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mild asymmetric pulmonary edema, more pronounced on the right, slightly worse in the interval.
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lung volumes remain quite low, particularly the left due to chronically elevated right hemidiaphragm. pulmonary vascular congestion continues to improve postoperatively. pleural effusions are small if any. there is no pneumothorax. postoperative cardiomediastinal silhouette is stable. right jugular line ends at the origin of the svc.
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bilateral pleural effusions, moderate on the left and small on the right, increased from the prior chest radiograph. however, no overt pulmonary edema identified.
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no acute cardiopulmonary process. indistinctness of a posterior lower rib may represent a mildly displaced overlapping fracture or less likely a lytic lesion of the bone. if this is the patient's area of pain, recommend chest ct for further evaluation.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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worsening pulmonary edema.
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no acute cardiopulmonary abnormality.
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no acute intrathoracic process.
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no acute cardiopulmonary abnormality. no new or worsening opacities to suggest pneumonia.
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tubes and lines are unchanged in position with the left basilar pigtail catheter unchanged in position. minimal blunting of both costophrenic angles likely reflect tiny effusions. no pneumothorax is appreciated, although the sensitivity to detect pneumothorax is diminished given semi-erect technique. lungs appear well inflated without evidence of focal airspace consolidation or pulmonary edema. cardiac and mediastinal contours are stable. multiple old left-sided posterolateral rib fractures.
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no acute intrathoracic process.
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despite a thick band of atelectasis or scarring in the left lower lobe present since at least , overall lung volumes are normal and there are no other focal pulmonary abnormalities. cardiomediastinal and hilar silhouettes and pleural surfaces normal. tip of the endotracheal tube ends just above the upper margin of the clavicles, no less than <num> cm from the carina with the chin down. the tube should be advanced at least <num> cm for more secure positioning. feeding tube passes into the stomach and out of view. left jugular line ends in the low svc. no pneumothorax or appreciable pleural effusion.
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no evidence of acute disease including no free air.
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no acute cardiopulmonary process.
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no evidence of congestive heart failure. widening of the superior mediastinum may relate to mediastinal lipomatosis. recommendation(s): comparison with previous chest radiographs is recommended to assess for stability of the superior mediastinal widening.
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interval placement of catheter the left lung base, with considerable interval decrease in size of left pleural effusion. a moderate to moderately large left pleural effusion remains present, with underlying collapse and/or consolidation.
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new blunting of the left costophrenic angle may be due to infectious process or possibly small pleural effusion. these findings were discussed with , m. d. by dr telephone at <num>am.
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no acute cardiopulmonary process.
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no acute findings.
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mild pulmonary vascular congestion without overt pulmonary edema. mediastinum stable since.
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port-a-cath appears in good position.
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the patient carries a left-sided picc line. the course of the line is unremarkable, the tip of the line projects over the mid to low svc. calcified structure projecting over the mediastinum, likely reflecting a calcified lymph node in the aortopulmonary window. low lung volumes. no pneumothorax.
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mild interval progression of the airspace opacification in the medial aspects of the lower lung zones bilateral may represent atelectasis or pneumonia.
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left lower lobe opacity concerning for pneumonia with possible small effusion.
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no evidence of acute cardiopulmonary disease.
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the endotracheal tube and nasogastric tube are unchanged in position. lung volumes remain low with patchy opacities at both bases likely reflecting atelectasis, although pneumonia or aspiration cannot be entirely excluded. overall cardiac and mediastinal contours are unchanged, although they are somewhat difficult to assess due to patient rotation on the current study. no pleural effusions. no large pneumothorax. no evidence of pulmonary edema.
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resolution of right middle lobe pneumonia without new focal consolidation.
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no acute intrathoracic process. particularly, no evidence of pneumonia. no definite lung nodules. if there is concern for small nodules, chest ct should be considered.
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atelectasis of the right lower lobe accompanied by a small right pleural effusion. given the unusual nature of the presentation, if there is further clinical concern, more definitive evaluation could be considered with ct. preliminary impression communicated to dr by dr telephone at am.
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no evidence of acute cardiopulmonary process.
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chronically elevated left hemidiaphragm and degenerative changes of the thoracic spine, unchanged since. otherwise, normal chest radiograph without evidence of pneumonia.
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emphysema with mild congestion and edema. bibasal atelectasis, mild cardiomegaly.
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pa and lateral chest compared to : transjugular pacer wire passes to the right ventricular apex. no pneumothorax, pleural effusion, or mediastinal widening. lungs clear. heart size normal. vascular catheter folded in the left axilla does not enter the chest.
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persistent left-sided pleural effusion and rounded opacity which was more fully characterized on remote prior ct as rounded atelectasis. presumed left basilar atelectasis noting that infection cannot be excluded.
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no acute cardiopulmonary process.
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right hilum slightly larger, could be nodal mass. further evaluation with ct is recommended.
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low lung volumes without definite evidence of traumatic injury on this nondedicated exam. correlate with focal the exam findings in obtain dedicated imaging as needed to evaluate for trauma.
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patchy right mid-to-lower lung opacity raises concern for infection and/or aspiration.
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no acute cardiopulmonary process.
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stable examination with retrocardiac opacification likely reflecting combination of atelectasis and moerate left effusion. trace right pleural effusion.
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emphysema. no radiographic evidence for pneumonia.
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no acute intrathoracic process.
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increased intravascular markings suggestive of increased intravascular volume and borderline heart failure.
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no evidence of active tuberculous.
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no significant pneumothorax remaining. no new pulmonary abnormalities. slight regression of pulmonary congestion.
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mediastinal wires and left-sided pacemaker are unchanged position. there is unchanged cardiomegaly. there is volume loss on the left side with a moderate loculated pleural effusion. small right-sided pleural effusion is also seen. overall, these findings are stable. there are no pneumothoraces.
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interval resolution of pulmonary edema. bibasilar opacities are likely atelectasis.
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moderate left and very small right pleural effusion have slightly increased and increasing mild pulmonary edema.
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no acute cardiopulmonary pathology.
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re- demonstration of a left suprahilar mass compatible with known malignancy with lymphangitic spread in the left lung and continued diffuse left-sided pleural thickening with a small to moderate left pleural effusion. no new focal consolidation identified in the right lung.
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heart size and mediastinum are unchanged including mild cardiomegaly. bilateral pleural effusions are at least moderate. bibasal consolidations are unchanged. mild vascular congestion/ interstitial edema are noted. infectious process in the left lower lobe in particular is still suspected.
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unchanged appearance of a right middle/right lower lobe airspace opacity compatible with pneumonia, although rounded atelectaasis is a possibility. mild cardiomegaly and central pulmonary vascular congestion.
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no pleural effusion, acute infiltrate, or pneumothorax. multiple nodular densities in the left lung field and dominant right basilar nodule which in this patient with a history of high-grade liposarcoma, likely represent metastases.
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small bilateral pleural effusions and bibasilar streaky opacities, likely atelectasis. no pulmonary edema.
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no acute cardiopulmonary process.
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in comparison with the study of , there is little change and no evidence of acute pneumonia, vascular congestion, or pleural effusion. bilateral total
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interval progression of multiple pulmonary lesions.
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as compared to the previous radiograph, the patient has received a nasogastric tube. the course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. no pleural effusions. no pneumonia, no atelectasis, no pulmonary edema. no pneumothorax.
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no acute cardiopulmonary abnormality.
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probable subcutaneous calcification or very dense soft tissue nodule, right back. suggest shallow oblique views with soft tissue marker to confirm. pleural thickening in the right apex.
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ng tube tip isin the stomach. there are low lung volumes with minimal atelectasis in the left base. the aorta is tortuous. cardiac size is top-normal. there is no pneumothorax. if any there is small left effusion.
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no acute cardiopulmonary process.
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no acute cardiac or pulmonary process.
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new focal right middle lobe opacity and unchanged right upper lung opacity. given these equivocal findings for an infectious process with a right lower lobe nodule seen on ct, chest ct is recommended for further evaluation. recommendation(s): chest ct is recommended for further evaluation of right lung opacities.
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patient has been extubated. little has changed except for slight increase in right basal atelectasis. right hemidiaphragm is chronically elevated. moderate cardiomegaly is long-standing. there is no pulmonary edema or pneumothorax. pleural effusion is small if any on the right. probably no pleural effusion on the left.
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no acute cardiopulmonary process.
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small left apical pneumothorax. interval re-expansion of the right upper lobe, with residual atelectasis adjacent to the fissure. these findings were communicated via telephone by dr to dr at on , min after discovery.
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as compared to the previous radiograph, the patient has been extubated, the nasogastric tube and the right internal jugular vein catheter have been removed. the lung parenchyma is now clear an free of focal parenchymal opacities. no pleural effusions. no pulmonary edema. normal size of the cardiac silhouette.
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near complete opacification of the left hemi thorax with leftward shift of midline structures. scattered opacities in the right lung, question pneumonia. ct is needed to further assess as malignancy is difficult to exclude.
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extensive right lower lobe consolidation is grossly unchanged from follow-up until resolution should be performed.
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small right pleural effusion.
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normal chest radiograph. no pneumonia.
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large left pleural effusion has increased since , probably slowly progressive since there is ipsilateral shift of the mediastinum indicating more atelectasis, rather than contralateral shift which would be seen with an acutely collecting pleural effusion. right lung is clear and pleural space is normal. left subclavian infusion port ends in the upper right atrium, as before. there is no longer any pleural air. this is
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compared to chest radiographs since , most recently. previous there are right hilar mass, decreased following treatment between and. it has not changed subsequently, but there is greater than tumor infiltration around the right main bronchus and lower trachea, substantially obscuring the airways. severe interstitial abnormality in the adjacent right lung probably combination of treatment and tumor infiltration of the lung is slightly more severe today than it was in. left lung is clear. heart size is normal.
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no acute cardiopulmonary abnormality.
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no acute cardiopulmonary abnormality.
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no acute cardiopulmonary abnormality.
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compared to prior chest radiographs, through :<num>. <num> frontal chest radiographs show successive advancement of the esophageal feeding tube from the upper to the lower esophagus and finally into the upper stomach. final radiograph in the series shows clear left lung and mild cardiomegaly. right pleural abnormality in heterogeneous consolidation or atelectasis in the right lung are unchanged over the past several days. the final radiograph in the series shows repositioning of the right pic line from a right internal jugular vein to the estimated location of the right superior cavoatrial junction alongside the indwelling right internal jugular catheter.
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left apical linear density is equivocal for a small pneumothorax. suggest repeating with a less lordotic view. left port-a-cath terminates in the upper svc.
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increased moderate left pleural effusion and left lower lobe atelectasis with stable small right pleural effusion and associated atelectasis.
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et and ng tube in satisfactory position. otherwise, doubt significant interval change. bibasilar atelectasis again noted.
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ng tube has been advanced and now ends in the expected location of the stomach.
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lower lung opacities likely atelectasis, difficult to exclude an early component of pneumonia. mild cardiomegaly.
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no evidence of acute cardiopulmonary process.
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no acute cardiopulmonary process.
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hyperinflation consistent with the patient's known emphysema. the nasogastric tube has withdrawn slightly, the tip distal stomach however a side hole is now positioned at the level the gastroesophageal junction.
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no evidence of acute cardiopulmonary process.
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no acute intrathoracic process.
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no acute abnormality identified.
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no acute cardiopulmonary process
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in comparison with the study of , the opacification in the right perihilar region appears slightly less prominent. the a engorgement of ill-defined pulmonary vessels is decreasing, consistent with improved pulmonary vascular status. otherwise, little change.