October 16, 2006

A 16 row detector spiral CT scan was performed through the chest with intravenous contrast. Multiplanar and mip reconstructions were obtained to better evaluate for mass lesions infiltrates, or adenopathy. Images were reviewed on an independent CT workstation. The examination is compared with prior study performed on 9/6/2006. A 3.5 cm mass centrally in the left lower lobe is stable in appearance. A large left pleural effusion is somewhat increased. There is partial atelectasis of the lingular segment of the left upper lobe and left lower lobe centrally which is increased. The left lower lobe atelectasis is likely compressive in nature. Prominence in the subcarinal region consistent with adenopathy contiguous with the esophagus is stable. No other significant mediastinal adenopathy is present. There are multiple small nodules in the right lung mostly in the upper lobe measuring up to 5 mm in diameter which are not calcified. These are stable in appearance. Scans through the upper abdomen reveal the adrenal glands to be normal in appearance. No other significant abnormalities are noted.

 

Impression:

1. Left lower lobe mass stable

2. Large left pleural effusion, increased

3. Increased atelectasis left lower lobe and lingular segment of upper lobe. The left lower lobe atelectasis is compressive.

4. Stable mediastinal adenopathy

5. Small nodules right lung stable since the prior study.

September 5, 2006

A 16 row detector spiral CT scan was performed through the chest with intravenous contrast. Multiplanar and mip reconstruction's were obtained to better evaluate for mass lesions infiltrates, or adenopathy. Images were reviewed on an independent CT workstation. The examination is compared with prior study performed on 7/21/2006. There is a moderate sized left pleural effusion, somewhat increased since the prior study. A 3.5 x 3.5 cm irregular mass in the superior segment of the left lower lobe is stable. There has developed infiltration in the left lower lobe since the prior study in addition to compressive atelectasis as previously noted. There is partial atelectasis of the left upper lobe secondary to increased pleural effusion. The right lung remains clear. The mediastinum is free of significant adenopathy and is stable in appearance. Small lymph nodes are again noted in the left paratracheal region and AP window. Scans through the upper abdomen including the adrenal glands are unremarkable and unchanged

 

Impression:

1. Left lower lobe mass centrally, stable

2. Increased left pleural effusion

3. Development of left lower lobe alveolar infiltrate

4. Partial atelectasis left upper lobe which has developed

5. No other interval change

July 25, 2006

A 16 row detector spiral CT scan was performed through the chest with intravenous contrast. Multiplanar and mip reconstructions were obtained to better evaluate for mass lesions infiltrates, or adenopathy. Images were reviewed on an independent CT workstation. The examination is compared to prior study performed on 5/5/2006. A lobulated mass in the left lower lobe measures 3.4 x 3.8 cm in the axial projection, is increased since the prior study at which time it measured 2.4 x 2.9 cm. Left pleural effusion is somewhat increased as well. Scattered small nodules are now noted bilaterally measuring up to 4 mm in diameter. These were not present on the prior examination. 

There is a 7 mm lymph node in short axis in the left AP window which is stable since the prior study. Other smaller nodes are stable as well. No significant adenopathy is present. Scans through the upper abdomen including the adrenal glands are unremarkable.

 

Impression:

1. Increased left lower lobe mass

2. Moderate sized left pleural effusion, somewhat increased

3. Multiple small pulmonary nodules bilaterally suspicious for metastases, also new.

May 5, 2006

A 16 row detector spiral CT scan was performed through the chest with intravenous contrast. Multiplanar and mip reconstructions were obtained to better evaluate for mass lesions infiltrates, or adenopathy. Images were reviewed on an independent CT workstation. Mass density in the left lower lobe is noted centrally measuring a maximum of 24 x 29 mm. This shows slight increase since the prior study. There is continued moderate left pleural effusion. No other pulmonary nodules are present. The lungs are hyperinflated. There is no significant mediastinal adenopathy. No lytic or blastic lesions are noted.

Impression:
1. Left lower lobe mass with mild enlargement since the prior study performed on 2/17/2006
2. Continued moderate left pleural effusion
3. No other interval change.

February 17, 2006

A 16 row detector spiral CT scan was performed through the chest with intravenous contrast. Multiplanar and mip reconstructions were obtained to better evaluate for mass lesions infiltrates, or adenopathy. Images were reviewed on an independent CT workstation. The examination is compared with prior study performed on 12/16/2005. Mass density centrally in the left lower lobe measures 19 x 26 mm, which is decreased since the prior study measuring 2.4 x 3.4 cm at that time. There is continued atelectatic change of much of the remainder of the left lower lobe. A moderate sized left pleural effusion is otherwise slightly decreased. No other pulmonary nodules are noted. There is no significant mediastinal adenopathy. Scans through the upper abdomen reveal the adrenal glands to be normal.

 

Impression:

1. Left lower lobe mass decreased

2. Left pleural effusion slightly decreased

3. No other significant abnormality or interval change.

December 16, 2005

A 16 row detector spiral CT scan was performed through the chest with intravenous contrast. Multiplanar and mip reconstructions were obtained to better evaluate for mass lesions infiltrates, or adenopathy. Images were reviewed on a CT workstation. A mass in the left lower lobe, centrally, is decreased in size since the prior study performed at South Jersey Healthcare on 10/5/2005. It now measures 3.4 cm in its greatest oblique axis as compared with 4.2 cm on the prior study. Left pleural effusion is significantly increased however. There is no significant mediastinal adenopathy. There is partial compressive atelectasis of the left lower lobe which was not present on the prior study.

 

Impression:

1. Decreased left lower lobe mass

2. Increased left pleural effusion with compressive atelectasis left lower lobe.

October 5, 2005

CT scan of the chest performed with intravenous contrast. Multiple axial images obtained from the lung apices to the region of adrenal gland. No prior studies available for comparison.

 

Examination demonstrates small sub cm nodular densities in the mediastinum probably representing inflammatory lymph nodes. No large lymph nodes identified at the right hilum. Density is noted in the left upper lobe , at the left perihilar region measuring approximately 4 cm probably representing a mass. There is a moderate left pleural effusion. Underlying neoplastic process is not excluded. Bronchoscopy can be of further value in the evaluation. There is questionable soft tissue density in the left mainstem bronchus concerning for neoplastic process. This is appreciated on image number 41 in the coronal planes. No significant pleural effusion identified on the right lung. There is a moderate atelectasis in the left lung.

 

Scanning through the upper abdomen demonstrates small hypodense lesion in the liver measuring approximately the 1 cm probably representing cyst. The visualized portions of the adrenal gland are grossly normal.

 

Impression:

1. Moderate left pleural effusion.

2. Left parahilar mass measuring approximately 4 cm as described.

3. Neoplastic process cannot excluded.

4. Bronchoscopy can be of further value in the evaluation. Follow-up suggested.

5. No significant rnecliastinal adenopathy.