickening of the colon wall affecting the entire colon. The hasutra are also thickened most markedly in the transverse colon demonstrating the accordion sign. The lumen contains fluid faeces. The small bowel is not involved. There is a small volume of ascites. No free gas and no collections.Known atrophic right kidney. No other significant abnormality.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: CT was performed 12 hours following the biopsy: There is a mixed-density crescentic collection indenting the lateral margin of the spleen, in keeping with a subcapsular haematoma. A hypodense tract can be seen extending through the spleen. On the arterial phase study, a tiny blush is evident within the posterior spleen, without expansion on the portal venous phase CT. Fluid is present within the anterior pararenal space and there is fatty stranding surrounding the pancreatic tail. Moderate volume high-density fluid (blood) within the pelvis and left paracolic gutter. Background hepatic steatosis. Small left pleural effusion. The patient's serum lipase was elevated.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Grey-white differentiation is preserved. Hyperdense right anterior cerebral artery, with filling defect of the the right A1 segment and subtle under-filling of the A2 segment on CTA.Fat density lesion within the right posteriorly paravertebral space likely represents lipoma.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Large descending right sided L4-5 disc extrusion which fills the subarticular recess and compresses the traversing right L5 nerve root.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There is a large right popliteal artery aneurysm. Thin, linear contrast enhancement is seen within the aneurysmal sac but no flow is seen within the distal popliteal artery.The right peroneal artery is reconstituted by superficial collateral vessels. Patchy opacification of the anterior tibial artery to the mid calf also reflects collateral flow.Smaller left popliteal artery aneurysm. Left posterior tibial artery is occluded close to its origin. The anterior tibial artery and peroneal artery opacity normally.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Large extracranial right parieto--occiptal cephalohaematoma is seen. The underlying skull vault appears intact with no depressed bony fragment.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Mural thickening of the cecum with surrounding fat stranding.There are multiple colonic diverticula, one of them arising from the anterior aspect of the cecum which shows prominent mural thickening and surrounding fat stranding as well as multiple enlarged lymph nodes. It also contains an internal gas lucency. The appendix appears normal with no evidence of inflammation.There is evidence of left colonic diverticulosis.Other incidental findings are multiple simple renal cysts and a retro-aortic left renal vein.Findings are pathognomonic of right sided non-complicated diverticulitis.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Multiple organ systems are markedly abnormal: There is diffuse enlargement and low-attenuation infiltration of the kidneys, low attenuation splenic lesions, thickening of the proximal small bowel, retroperitoneal adenopathy, diffuse enlargement and irregularity of the inferior rectus abdominis musculature and inguinal/pelvic adenopathy.The non-contrast images were included for educational benefit, particularly how the renal abnormalities can still be appreciated (though subtle).


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: CT images show large diverticulum arising from left infero-lateral wall of urinary bladder (neck- 14 mm) measuring 11 x 5.8 x 9.7 cm (AP x TR x CC). The diverticulum is located at the level of left vesico-ureteric junction with left distal ureter opening into the diverticulum. These features are consistent with large congenital Hutch diverticulum of urinary bladder.The diverticulum shows irregular wall thickening and enhancement- representing diverticulitis. Small calculus is noted in dependent portion of diverticulum.Moderate left hydroureteronephrosis is noted with dilated extrarenal pelvis. No ureteric calculus is seen. There is medial deviation, stretching and narrowing of left distal ureter by the large diverticulum resulting in hydroureteronephrosis.Left kidney is small in size with moderate parenchymal thinning.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Colonic diverticulosis.Extensive irregular wall thickening and hyperenhancement of a short segment of the distal sigmoid colon with pericolonic inflammation.A thin, fistulous tract can be seen extending from the inflamed sigmoid colon into a round collection abutting and invading into the bladder wall distorting the contour and containing mostly fluid and a few small locules of air. This communicates with a tiny defect in the bladder mucosa, and represents the point of fistulous communication with the bladder lumen (see annotated images).Inflammatory bladder wall thickening and mucosal hyperenhancement with a small amount of intraluminal air.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: The classic triad of the disease is evident:1. severely hypoplastic vermis with cephalad rotation of the vermian remnant2. cystic dilatation of the fourth ventricle extending posteriorly to an enlarged posterior fossa3. significantly enlarged posterior fossa with torcular-lambdoid inversion and open posterior fontanel and thinning of adjacent bonesMarked communicating chronic hydrocephalus.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Left hepatic lobe atrophy. Massive splenomelagy. Numerous upper abdominal varices, many of which encase the pancreas. Gastric submucosal varices.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: The CT shows compression of the left renal vein between the superior mesenteric artery and aorta. There is also a varicose dilatation of the left testicular vein.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Multiple anterior abdominal wall incisional hernias. Two loops of herniating small bowel, with one loop obstructed and not incarcerated, and another which is incarcerated but not obstructed - conforming to a Richter's hernia. Incidental horseshoe kidney with a left ureteric stent.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Distended small bowel loops in the central lower abdomen. Transition points seen both up and downstream of the distension. Associated haziness of the mesentery consistent with mesenteric oedema and congestion. Thickening of the wall of one of the distended loops, suggestive of developing small bowel ischaemia. Scattered free fluid in the abdomen, no free gas.Multiple enlarged peritoneal lymph nodes in the upper abdomen.Hernia mesh in the lower anterior abdominal wall.Large right sided pleural effusion. Collapse of the right lower lobe.Small mass lesion demonstrated immediately superior to the collapsed lung.Sclerotic lesion in the posterior aspect of the body of T10.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Extensive nodular laminar calcification of the falx cerebri, tentorium cerebelli, and petroclinioid ligaments. Trigonal appearance of the anterior skull with a midline bony defect.No parenchymal abnormality.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Polysplenia is present.The pancreatic body and tail are absent with preservation of the pancreatic head. No inflammatory changes are seen around the remnant pancreas.Both kidneys show normal size and position. Ill-defined hypoattenuating foci are seen of the right renal parenchyma. A few subcentimetre simple cortical cysts also are observed bilaterally. The renal pelvis and calyces show a normal configuration. The urinary drainage tract is unobstructed and delayed images show symmetrical contrast excretion into the renal pelvis with no filling defect.The adrenal glands are unremarkable.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Extreme dilatation of the stomach and proximal duodenum with tapered narrowing of the 3rd part of the duodenum as it passes between the SMA and aorta. The rest of the small bowel are collapsed distally.The left renal vein is also compressed between the SMA and aorta.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Subtle hypodense area involving the left frontal region suggestive of acute infarction in the left middle cerebral artery territory.Old lacunar infarcts involving the right frontal region.No intracranial haemorrhage.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Marked dissension of the intragastric balloon, distended with air-fluid level and associated with stranding of the peritoneal fat anterior to the gastric wall. There is normal progression of oral contrast.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: CT confirms destruction of the T12 vertebral body, with sclerosis of the existing bone. There is a large collection in the left retroperitoneal space, involving the psoas muscle. The appearances are of an aggressive infection.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: No traumatic injury. Small cleft on the lateral margin of the spleen is adjacent to a small diaphragmatic slip.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: A well defined pelvi-abdominal cystic lesion is seen slightly inclined to the right side. It has a multiple thin walled internal sepate some assuming intracytic appearance. The cystic lesion has relatively wall thicknesss. No calcification. It measures 20x19.7x14.6 cm in its maximum three dimensions. The cystic mass indents the related superior surface of the urinary bladder and splaying as well as displaces the related small bowel loops. Anteriorly to the right the cystic mass abutts the anterior abdominal wall and posteriorly it reaches to a prevertebral location (opposite L5) and compresses the right common iliac v opposite L4. Small ovoid left sided pelvic cyst is seen likely adnexal. It measures 26x22 mm. It is likely simple ovarian cyst. The uterus could not be identified owing to previous hysterectomy.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Left common iliac artery shows a large saccular aneurysm proximal to its bifurcation with partial thrombosis. The aneurysm measures 5.5 cm in its greatest dimension. A large heterogeneous iso to hyperdense collection is seen in retroperitoneum causing superior displacement of right kidney consistent with hematoma.Moderate left and mild left pleural effusions are seen.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: A 103 x 100 x 83 mm ill-defined low-enhancing mass in the right lower lobe of the liver that invades adjacent duodenal loop and hepatic flexure of the colon. The gallbladder cannot be separated from the mentioned mass. Lymphadenopathy is seen in the vicinity of the mass. The right kidney is markedly small and hardly visible. The left kidney shows compensatory hypertrophy with a few simple small cortical cysts.A 73 x 31 mm well-defined enhancing soft tissue mass is noted in the right lower anterior abdominal wall.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: CT showing dilated intrahepatic ducts, CBD, and pancreatic duct. "Double duct sign". No gallstones or signs of pancreatitis. No evidence of cholecystitis or pancreatitis.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There are numerous variable sized ill-defined low density lesions within the liver in keeping with metastatic disease. The portal vein is clear. Moderate intrahepatic bile duct dilatation and marked extra hepatic bile duct dilatation is secondary to a well-defined 13 mm round slightly hyperdense (to bile) filling defect obstructing the distal CBD. It has a central tiny focus of calcification and I cannot see any connection to the bile duct wall. There are numerous small calcified dependent gallstones within the distended gallbladder, none of which however are the size of the CBD filling defect. There is also a possible enhancing mural nodule arising from the gallbladder neck although this could represent a lymph node.No definite colon primary malignancy is identified however there is there are 2 areas of mildly suspicious wall irregularity, within the hepatic flexure and the sigmoid colon. Simple cyst in the left kidney. No adrenal mass. Small volume of pelvic free fluid noted.Lung bases are clear and emphysematous. No bony metastasis evident. Compression fractures of L3. L4 and L5 are likely long-standing. Conclusion Diffuse metastatic disease of the liver without an obvious primary identified. The bile ducts are obstructed at the level of the distal CBD by a likely 13 mm predominantly non-calcified calculus. It would be uncommon for this to represent a pedunculated bile duct tumour.Potential sites for malignancy include a possible gallbladder enhancing nodule (gallbladder carcinoma) and minor colonic irregularity of the hepatic flexure and sigmoid colon (colorectal primary). Other common primaries such as lung and melanoma require exclusion. CXR is advised in the first instance.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Both kidneys show multiple microcysts, corresponding to the multiple echogenic interfaces described in the ultrasound. Some simple cysts are also confirmed. This appearance is typical of lithium-induced nephropathy.Incidental vertebral hemangioma in L3.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: No enhancing intracranial lesion identified  ~ 10 mm fat density lesion within the suprasellar cistern posterior to the pituitary infundibulum. Bilateral cerebellar tonsillar descent of approximately 9mm below the foramen magnum.Courtesy of Dr Kapilan Varatharajah.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: There is a right lumbar hernia below the 12th rib, and through the iliac crest defect, and inferior lumbar triangle, containing the coecum, ascending colon as well as ileal loops with no bowel obstruction seen.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: A well-defined cystic lesion is seen in the middle mediastinum between the trachea and esophagus with the inferior part of the lesion compressing the left main bronchus resulting in hyperinflation of the entire left lung, trans-herniating of the left lung to the right side with a contralateral mediastinal shift.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Initial CT brain Extensive acute fronto-temporo-parieto-occipital infarct in the right MCA territory with gyral effacement. Ipsilateral MCA dot sign (M2 thromboembolus).Old lacunar infarct in left frontal corona radiata.Small, old infarct in right cerebellar hemisphere.Calcified plaque in cavernous segment of ICA bilaterally.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: A 4 mm subpleural nodule is noted at right lower lobe which seems to be fibrotic.Circumferential wall thickening due to tumoral infiltration is noted at middle and superior portion of rectum associated with mild perirectal fat stranding. A few perirectal lymphadenopathies are present. There is no sign local invasion to mesorectal facia and other pelvic organs.The prostate gland is enlarged.Grade I spondylolisthesis with bilateral spondylolysis are noted at L5/S1 level.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: FINDINGS: A well-defined rounded hyperdense lesion measuring 2.4 x 2.4 cm is seen within the roof of the third ventricle, which is likely a colloid cyst. Mildly dilated both lateral ventricles, likely due to obstruction at the level of the foramen of Monro. Two frontal VP shunts with their tips lying within the frontal horns of the lateral ventricles are seen in situ. No recent infarction or intracranial hemorrhage is seen.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: CT demonstrated a compression fracture of the lesser tuberosity, characteristic for the reverse Hill-Sachs lesion, caused by the impaction of the anteromedial part of the humeral head against the glenoid rim.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Expansile, macroscopic fat-containing lesion in the head-neck of left 12th rib, with lobulated borders and cortical thinning. No marked contrast enhancement noted on contrast-enhanced series.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: No intracranial haemorrhage. Low density (-40 HU) mass in the left choroid plexus at the trigone.


Question: <image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image><image>Given a series of medical images, describe the key abnormalities, including the anatomical regions involved, any unusual structures, densities, or masses, and suggest possible diagnoses based on these findings.

Response: Bilateral pleural effusions are present, left more than the right side, accompanied by left lower lobe partial collapse. There are no intrapulmonary nodules.Multiple lymphadenopathies are seen at mediastinum and both hilar regions with maximum SAD of 20mm. Multiple para-aortocaval, peripancreatic, celiac and mesenteric lymphadenopathies are seen. The largest one measures 57×37mm. Additionally, several lymphadenopathies are also seen at para-iliac and inguinal regions. The largest one measured 39×30mm. The spleen is enlarged and its cephalocaudal height measured 156mm.A few cortical cysts are seen at both kidneys less than 33mm. Several stones are noted at right kidney with a maximum diameter of 20mm, accompanied by mild hydronephrosis. Two 6mm and 3mm stones are also observed at left kidney without hydronephrosis.A small amount of free fluid is present. Diffuse ankylosis of thoracolumbar spine is present with bilateral sacroiliac joints narrowing.