MadMed wrote:Progression in the lung mets ? Sorry pccr, gut punch.
New lymph nodes, as well.
Comparison was all the way back to March 3.
LUNGS, AIRWAYS: Central airways are patent. Mild diffuse bronchial wall thickening. Status post interval sublobar resection of the middle lobe with mild soft tissue thickening along the surgical chain sutures, with surrounding scarring and architectural distortion, representing postsurgical changes. Numerous bilateral solid lung nodules have enlarged since the immediate prior chest CT, most of which demonstrate lobulated and spiculated margins, measured on series 5. For reference, 1.6 x 1.5 cm nodule in the left upper lobe on image 127 (previously 1.2 x 0.9 cm), 1.9 x 1.7 cm nodule in the lingula on image 286 (previously 1.0 x 1.0 cm) and 2.2 x 2.0 cm right lower lobe nodule on image 315 (previously 1.2 x 0.7 cm).
PLEURA: No pleural effusion or pneumothorax.
MEDIASTINUM, HILA, LYMPH NODES: Multiple enlarged bilateral hilar and mediastinal lymph nodes are new or enlarged since the immediate prior study, some of which are centrally necrotic, including in the sternal notch, para-aortic, AP window, right and left paratracheal, and subcarinal stations, consistent with nodal metastases. For reference, new 3.6 x 3.0 cm lobulated centrally necrotic right paratracheal lymph node on series 3 image 65 and enlarging 3.2 x 2.4 cm necrotic AP window lymph node on series 3 image 60 (previously 1.3 x 1.0 cm).
HEART AND VESSELS: Normal heart size. No pericardial effusion. Normal caliber thoracic aorta and central pulmonary arteries.
UPPER ABDOMEN: See separately dictated report of companion abdomen/pelvis CT for detailed findings.
BONES AND SOFT TISSUES: No significant chest wall abnormalities. No aggressive osseous lesions.
LOWER NECK: No masses identified in the visualized lower neck.