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CT CAP Lung Mets

FINDINGS: The left perihilar mass increased in size measuring 5.8 x 6.0 cm previously 5.3 x 4.3 cm with adjacent pleural effusion. There are multiple new and enlarging nodules identified within the left lower lobe, lingula and upper lobe, the largest one measures 1.8 x 1.5 cm in the lingula, with several adjacent nodules in the lingula and left lower lobe of similar size.

Loculated right-sided effusion has enlarged from prior. Right lower lobe atelectasis. There are no pathologically enlarged mediastinal lymph nodes. Stable sternotomy wires and residual epicardial pacing wires. There is a metallic object adjacent to the left cricoid cartilage which most likely represent a vocal cord prosthesis.

The liver, gallbladder, pancreas, spleen and adrenals demonstrate normal morphology and enhancement without mass lesions. Right kidney is surgically absent. Left kidney demonstrates several small hypodense cystic well-circumscribed lesions. Enteric contrast extends to the hepatic flexure. The hollow viscera are without evidence for wall thickening, mass, or obstruction. No evidence of free fluid or free air in the peritoneal cavity. No evidence of mesenteric or retroperitoneal lymphadenopathy.

The bladder is normal. There is a sclerotic lesion within the right ilium, stable for many years. Degenerative changes of the lumbar spine are noted.

1. Interval worsening metastatic lung disease with multiple new and enlarging lesions since prior exam as above.
2. No metastatic involvement of intra-abdominal parenchymal organs.
3. Chronic changes as above.