Heres My last CT scan report guys..

CT NECK CHEST ABDOMEN PELVIS W/WO CONTRAST

DATE OF SERVICE: 12/2/2019

COMPARISON: 9/25/2019

RADIATION DOSES: CTDI VOL (1): 3.91 mGy; CTDI VOL (2): 8.25 mGy;
DLP: 1191 mGy-cm

PROCEDURE: Multiple axial CT images were obtained from the skull
base to mid thigh before and after the administration of 100mL of
Omnipaque 350.

FINDINGS:
NECK: The skull base is unremarkable. The previously noted
air-fluid levels within the bilateral maxillary sinuses has
resolved. The nasopharynx, oropharynx, hypopharynx and larynx are
unremarkable. The salivary glands are unremarkable. The thyroid
gland is unremarkable. No enlarged lymph nodes are identified.
Scattered subcentimeter bilateral cervical lymph nodes are noted.
No focal osteoblastic or osteolytic lesion is identified.

CHEST: The trachea and central airways are patent. Linear scarring
or atelectasis is seen within the left lower lobe. There is
evidence of a prior right lower lobectomy. No new, suspicious
pulmonary nodules are identified. There is no pleural or
pericardial effusion. The heart is normal in size. Aortic
calcifications are seen consistent with atherosclerotic vascular
disease. Coronary artery calcifications are seen. There are
multiple, prominent mediastinal lymph nodes again seen seen, with
a rounded contour, concerning for nodal metastasis. For example, a
right paratracheal lymph node measures up to 0.7 cm, unchanged as
compared to the prior examination. Additionally, there is
increased size of multiple prominent and mildly enlarged left
axillary lymph nodes concerning for nodal metastatic disease. For
example, a left axillary lymph node (image 21) measures up to 1.1
cm compared to 0.7 cm on the prior examination. There is increased
size of 2 subcutaneous nodules seen within the left chest wall
(image 37 and 30), the largest now measuring 1.1 cm compared to
0.8 cm on the prior examination. No focal osteoblastic or
osteolytic lesions are identified.

ABDOMEN/PELVIS: The liver, spleen, pancreas, adrenal glands and
gallbladder are unremarkable. A small right renal cyst is seen.
The kidneys otherwise demonstrate symmetric enhancement without
evidence of hydronephrosis. There is increased size of a
heterogeneous soft tissue mass seen arising from the sigmoid colon
(image 106) now measuring up to 4.7 cm compared to 4.0 cm on the
prior examination. This mass remains contiguous with the lumen of
the sigmoid colon. The prostate gland is not enlarged. Aortic
calcifications are seen consistent with atherosclerotic vascular
disease. No enlarged lymph nodes are identified within the abdomen
or pelvis. Surgical clips are seen within the left inguinal
region. There is increased size of a centrally necrotic mass seen
within the left abdominal oblique musculature (image 79) now
measuring 6.0 cm compared to 4.5 cm on the prior examination.
Additionally, there is a stable 1.1 cm enhancing nodule seen
within the right gluteus musculature (image 107) concerning for
metastasis. No focal osteoblastic or osteolytic lesions are
identified.

IMPRESSION:
1. Increased size of a centrally necrotic mass seen within the
left abdominal oblique musculature consistent with metastasis.
2. Increased size of two subcutaneous nodules seen within the left
chest wall consistent with metastasis.
3. Increased size of a heterogeneous soft tissue mass seen arising
from the sigmoid colon, which is contiguous with the lumen of the
sigmoid colon, favored to represent a colonic metastasis over a
primary colonic malignancy.
4. Increased size of left axillary lymph nodes consistent with
nodal metastatic disease. There are stable prominent, rounded
lymph nodes within the mediastinum also concerning for nodal
metastatic disease.
5. Stable enhancing nodule is seen within the right gluteus
musculature concerning for metastasis.
6. Status post right lower lobectomy.
7. Postoperative changes within the left inguinal region.
8. Atherosclerosis, including coronary artery calcifications.

Reviewed and Interpreted by: Pareen Mehta 12/2/2019 12:28 PM