tudy Result
Impression
In the thorax small 6 mm nodule left lower lobe is again noted and stable the
other nodules described on prior study are less conspicuous on today's exam some
of this may simply be technical as they are tiny. No evidence of progressive
metastatic disease in this patient.
Left biliary stent is in place and in good position no ductal dilation and I no
longer identify any type of mass on today's exam.
No acute process in the chest abdomen or pelvis.
Electronically signed by: MICHAEL SARSON, Radiology Associates of Keene, at 8/18/2018 2:29 PM
Narrative
EXAMINATION: CT CHEST ABDOMEN PELVIS W CONTRAST (GENERIC)
CLINICAL HISTORY: History of cholangiocarcinoma evaluate for interval change
TECHNIQUE: Helical CT of the chest, abdomen, and pelvis was performed following
intravenous administration of 120 ml of Omnipaque 300. Oral contrast was
administered.
COMPARISON: 7/5/2018
FINDINGS:
Chest:
Lungs and large airways: Changes of advanced emphysema. There is a 6 mm nodule
in the left lower lobe seen best on image #183 which is unchanged from prior
study. Prior study described multiple other tiny nodules these are less
conspicuous on this exam. Changes of advanced emphysema are present
Pleura: No pleural or pericardial effusion calcified pleural plaque present
unchanged
Heart/vasculature: Coronary artery calcification
Lymph nodes/Mediastinum/Hila: I do not see any mediastinal or hilar masses or
adenopathy. No axillary or supraclavicular nodes
Abdomen/pelvis:
Liver: Biliary stent is in place appears to be in good position tracking up into
the left lobe of the liver. I do not see a discrete mass on today's exam
Bile ducts: Nondilated.
Gallbladder: Decompressed
Pancreas: Normal attenuation without ductal dilatation.
Spleen: Normal.
Adrenals: Normal.
Kidneys: Normal.
Vasculature: Advanced atherosclerosis
Lymph Nodes: No enlarged lymph nodes.
Bowel: Scattered diverticuli
Peritoneum and mesentery: No ascites, free air, or loculated fluid collection.
No mesenteric inflammation.
Abdominal wall: Normal.
Urinary Bladder: Normal.
Reproductive organs: Normal.
Osseous structures: No acute process
Impression
In the thorax small 6 mm nodule left lower lobe is again noted and stable the
other nodules described on prior study are less conspicuous on today's exam some
of this may simply be technical as they are tiny. No evidence of progressive
metastatic disease in this patient.
Left biliary stent is in place and in good position no ductal dilation and I no
longer identify any type of mass on today's exam.
No acute process in the chest abdomen or pelvis.
Electronically signed by: MICHAEL SARSON, Radiology Associates of Keene, at 8/18/2018 2:29 PM
Narrative
EXAMINATION: CT CHEST ABDOMEN PELVIS W CONTRAST (GENERIC)
CLINICAL HISTORY: History of cholangiocarcinoma evaluate for interval change
TECHNIQUE: Helical CT of the chest, abdomen, and pelvis was performed following
intravenous administration of 120 ml of Omnipaque 300. Oral contrast was
administered.
COMPARISON: 7/5/2018
FINDINGS:
Chest:
Lungs and large airways: Changes of advanced emphysema. There is a 6 mm nodule
in the left lower lobe seen best on image #183 which is unchanged from prior
study. Prior study described multiple other tiny nodules these are less
conspicuous on this exam. Changes of advanced emphysema are present
Pleura: No pleural or pericardial effusion calcified pleural plaque present
unchanged
Heart/vasculature: Coronary artery calcification
Lymph nodes/Mediastinum/Hila: I do not see any mediastinal or hilar masses or
adenopathy. No axillary or supraclavicular nodes
Abdomen/pelvis:
Liver: Biliary stent is in place appears to be in good position tracking up into
the left lobe of the liver. I do not see a discrete mass on today's exam
Bile ducts: Nondilated.
Gallbladder: Decompressed
Pancreas: Normal attenuation without ductal dilatation.
Spleen: Normal.
Adrenals: Normal.
Kidneys: Normal.
Vasculature: Advanced atherosclerosis
Lymph Nodes: No enlarged lymph nodes.
Bowel: Scattered diverticuli
Peritoneum and mesentery: No ascites, free air, or loculated fluid collection.
No mesenteric inflammation.
Abdominal wall: Normal.
Urinary Bladder: Normal.
Reproductive organs: Normal.
Osseous structures: No acute process
Bet it’s going to seem like a short day 
not moving fast .... yet 
