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: An irregular infiltrating soft tissue density lesion originating from left parotid gland and extending medially displacing the left carotid sheath. It has a heterogeneous enhancement in the post I.V contrast phase.Different sizes cervical lymph nodes are noted in the neck, the largest is located in left anterior triangle superiorly and also in the left supra-clavicular angle.Well defined variable sizes and shape focal metastatic lesions are seen within both lung fields. Evidence of right sided mild to moderate pleural effusion with possible underlying consolidation /collapse.Evidence of mediastinal lymphadeopathy are seen. Some show calcific foci. Bony osteolysis and deposits of D3 and D5 vertebrae.


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: Lower left rib fractures with small hemothorax. Small splenic lacerations with probably small pseudoaneurysm and surrounding blood. Complex renal cortical injuries with perinephric blood and multiple areas of active extravasation. No definite renal artery injury. Small amount of hemoperitoneum. Right internal oblique, bilateral Iliopsoas/iliacus, and paraspinal injury with active extravasation.Left transverse process fractures, traumatic subluxation with jumped facets of L5 on S1. Delays: No urine leak. Foci of active extravasation on the portal venous phase have disbursed.


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 beading/undulation of the entire main right renal artery. Probable tiny saccular aneurysm projecting posteriorly from a segmental branch in the interpolar region. Less pronounced, mildly beaded appearance of the main and accessory left renal arteries. No dissection or aneurysm. Possible mild ectasia of the celiac trunk. Normal adrenals.


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: Significant distension of the sigmoid colon measuring up to 10 cm in diameter secondary to twisting of the distal part of its mesentery. No definite signs of intestinal ischemia.No free fluid or collection.


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 defined pleural based opacity at the left upper zone with a rather smooth surface, measuring 1.5 x 3.5 x 3.5 cm in size.  The fat plane of the intercostal muscles is preserved, suggesting there is no evidence of invasion into the chest wall. No hilar and no mediastinal mass lesion.  The rest of the lungs are clear.Fatty infiltration of the liver.  No focal liver lesion. The spleen, adrenals, kidneys and pancreas are normal.


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: Heavily comminuted fractrure of the mid diaphysis of the femur, with posterior displacement, there is a a sudden cutoff at the profunda femoris at the mid femur yet the SFA and the popliteal artery are normal. Subcutaneous air gives evidence of an open injury. Anterior compartment demonstrates an intramuscular haematoma.The left medial patella is comminuted, with a significant soft tissue defect, the anterior portion of the medial aspect of the femoral condyle is also heavily communited.


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: Single image from a CT demonstrates a focal out-pouching at the right posterolateral aspect of the trachea.


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 left pneumothorax with chest tube. Small right effusion. Hemomediastinum. Transection of the thoracic aorta near the isthmus with large pseudoaneurysm.


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 sided aortic arch is seen with an aberrant origin of the left subclavian artery, which is seen arising as a last branch from the arch. There is focal dilatation at its origin, consistent with a Kommerell's diverticulum. Significant indentation and narrowing of the trachea is seen, which could probably be an explanation for patient's symptoms.Additional vascular variations are noted: left vertebral artery is originating  from the left common carotid instead of subclavian artery right vertebral artery is originating directly from the arch of aorta, in between the origins of right common carotid and right subclavian artery


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: Arrow injury through the tip of the left sphenoid greater wing, with tip injuring the tip of the left temporal lobe, but not extending to the orbital apex.


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: Nasogastric tube passes into the stomach, anterior to the cystogastrostomy stent with distal pigtail within the antrum of stomach. Small cystogastrostomy stent insitu with a short pigtail stent passing through this from the stomach into the pancreatic collection.Two, rounded hyperdense foci in the dependent stomach most consistent with medication pills.No pneumoperitoneum. Large, known pancreatic collection has maximal dimensions of 6 x 15 x 5cm (AP x trans x CC), similar to previous. Multiple gas locules within the collection.Small mesenteric fat containing anterior abdominal wall hernia with no evidence of complication.Pericholecystic fatty stranding.Left basal atelectasis with adjacent pleural effusion. IMPRESSION Intended naso-cystic (pancreatic collection) tube distal portion is within the antrum of the stomach, not the pancreatic collection as understood to be intended.Cystogastrostomy stent remains appropriately positioned with a smaller pigtail passing from the stomach through this into the pancreatic collection.Large pancreatic collection with gas locules within.


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 study shows localized gallbladder fundal mural thickening associated with an intra-luminal stone, which has fat density.


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 anterior diaphragmatic hernia containing loops of bowel. Secondary displacement of the mediastinum and volume loss in the lung bases. No evidence of obstruction or strangulation.Incidental note of aberrant right subclavian artery.Incompletely visualised hypodense focus in the right lobe 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: Orphaned sheared segment of previous subclavian venous tubing, unchanged in position, in the segmental branch of the left lower pulmonary artery.


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: Axial non-contrast abdominopelvic CT scan shows a small spleen with dense granular foci. On sagittal non-contrast thoracic and abdominopelvic CT fish mouth appearance of vertebrae is depicted.


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: On subsequent CT obtained two years later, mass has moved to posterior deep pelvis (arrows). The bone window (third image) better depicts the surgical clip in the center (arrowhead).


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 osseous impingement at the ankle. Subchondral lucency at the talar dome in keeping with the Hawkin sign, likely from disuse osteopenia or local hyperemia in this case.  Small volume ankle joint effusion. Degenerative changes at the middle and anterior subtalar, talonavicular and proximal intertarsal joints. Subluxation of the talonavicular joint. Ossification of the Achilles tendon. Haglund deformity of the calcaneus. Plantar calcaneal spur.


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 parietal scalp swelling. Complex fractures of the right and left parietal bones. Bilateral vertex subdural hemorrhage. Loss of supratentorial gray/white differentiation. Right orbital roof fracture.Bone window view of the right orbital roof fracture, right and left parietal fractures.


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 long segment of distal small bowel thickening along with engorgement of the adjacent mesenteric vessels and mild fat stranding inferring comb sign.A few small cysts are seen at the liver less than 5 mm. A little amount of free fluid is present in the pelvis.Degenerative changes as osteophytosis are seen at the lumbar spine.


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 multiloculated cystic non-enhancing lesion arising from the upper pole of the left kidney. Associated moderate hydronephrosis with displacement of the adjacent vessels contralaterally without intraluminal filling defects. Right lower lobe consolidation.


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 7 mm obstructive stone in the mid-portion of the left ureter causing proximal mild hydronephrosis and hydroureter, in addition to perinephric stranding and minimal perirenal fluid.Mild enlargement of the left adrenal gland lateral limb is seen measuring around fifteen millimeters.


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 abscess. with flecks of gas, involving the left masseter, surrounding the mandibular ramus and extending into the left submandibular space. No extension of the collection superior to the zygoma.Multiple carious teeth, with lingual cortical erosion adjacent to LL7 communicating with the abscess. Associated reactive mandibular hyperostosis.The left submandibular gland is displaced medially, as is the orophayrnx and cartilaginous complex, but no other spread. Reactive lymph nodes.


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 shows an enlarged left kidney with heterogeneous contrast enhancement. There are bubbly and linear streaks of gas within renal parenchyma and perinephric space. Left perinephric fat stranding.


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 prostate gland is enlarged. There is no sign of local invasion to adjacent structures. No regional lymphadenopathy is identified. Diffuse osteoblastic lesions are seen at thoracolumbar vertebrae, bony structures of the pelvis and proximal of both femurs.


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 multi-loculated air-filled, cystic lesion in the right hemithorax resulting in contralateral mediastinal shift to the left. The overall size of the lesion measures 8 x 9 x 7 cm. The locules of the lesion are larger than 2 cm in size. Right-sided chest tube is seen with mild pneumothorax and surgical emphysema in the right upper anterior chest wall. Evidence of segmental collapse and consolidation in the left lung.Diaphragm is intact: no evidence of congenital diaphragmatic hernia.


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: Erosion of the T12-L1 inferior and superior endplates with loss of T12-L1 disc height associated with pre-vertebral fluid collection measures 15 mm in thickness.Left paravertebral fluid collection measuring 22 mm in thickness as well as right paravertebral collection involving the right psoas muscle measuring 38 x 27 mm which extends craniocaudally from the level of upper border of T12 to lower border of L2.


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 stable well-defined extra-axial calcified lesion which was seen in the posterior fossa resting on the inferior aspect of the tentorium cerebelli suggestive of calcified meningioma.Ventricles are unremarkable 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: The splenic vein appears dilated and filled with hypodense material without evidence of contrast enhancement consistent with its thrombosis.The spleen appears congested with a small amount of fluid in the anterior pararenal space.The posterior branch of the right portal vein is not opacified, with a segmental area of low attenuation involving the hepatic parenchyma not exerting a mass effect at segments VI and VII of the liver, consistent with the affected area that is supplied by this vessel appearing as transient hepatic attenuation differences (THAD).The anterior branch of the right portal and superior mesenteric veins are patent.The rest of the organs and abdominal vessels appear normal.


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: Calcified walled left sellar and perasellar lesion with internal fat density material with additional fat locules in sylvian fissures bilaterally, sulci and right ambient cistern consistent with fat of ruptured dermoid cyst.Additionally noted lacunar infarcts right basal ganglia.


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 low density thickening of the large bowel from the mid transverse round to the mid descending colon. Uncomplicated sigmoid diverticulosis. Normal enhancement of the heavily calcified arteries.


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 atrial appendage is to the left of left atrium close to the left upper lobe pulmonary vein.Here it is to the left of the left atrium between the aorta and main pulmonary artery.No other congenital heart diseases.


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-guided transforaminal epidural steroid injection (TFESI) - Smaller 30G needle used to aid correct needle position and administer local anesthesia.  - Final pre-contrast position of the 25G Quincke needle.- Post-contrast images show contrast extends through the targeted right C5/6 foramen with epidural extension.


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: Bilobed predominantly low density mass extends from the posterior fossa through the left jugular foramen and into the neck with smooth expansion of the left jugular fossa.


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 wall thickening measuring approximately 7-10 mm noted involving the terminal ileum with significant luminal compromise and stricture narrowing of the terminal ileum near ileocecal junction.There is infiltration of low attenuation material (HU= -40) in the submucosal layer which is non-enhancing. The overlying muscularis propria and undelying mucosa are enhancing well and depicting fat halo sign.There is surrounding mesenteric fat stranding and fibrofatty proliferation and perivascular inflammatory infiltration outline the distended intestinal arcades, displaying comb sign.Few enlarged, non-necrotic lymph nodes are noted in the inflamed part of the mesentery.Imaging features are most likely represent Crohn's disease


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: Hysterectomy.Multiple distended, predominantly fluid field loops of small bowel with fluid levels. The maximum transverse diameter of the small bowel is 4.7 cm. Transition point low in the left side of the pelvis with two points obstructed in one location along the course.1.2cm enhancing serosal/mural based nodule on the second part of the duodenum.A small amount of pelvic free fluid. No free gas.  Unremarkable appearances of the solid organs.


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-marginated hypoattenuating pancreatic body lesion arises from the posteroinferior aspect of the pancreatic body. It measures 5.7 x 5.3 x 5.0 cm. It is mainly cystic unilocular with few thin septations and peripheral calcification (seen in the left lateral wall). It compresses the splenic vein displacing it inferiorly, attenuating its lumen with development of mesneteric collaterals draining into the SMV.  Intact splenic artery, although the cystadenoma abuts the lesion. Main pancreatic duct is normal caliber.


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: Evidence of premature closure of sagittal suture with the somewhat elongated shape of the skull representing craniosynostosis with scaphocephaly.


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 bilobed fat containing heterogeneous mass in the pelvis posterior to the uterus, with amorphous calcific foci within it. Within its lower moiety a tooth is simulated. The appearances are consistent with a mature cystic teratoma. Minimal free fluid is demonstrated in the pouch of Douglas.Furthermore, there is intraperitoneal fat density material similar to that within the pelvic tumour, insinuating in the pelvis, overlying the urinary bladder, extending cephalad over the right iliac fossa reaching the hepatorenal recess and forming a shallow accumulation of the surface of the right liver. The appearances are concerning for intraperitoneal rupture of the cystic teratoma.The appendix is mildly distended, and there is minimal periappendiceal fat stranding and free fluid. An appendicolith is identified at the appendix ostium. There are a few enlarged lymph nodes in right iliac fossa. All these findings are suggestive of acute appendicitis.


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: Incidental finding of an extrahepatic portalvenous aneurysm (4 cm x 3,5 cm) - Aneurysms of the portal venous system.


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: Irregular calcified mass in the left globe.Small calcified mural nodule in the right globe.Large sellar-suprasellar mass with coarse calcification.


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 rounded extra-axial soft tissue isodense lesion in the right frontal region showing intense homogenous post contrast enhancement. Findings are likely due to meningioma.


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 bilateral renal angiomyolipomas. Large right retroperitoneal haemorrhage. Appearance suggestive of a pseudoaneurysm at the upper pole of the right kidney.


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: Hepatosplenomegaly.The liver and spleen are hyperdense in keeping with iron deposition.Multiple lesions of varying size up to 2cm in the liver are consistent with abscesses.  Cystic lesions in the spleen are consistent with microabscesses.Multiple calcified upper abdominal lymph nodes.Free fluid in the pelvis.Coarse appearances of the bony skeleton.Small paravertebral soft tissue masses in keeping with extramedullary haematopoiesis.


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 case was managed conservatively. A follow-up non-contrast CT brain done on the next day showed a right MCA territory infarct. This is can be caused by arterial spasm/dissection secondary to trauma.


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: Duplicated left-sided inferior vena cava which crosses anterior to the aorta at the level of the left renal vein to join right IVC.


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 scan with contrast confirms the presence of markedly enlarged central pulmonary arteries, suggestive of pulmonary arterial hypertension. The right ventricle also appears hypertrophied with leftward bowing of the intraventricular septum.


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: Axial CT scan of the abdomen with IV and oral contrast shows a large, heterogeneously enhancing (more pronounced on delayed images), left renal mass, occupying most of the left abdomen, displacing bowels, and pancreas to the contralateral side, with no vascular or adjacent organ invasion.


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 distal abdominal aorta is dilated measuring 9 cm in diameter with areas of mural calcification seen. Post contrast images delineate a large mural thrombus within the aneurysm.


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 heterogeneously enhancing soft tissue mass lesion seen in the right iliac fossa, arising from the mesentery of small bowel. It contains areas of necrosis and foci of calcifications and causes a desmoplastic reaction.Multiple adjacent ovoid-shaped enhancing regional lymph nodes are also present.Multiple hypodense lesions seen scattered in the liver; the largest one is seen in segment IVa, concerning for metastases.Multiple enhancing pathological lymph nodes are seen in the coeliac, preaortic, aortocaval, left and right para-aortic, peripancreatic regions and the mesentery.


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: 6cm solid enhancing mass in the lower pole of the left kidney with a central stellate area of low attenuation.Separate simple cyst abutting the mass as well as a further simple cortical cyst in the left mid pole.Normal right kidney.No para-aortic lymphadenopathy.


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 examination shows loss cortical- subcortical differentiation and decreased subarachnoid space of convolutions of the convexity and ventricles. A marked hypodensity is observed in both caudate nuclei. In the remaining white matter nuclei appear normal. Small hypodense area in the left corona radiata compatible with lacunar infarction.


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: Wedge-shaped hypodensity within the spleen with mild surrounding fat stranding. Filling defect within a hilar branch of the splenic artery, consistent with thrombus. Proximal splenic artery is not well seen with prominent collateral arteries around the stomach. Trace of pelvic free fluid. No free gas.Liver, adrenal glands, gallbladder, and pancreas are unremarkable. Bowel is unremarkable. Few small simple renal cortical cysts bilaterally. Prostatomegaly.


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 images demonstrate: distended urinary bladder with a thickened wall mild-to-moderate bilateral ureterohydronephrosis with no ureteric stone seen.  prostatic hypertrophy (90 grs in this case).  retroperitoneal fluid collection is noted in the left perirenal space corresponding to a urinoma confirmed on the excretory phase (contrast extravasation), indicating a rupture of the collecting system. left renal vein thrombosis was seen as a filling defect within the renal vein on the portal venous phase with a lack of parenchymal enhancement as compared to the right kidney.  liver cirrhotic changes are seen as hypertrophy of the caudate lobe, atrophy of the segment IV with irregular borders. Dilated portal vein (16 mm) with no enlarged spleen.


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: Axial non-contrast CT images of both upper thigh show chronic tear of the distal third of right adductor longus muscle (as evidenced by its non-visualisation) with retracted, bulked-up mid third of muscle forming pseudomass.Fatty streaks are seen in the retracted, bulked-up mid third of muscle with two punctate foci of calcifications at the tear site.Comparison can be done with normal appearing left adductor longus muscle.


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 dilated loops of small bowel containing fluid and gas noted throughout the abdomen.There is narrowing of the caecal lumen with irregular circumferential thickening, which is likely the transition point of partial small bowel obstruction.  The thickening extends into the terminal ileum.Ill-defined hypodensities are seen throughout the liver, suggestive of metastases.


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: Post cholecystectomy changes with surgical clips in operative bed. Three different well defined radiodensities seen per abdomen. One adjacent to retrohepatic IVC, largest along lesser curvature of stomach and smaller stones along right external iliac 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: A 52×35mm low enhancing mass is noted at pancreatic body and tail which invades proximal portion of splenic vessels. Few enlarged lymphnodes with maximum SAD of 7mm are seen in the vicinity of the mass.Multiple low-enhancing masses are seen at liver parenchyma less than 60mm in diameter.The prostate gland is enlarged. Degenerative changes as osteophytosis are seen at the lumbar spine.


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 large hypodense lesion measuring 7.5 x 5.5 cm is seen in segment VIII of the liver. It shows early peripheral discontinuous nodular enhancement on the arterial phase, progressive centripetal fill-in on portal venous phase and becoming isodense to the liver parenchyma on delayed phase, this is likely a giant hepatic hemangioma. Another lesion measuring 1.4 x 1.1 cm, showing enhancement on the arterial phase and becoming isodense to the liver on the venous phase is noted in segment II of the liver; this is likely a flash filling hepatic hemangioma. The rest of the liver is unremarkable.A well-defined enhancing solid exophytic lesion measuring 1.5 x 1.6 cm is seen along the posteromedial aspect of the mid pole of the left kidney, which is suspicious for a primary renal malignancy. A few small retro-aortic lymph nodes are noted at the level of the renal hilum. Renal vessels and IVC are patent and well-opacified. Multiple small well-defined non-enhancing hypodense lesions (suggestive of benign cysts) are noted in both kidneys.


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: Post-contrast CT study revealed, enlarged liver with heterogeneous parenchyma, central patchy enhancement and peripherally hypodense / hypoenhancing, giving nutmeg appearance. Enlarged caudate lobe. No focal lesion is noted.The spleen is not enlarged. Moderate ascites.The IVC is attenuated but the hepatic veins are not seen clearly. The gallbladder shows increased wall thickness without gallstone. Right sided pleural effusion.


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: Hyperdense right MCA sign and discretely hypodense right parenchyma with loss of gray-white matter differentiation.


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 wall thickening with heterogeneous enhancement in rectosigmoid junction with a total length of 85 mm accompanied by pericolic fat stranding and a few prominent regional mesenteric lymph nodes.A hypodense mass lesion with ill-defined border and peripheral enhancement in the liver segment VII suggestive of metastasis.Hypodense mass lesion about 12*14 mm in the right adrenal gland.Cortical scar in the right kidney mid pole with adjacent calyectasia.Cortical cyst in the left kidney mid pole.Hypodense mass lesion about 40*50 mm along with uterus posterior wall.Degenerative changes as endplate sclerosis and marginal osteophyte formation along with the thoracolumbar spine..


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: Deficient muscle in the lower right anterior abdominal wall associated with surgical clips.  Minor bulging of small bowel at the point of deficiency.


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: Massive pericardial effusion. Enlarged upper mediastinal lymph nodes. Nutmeg liver. Ascites.


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 lung parenchyma as well as the left lower lung lobe are replaced by multiple innumerable air-filled cavities denoting severe centrilobular emphysema, this is associated with: a large left pleural effusion and pneumothorax with subsequent consolidation and collapse of the left upper lung lobe small right pleural effusion


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 heavily calcified well-defined oval-shaped soft tissue mass in left suprarenal area displacing the left kidney downward. There are enlarged regional retroperitoneal lymph nodes. No evidence of intraspinal extension. It is partially encasing the aorta and the renal vessels. There is rounded hypodensity in segment four of the liver raising the possibility of liver metastasis. The cuts on the lower chest showed multiple heavily calcified pleural based and pulmonary nodules/metastasis. As well there are anterior mediastinal calcified masses. The spleen, pancreas appear unremarkable. Apart from the adjacent mass effect. No biliary dilatation No ascites.Stage IV disease with heavily calcified left suprarenal tumour, multiple pulmonary and pleural-based metastases.  On top of differential diagnosis is neuroblastoma.


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 appendix is retro-caecal sub-hepatic in location. It shows mural thickening and enhancement, its lumen is seen distended by fluid density; Extensive blurring and smudging of the surrounding fat planes. Fairly defined elliptical cystic fluid collection is seen at the sub-hepatic and right para-colic region measuring 6 x 3.1 cm along its maximum axial dimensions showing thick enhancing walls and abutting the inferior lateral surface of the liver likely representing an "abscess".Mild right pleural effusion with bilateral basal atelectatic changes.


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 reveals a giant infrarenal abdominal aortic aneurysm, measuring 11x10x10 cm. The aneurysm has a partially thrombosed lumen and maximum thrombus thickening measuring 5 cm. There is right-sided perianeurysmal retroperitoneal hematoma due to aneurysm rupture.No active contrast extravasation.


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: Axial nonenhanced CT image shows a slightly heterogeneous midline posterior fossa mass in the cerebellar vermis. The fourth ventricle is obliterated and not 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: Liver laceration (grade 4) involving segment VI with active extravasation of contrast with an associated subcapsular haematoma and haemoperitoneum. Right transverse process fractures of the T12 and L1 vertebrae.


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: Two-phase contrast CT shows occlusion of the left main portal vein and its tributaries and subsequent hyperperfusion of the left liver lobe in the arterial phase, most likely due to consecutive predominant arterial supply of the left liver parenchyma via the hepatic artery.Evidence of a heterogeneous subcapsular hepatic lesion in segment II, measuring 4,5 x 2,7 x 3 cm. The lesion demonstrates a hypodense centre and a double ring, the thin inner ring being hyperdense and the thicker outer ring hypodense, compared to the adjacent liver parenchyma. The appendix appears mildly swollen with moderate surrounding fat stranding. A fluid collection is seen medial to the tip of the appendix with a thick hyperdense wall and hypodense content alongside some gas bubbles. This formation measures 6,5 x 2 x 3 cm and abutts the urinary bladder. The right ventral bladder wall appears markedly thickened. Evidence of para-aortal lymphadenopathy.No other acute findings. Secondary findings include hepatic steatosis, small liver cysts, advanced arteriosclerosis, reperfusion of the umbilical vein and some bilateral dystelecatic changes of the dorso-basal lung parenchymaCONCLUSION: Clinical history, examination, lab results and CT features are in keeping with chronic appendicitis with appendicular abscess and a pyogenic spread of the intraabdominal infection via the portal venous drainage way. Consecutive pylephlebitis of the left portal vein with a superimposed hepatic abscess in the affected left liver segment II. The abscess demonstrates a double target sign which is a characteristic image feature of a hepatic abscess.


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 paranasal sinus in bone window demonstrates air pockets along the medial aspect of the left orbit traversing the left lamina papyracea/vertical plate of left ethmoid, bilateral ethmoid air cells, nasal septum, left side of sphenoid sinus, left pterygoid fossa and the bony canal of the horizontal left petrous temporal bone with involvement of the right petrous canal roof. Hemosinus noted within the left maxillary, ethmoids, and right sphenoid sinuses.The globes and conal compartments were intact.Identification of the "track" and asymmetry of both petrous carotid canals lead to the identification of "raised" bony chip off the right carotid canal warranting further assessment wiht 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: 15 mm thick subcarinal lymph node and borderline-sized right paratracheal node. Bilateral perihilar nodes with maximum thickness of 15 mm. Status post-left upper lobectomy. Right upper lobe centrilobular and paraseptal emphysema. Bilateral cylindrical bronchiectasis and peribronchial cuffing. Large ground glass opacities in both lungs - most probably a manifestation of gemcitabine toxicity. Minuscule amount of right pleural effusion, small amount on left. Status post-pancreaticoduodenectomy, with the anastomoses appearing intact. The pancreatic head and tail are atrophied - a manifestation of pancreatic ductal adenocarcinoma. No evidence of local or distal abdominal lymphadenopathy. Omental and retroperitoneal areas of fat stranding. Fatty liver. Elongated structure in the gallbladder bed, perhaps fat necrosis. Right posterior tracheal diverticulum at the level of the clavicles. Sigmoid, right (not shown) and left colonic diverticula.


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 tracheal is significantly dilated (measuring >3 cm) and associated with an outpouching/diverticulum projecting posteriorly. There is also mild dilation of the central bronchi bilaterally. These findings are in keeping with tracheobronchomegaly.


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: Minor pancreatitis, improved from the previous CT last month. No pseudocyst or collection. Metallic wire within the venous system extending from a left gluteal vein, through the left internal iliac, left external iliac, IVC, extending through the right atrium into the SVC. The superior tip is not visualised.


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: Gross ascites with peritoneal deposits in the undersurface of right hemidiaphragm, along the phrenic margin of spleen, layers of omental caking, chunks of peritoneal deposits in right iliac fossa and pouch of Douglas. Poorly marginated and bulky appearing right ovary.


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 lobulated mass in the apical segment of the right lower lobe, abutting the oblique fissure. There is extensive nodularity adjacent to the mass. Inferior to the mass tubular opacities appear continuous with the bronchus and may represent impacted mucus rather than additional tumour.Patch of groundglass opacity in the right upper lobe. Background centrilobular emphysema throughout both lungs. Trachea and main bronchi are normal.Right hilar node enlargement with calcific focus and prominent round pre-tracheal node.The oesophagus is dilated and fluid filled, representing an aspiration risk.Multiple liver lesions and duct dilatation are again noted as described previously. No destructive skeletal lesion although there is a sclerotic focus in the lateral right third rib. Conclusion Large right lower lobe mass in keeping with a primary lung cancer with liver metastases. Prominent right hilar and pretracheal lymph nodes are suspicious of further metastases.


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 angiogram revealed a right-sided aortic arch crossing the midline posterior to the esophagus, further descending on the left side (circumflex aorta). The circumflex arch is ectatic and measures 38 mm in its maximum diameter. Marked compression on the posterior aspect of the esophagus by the ectatic circumflex arch is also noted.The first branch arising from the arch is the left common carotid artery, followed by the right common carotid artery, right subclavian artery, and finally the aberrant left subclavian artery which arises from a small diverticulum after the aortic arch has crossed the midline to the left. A left ductus arteriosus is also present which completes the vascular ring. The thoracic aorta descends on the left side. The diagnosis is consistent with right circumflex aorta with aberrant left subclavian artery.


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: Skeletal changes of chronic renal failure are manifested e.g. diffuse osteosclerosis, thickened cortex and osteomalacia with prominent femoral neck trabeculae. There are multiple osteolytic areas within the ilia, sacrum and proximal femora. Moreover there are bilateral femoral neck fractures which are characteristic of insufficiency fractures.


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: Avulsed posterior tibial plateau at the PCL insertion. Mild volume lipohaemarthrosis. Fractured inferior margin of the patella. Small intra-articular loose body is seen at the knee joint space.


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: Hypertrophic phenomena and gross heterogeneous muscle calcifications that extend from the pelvis to the middle third of the thighs. A firearm projectile is located in the soft tissues in left inguinal region. Notice that the bone cortical isn't affected.


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: For practical reasons, this exam was carried out about one hour after intravenous contrast injection. The most striking finding is perhaps that of a persisting contrast enhancement of the left kidney parenchyma, indicating impaired left renal function. You will also find that the excreted contrast fills the ureter all the way to the calculus but does not seem to pass distal to it. Excreted contrast is also found in the perirenal fluid collections, thus proving the presence of a rupture of the renal 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: Large mixed density ovoid soft tissue density mass within the left anterior chest wall measures 126 x 127 mm in the axial plane (increased compared to 116 x 112 mm previously) and 105 mm in the coronal plane. It is centred on the anterior left 3rd rib with rib splaying evident. Destructive bony changes in the associated left anterior 2nd, 3rd and 4th ribs. There is a further expansile lesion in the lateral aspect of the left 3rd rib which is unchanged in size and appearance. No new bony lesions identified.The chest wall mass exerts mass effect on the left ventricle. The heart, pericardium and great vessels are otherwise within normal limits. No lymphadenopathy within the thorax by CT size criteria. The lungs and pleura are clear.Limited views of the upper abdomen are within normal limits. IMPRESSION Slight increase in the size of the left anterior chest wall pseudotumour as described above but not exceeding that of the prior CT.


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: Subsequent CTA showed occlusion of P1 posterior cerebral artery.


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: Endovascular repair of splenic artery aneurism.There is an endoleak seen adjacent to the distal stent graft attachment with an enlarged aneurism sac.


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 appendix is enlarged measures 9 mm diameter at its tip with increased wall thickness and enhancement, mild surrounding fat stranding, no extraluminal air or localized collection.A small oval-shaped lesion measures 8 mm seen at the posterior wall of the ascending colon with a fatty core (-11 HU) showing minimal stranding of the adjacent fat, findings are suggestive of epiploic appendagitis.Mild free pelvic fluid.


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: Mildly prominent pancreatic duct. Stranding and unorganized fluid about the pancreas. Pancreas enhances symmetrically. Portal, splenic, SMV patent. Calcifications over pancreatic body are related to splenic artery. Small effusions and basilar atelectasis. Fluid in esophagus raises possibility of aspiration. Mild enhancement of CBD likely inflammatory. Large right indirect inguinal hernia containing ascites.


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 calculi in the right distal abdominal ureter with proximal hydroureteronephrosis. There are also large calculi in the dilated right renal pelvis and in the lower pole of the right kidney. Large densely calcified bladder calculus engulfs the displaced JJ-stent (seen on bone windows, not included).Incidental findings include prior left renal infarct and a small hypodense nodule at the uncinate process of the pancreas, likely a cystic pancreatic neoplasm which will require further characterization with MRI, among others.


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 gall bladder is distended with multiple calculi largest measuring ~ 1.0 x 1.0 cm. Wall thickening (measuring ~ 6.4 mm) showing post contrast enhancement with adjacent pericholecystic fat stranding and thin rim of fluid- features suggestive of cholelithiasis with acute cholecystitis.Incidentally dilated and tortuous pulmonary vessels in both lower lobes lung parenchyma, the largest in the posterobasal segment of left lower lobe showing avid enhancement.


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 saccular aneurysmal dilatation of the aortic arch measuring 5.5 (AP) x 5.3 (ML) x 8.4 (CC) cm. Presence of intramural haematoma mainly at the superior aspect. It displaces the trachea to the right side. The aneurysm is in close proximity with the oesophagus but no clear communication seen between these structures. No blood products in the oesophagus. No contrast extravasation or haemothorax to suggest ruptured aneurysm. Left common carotid and subclavian arteries are normal.A cavity with surrounding consolidation seen in the right middle lobe. Aneurysmal branch arising from the right middle lobe pulmonary artery seen within the cavity suggestive of Rasmussen aneurysm. Haematoma seen surrounding the aneurysm.Tree-in-bud appearance and numerous tiny nodules seen in the right middle and lower lobes indicating active endobronchial 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: Thin-walled, smooth, well-defined homogeneously fluid-density cyst with an anterior midline location at the level of hyoid bone.


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 gallbladder is grossly distended passing inferomedially to cross the midline at the level of the pelvic inlet. A large calculus in the neck of the gallbladder. Mild biliary dilation, without detected stricture of duct calcification. There is no free intraperitoneal fluid or gas. There is no gas in the biliary tree. No gallbladder wall thickening. Calcifications within the uterus are most in keeping with fibroids.CONCLUSION:Gallbladder hydrops with a large neck stone.


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: Oval mass projecting from the inferior aspect of hepatic segment 3, with peripheral nodular discontinuous enhancement. Acute uncomplicated appendicitis. Hepatic steatosis.Note: the sagittal images are unfortunately of degraded quality as they were reconstructed from the axial dataset, but I included them to help show the relationship of the hemangioma with 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: Dextrocardia.Reversal of situs of the abdominal organs.Gallbladder, intrahepatic and extrahepatic ducts showing significant dilatation. Radiopaque stones in the distal common bile duct. Patchy geographic regions of hypodensities within the liver parenchyma are also seen.Degenerative changes along the imaged spine.


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 obstructive colorectal cancer with venous tumor invasion and enlarged perirectal nodes. Enlarged left common iliac node. Liver metastases. Complex multiloculated mass in right ovary. Rounded submucosal mass in anterior uterine fundus likely fibroid.Pelvic floor insufficiency.


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 cystic bronchiectasis in the right upper lobe with mild cylindrical bronchiectasis throughout the remainder of the lungs. Numerous calcified mediastinal lymph nodes.


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 abnormal position of the caecum which passes through the foramen of Winslow to lie within the lesser sac. The foramen of Winslow is widened with the main portal vein partially effaced by the adjacent large bowel. Both the terminal ileum and appendix have a normal appearance with the appendix lying outside of the lesser sac. No small bowel obstruction.There is a small volume of free intra-vesical gas, with no IDC and preservation of the fat plane around the bladder. 3.4 cm ovoid hypodense right adnexal lesion.Conclusion:Internal herniation of the caecum into the lesser sac. No small bowel obstruction.


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: On the non-contrast series, we see blood in the ventricles, both parietal sulci, and the prepontine and pontocerebellar cisterns. The left internal carotid artery is dilated.CT angiography shows small dilatations of the basilar artery and right cerebral posterior artery, and a larger one of the left internal carotid artery.The third and fourth series are MIP reconstructions, in which the arterial vessels are more easily appreciated.


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 suprarenal gland shows four lesions, the largest lesion measuring 6.3 x 7.8 x 7.4 cm in AP, SS and CC dimensions. They show heterogeneous post-contrast enhancement, mainly peripheral with gradual filing in along the multiphasic study.The largest one shows local mass effect, indenting the anterior border of the left kidney, contacting the left crus of diaphragm with downward displacing the left renal hilar vessels.Left renal hilar enhancing lymph node is noted.Left posterior pararenal rounded enhancing lesion is noted. Left renal lower pole subcapsular lesion measuring 2.2 x 2.5 cm with arterial enhancement and washout in venous and delayed phases, suspicious for a recurrent left renal malignant lesion.


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: Associated superior end plate of L3 fracture.Axial and coronal images marking shows the pancreatic laceration site.


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 pulmonary emboli. Massive right renal mass (17 cm), with enhancing tumor thrombus in the IVC. Retroperitoneal adenopathy. Bulky, lobulated left pelvic sidewall/space of Retzius adenopathy with surrounding fatty proliferation.


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: Focal dilatation of the anterolateral wall of the left ventricle with a wide neck and calcified rim.Bilateral mild pleural effusions.


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: CTA demonstrates developmental venous anomaly (DVA) in the left cerebellar hemisphere, with multiple radiating veins and draining into the posterior aspect of straight sinus.


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: Calcified irregular shaped lesion is seen in segment II of the liver, extending into left hepatic duct and common hepatic duct causing obstructive biliopathy - consistent with intrabiliary rupture of calcified hepatic hydatid cyst.


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: Axial CT of the temporal bone showing bilateral, more pronounced on the right, focal area of lucency (demineralisation) just anterior to the oval window.


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 moderate intrahepatic biliary ductal dilatation in the right and left hepatic lobes most notably involving the right anterior and left medial hepatic segments with relative narrowing of the intrahepatic bile ducts towards the liver hilum. Pneumobilia is noted within the left hepatic lobe.  There is no visible periductal infiltrative parenchymal changes near the liver hilum. Multiple rounded hyperdense filling defects are seen within the distended intrahepatic bile ducts in the right anterior hepatic segment, resembling biliary stones. The common bile duct is slightly enlarged measuring 8 mm. The gallbladder is surgically absent.


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: Incidental discovery of bilateral accessory parotid glands overlying the masseter muscles. No signs of inflammation or stones.


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 haematoma lies anteriorly to the right iliac fossa transplant kidney and extends into the pelvis. RIF transplant kidney JJ stent and drain tube noted. Post-surgical changes are noted, along with a small right rectus sheath haematoma. Small volume of intraperitoneal free fluid.Left iliac fossa transplant kidney with a cyst at the upper pole. Innumerable cysts on both native kidneys. Small bilateral pleural effusions with associated lower lobe atelectasis.


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 fluid-filled cystic lesion, without soft tissue component or calcification, is seen at left supraclavicular fossa.


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: Comminuted, displaced and impacted fracture of the proximal left humerus, extending from the anatomical neck to the surgical neck. Posterior dislocation of the humeral head relative to the glenoid cavity (with further locking/impaction).


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 51×38mm thick-walled fluid density lesion with internal air bubbles is noted at right liver lobe which shows peripheral ring enhancement.The gallbladder is contracted and contains a 6mm gallstone.


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: Although slightly distorted by motion artifact, these images show a well formed cavitary lesion at the left lower lung lobe, at the dependent portion of which lies a soft tissue mass. A rim of gas is seen around the lesion and fibrotic changes surround the cavity.A nodule is seen at the right middle lung lobe.Both lungs show diffuse ground glass opacity.


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: Non contrast CT axial, coronal and sagittal images show biconvex hematoma, which displaces the parietal pleural and the extrapleural fat.In addition multiple rib fractures 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: Evidence of partial gastrectomy and Billroth II gastrojejunostomy is seen, without any sign of anastomosis recurrence. The ingested contrast material passes through the patent duodenal stump into a cavity. The cavity is confined superiorly by underneath of the left liver lobe, inferiorly by the transverse colon, and medially by the gallbladder, and fistulized to the two hollow organs. A part of the cavity is within the left liver lobe. The liver parenchyma in the superior wall of the cavity shows liquefaction and multiple air bubbles in favor of gas-forming infection. Multiple hepatic masses in favor of metastases, severe ascites, and a few peritoneal implants are visible. An anterior abdominal wall tumoral implant is seen, which invades a part of the efferent loop behind it, about 40- 50 cm after gastrojejunostomy with minimal proximal bowel dilation. Significant bowel obstruction is not present.


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 kidney is enlarged with dilated pelvicalyceal system, upper ureter and multifocal parenchymal air foci within. A calculus measuring ~13 x 10 mm, density 1286 HU, is noted in the lower pole of the right kidney.A second calculus measuring ~27 x 7 mm, density 1217 HU, with internal air foci are noted in the right upper ureter at L5 vertebral level. There is associated mild wall thickening of right upper ureter. Left kidney and ureter are normal.Degenerative changes were seen in the thoracolumbar spine.Mild atrophy of thoracolumbar paraspinal and gluteal muscles.


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: Contrast-enhanced abdominal CT scan is performed showing multiple well-circumscribed gas-filled cysts within the colonic wall with a honeycomb pattern. The affected walls are not thickened and pericolic fat stranding is not seen. Lung window helps in the recognition of the cysts, so it is attached. A small volume of pneumoperitoneum and a small quantity of perihepatic free fluid are also present. The PEG is well-positioned.Additionally, there is diffuse hepatic steatosis and multiple calculi in the right kidney and inside the renal 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: Axial and coronal series demonstrate a significantly enlarged, heterogeneously enhancing right parotid gland, compatible with severe right parotitis. There is no evidence of an obstructing sialolith, although variable degrees of ductal ectasia are noted.The left maxillary sinus is opacified, as is most of the left ethmoidal sinus.Asymmetric developmental enlargement of right submandibular gland is present.


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: Diffuse enlargement of the pancreas with minimal surrounding haziness/fluid. Perhaps some low-attenuation "halo" near the tail.Concentric thickening and enhancement of the common bile duct.