Neck CAT Scan

NECK CAT SCAN

INDICATION FOR STUDY:  Left neck mass.

FINDINGS:  Computerized axial tomography of the neck, both without and with intravenous contrast enhancement was accomplished without difficulty.

In the mid left neck, there is a reasonably well-marginated soft tissue density measuring
1.8 x 1.2 cm lying just anterior to the left sternocleidomastoid muscle.  The remaining tissue structures within the neck appear to be symmetrical bilaterally.  Vascular structures appear to be normal.

The thyroid gland appears to be bilaterally symmetrical with no solid or cystic lesions seen.

IMPRESSION:  1.8 x 1.2 cm soft tissue mass in the left mid neck lying just anterior to the edge of the left sternocleidomastoid muscle.

Abdominal and Pelvic CAT Scan

ABDOMINAL AND PELVIC CAT SCAN

INDICATION FOR STUDY:  Abdominal pain as well as scrotal pain and the patient was known scrotal varices.

FINDINGS:  Computerized axial tomography of the abdomen and pelvis, both without and with intravenous contrast enhancement and following oral contrast was accomplished without difficulty.

The lower lung fields appear to be normal.  There is fatty infiltration of the liver with decreased attenuation of the liver in relationship to the spleen.  The gallbladder is normal.  The pancreas, adrenal glands, and right kidney are normal.  A very small cyst is seen in the anterior aspect of the left kidney in its mid portion.  The spleen appears to be normal.

Vascular structures are normal.  I see no evidence of ascites.

Extending the examination into the pelvis, organ structures and tissue planes appear to be normally maintained.  No solid or cystic lesions are seen.  I see nothing to suggest diverticular disease involving the lower colon.  The upper scrotum appears to be normal.  A more definitive examination of the scrotum and is contents would be by ultrasound.

IMPRESSION:

1.                   The lower lung fields are normal.

2.                   Fatty infiltration of the liver.

3.                   Small left renal cyst.

4.                   No acute abdominal or pelvic abnormality is identified.

Abdominal CAT Scan

ABDOMINAL CAT SCAN

FINDINGS:  Computerized axial tomography of the abdomen, both without and with intravenous contrast enhancement and following oral contrast was accomplished without difficulty.

The lower lung fields appear to be normal.  The hepatic parenchyma appears to be grossly normal.  On image 8 of series 4, there is a very small area of lucency seen in the anterior aspect of the liver perhaps representing a very small hepatic cyst.  No other solid or cystic lesions are seen.

The pancreas, spleen, adrenal glands, and kidneys appear grossly normal with the exception of some small areas of decreased attenuation seen in the kidneys representing simple renal cysts.  These are quite small.  No solid masses are indicated.

Vascular structures are normal.  I see no evidence of periaortic or retroperitoneal adenopathy.  There is no evidence of ascites.

Extending the CAT scan into the pelvis, organ structures and tissue planes in the upper pelvis appear to be normal.

IMPRESSION:

1.                   Probable very small hepatic cysts seen in the anterior aspect of the liver as described.

2.                   Small bilateral renal cysts.

3.                   No acute abdominal process is identified.

Pulmonary Function Test (PFT)

PATIENT NAME:  Patient Name

DOB:  10/18/1932

DOP:  09/20/11

DOD:  10/10/11

PROCEDURE:  PFT.

FINDINGS:

The flow volume loop shows a restrictive pattern.

Spirometry shows that the forced vital capacity is 54% of predicted.  The forced expiratory volume at one second is 68% of predicted.  The forced expiratory volume at one second to the forced vital capacity ratio is 0.92.  After the administration of a bronchodilator, the forced vital capacity increased by 20% and the forced expiratory volume at one second increased by 8%.

Lung volumes were not measured.

The diffusion capacity is 50% of predicted, which corrects for alveolar volume.

IMPRESSION:

1.   Patient has a restrictive lung defect.  However, patient did have significant bronchodilator response.  Therefore, a trial of inhaled bronchodilators may be indicated.

2.   Diffusion capacity corrects for alveolar volume, which suggests an extrathoracic or extraparenchymal lung defect.  Clinical correlation is recommended.

Brain CAT Scan

BRAIN CAT SCAN

INDICATION FOR STUDY:  Syncope.

FINDINGS:  Computerized axial tomography of the brain, but without intravenous contrast enhancement was accomplished without difficulty.

I see no evidence of a recent intra-axial or extraaxial hemorrhagic process.  There is no mass effect.  The brain substance abuts the inner table of the calvarium throughout.

There is mild cerebral atrophy seen.

IMPRESSION:

1.                   Mild cerebral atrophy.

2.                   No acute intracranial process is identified.

CT Evaluation of the Soft Tissues of the Neck without Contrast

CT EVALUATION OF THE SOFT TISSUES OF THE NECK WITHOUT CONTRAST

INDICATION FOR STUDY:         Palpable mass, left-sided neck.  Thyroid ultrasound examination from February 20, 2012.

FINDINGS:             The area of concern was marked with a metallic BB.  There is no significant mass lesions or adenopathy clearly identified.  There are vessels identified, which of course are in a normal pattern.  The muscles, submandibular gland, parotid gland, and thyroid gland show no significant abnormality.  The examination is limited without I.V. contrast, but there is no specific change to suggest abnormal mass lesion or adenopathy.  There are a few small nonspecific lymph nodes, which appear within normal limits and symmetric in appearance.  The visualized airway shows no gross abnormality.  The parapharyngeal fat and prevertebral soft tissues show no significant abnormality.

IMPRESSION:        The area of concern in the left neck was marked and there is no specific lesion or mass clearly identified.  The soft tissues and muscle planes all appear symmetric on the left and right side.  There are degenerative changes of the spine, but no other significant abnormality identified.  The examination is limited without I.V. contrast, but from the evaluation, there is no specific lesion or mass.  Would recommend clinical correlation or further evaluation as necessary.

CT Evaluation of the Abdomen and Pelvis with and without I.V. Contrast

CT EVALUATION OF THE ABDOMEN AND PELVIS WITH AND WITHOUT I.V. CONTRAST

INDICATION FOR STUDY:         Fall.  Fractured ninth left rib.

FINDINGS:             I understand the patient has a left ninth rib fracture, which is nondisplaced and not as apparent on the CT evaluation, but it is identified on approximately image 6 of series 3.  There is no significant surrounding edema.  The remainder of the bony structures show slight chronic changes, but no other acute abnormality in the abdomen or pelvis.  In the liver, there are a few simple cysts identified, one noted in the left lobe on image 12 through 14 of series 5, which measures approximately 2 cm.  There is another one in the right lobe measuring 4 mm on image 14, another one in the right lobe more posteriorly and medially measuring 14 mm on image 17, and another one in the right lobe more laterally and inferiorly measuring 14 mm on image 22.  There is a simple cyst in the left kidney, which measures approximately 14 mm on image 27.  It is not as optimally characterized.  There is a horseshoe kidney.  There is no evidence of significant fracture or laceration to the liver, spleen, or kidneys.  There is no evidence of free fluid or free air in the abdomen or pelvis.  There is no evidence of calculi in the kidneys or gallstones.  There is no obstruction.  The remainder of the abdomen and pelvis shows no gross abnormality.  The pelvic evaluation shows no significant free fluid or free air and the bony structures show no fracture.  There is contrast in the bladder and the bladder is not significantly distended.  The bowel loops are not completely opacified.  A preliminary report was discussed with Dr. Roberts.

IMPRESSION:        Horseshoe kidney.  Simple cyst in the left kidney measuring approximately 1.4 cm.  Multiple simple cysts in the liver.  No clear evidence of significant laceration or rupture of the solid organs in the abdomen or pelvis.  The patient’s known left ninth rib fracture is identified on the CT evaluation as discussed above.  There is no free fluid or free air.  Would recommend clinical correlation or further evaluation as needed.