surajkapoor/CT_csv huggingface dataset:
Findings: Imaged lung bases are clear. No pleural effusion. Normal heart size without pericardial effusion. Post surgical changes of Roux-en-Y hepaticojejunostomy. Interval removal of a internal/external biliary drain. Mild dilation of the left and right hepatic duct, similar to prior. Pneumobilia. Changes of cholecystectomy. Unchanged embolization coils or surgical clips in the right hemiliver. Normal spleen, pancreas, and adrenal glands. Normal kidneys. Normal urinary bladder. Interval removal of a left upper quadrant pigtail drainage catheter. Decrease in size of both the left lower quadrant and right lower quadrant peripherally enhancing fluid collections. The left lower quadrant collection measures 1.7 x 1.2 cm, decreased from prior in the right lower quadrant collection measures 1.3 cm, decreased from prior. There is a new mildly complex fluid collection in the pelvis (cul-de-sac) that measures 9.5 x 6.5 cm in maximum axial dimensions with mild peripheral enhancement and mild internal septations (series 2, image 192). There is a mildly hyperattenuating dependent component, which may represent layering blood products. There is a right adnexal cyst measured 2.1 cm with some peripheral enhancement, which may represent a hemorrhagic cyst. There is heterogenous hyperenhancement of the uterus, new from prior. No evidence of bowel obstruction. There is a new umbilical hernia containing nonobstructed bowel. No lymphadenopathy in the abdomen or pelvis. No free air. Portal veins are patent. No suspicious lytic or blastic osseous lesion. Multilevel degenerative disc disease of the lumbar spine.

Impression: 1. Mixed response of hepatic metastatic disease with increase in size of some lesions and decrease in size of others. 2. Increased peritoneal and omental disease. Of note, there has been increase in size of a peritoneal deposit at the inferior aspect of the right lower quadrant ileostomy. 3. No evidence of metastatic disease in the chest. 4. Interval resolution of previously seen small bowel obstruction.
Findings: Chest: Heart size is at the upper limits of normal. No pericardial effusion. Right internal jugular approach chest port catheter tip terminating at the superior cavoatrial junction. Several small supraclavicular and mediastinal lymph nodes, unchanged in size compared to prior. For example, a left supraclavicular lymph node measures 6 mm in short axis diameter, unchanged from prior (series 2, image 20). No axillary lymphadenopathy. Unchanged 5 mm groundglass nodule in the left upper lobe (image 37). No new or enlarging pulmonary nodule. No pneumonic consolidation. No pleural effusion. No pneumothorax. Abdomen/Pelvis: Increased size and number of hepatic metastatic lesions. For example, a heterogenous lesion enhancing lesion in the inferior right hemiliver measures 4.5 x 4.1 cm, increased in size compared to prior. No substantial change in the central hepatic hypoattenuating lesion with calcifications that measures approximately 4.6 x 3.8 cm. There is unchanged occlusion of left portal vein. There is new nonocclusive thrombus in the main portal vein extending to the distal superior mesenteric vein. Increase in size in loculated fluid collections in the upper abdomen. There is diffuse peritoneal thickening and nodularity, increased from prior, most pronounced in the cul-de-sac. Splenomegaly, increased from prior with the spleen measuring up to 16.7 cm in length, previously 15.2 cm. Multiple collateral vessels in the abdomen. Normal pancreas and adrenal glands. Normal kidneys and urinary bladder. The uterus is absent. No evidence of bowel obstruction. Interval resolution of previously seen gastric distention. Normal caliber abdominal aorta with mild atherosclerotic calcifications. Similar to slight increase in size of retroperitoneal lymph nodes. For example a peripancreatic lymph node measures 11 mm in short axis diameter, previously 10 mm (series 2, image 157). No suspicious lytic or blastic osseous lesion is seen.

Impression: 1. New extensive subcutaneous air centered in the right suprapubic region and tracking inferiorly to the perineum and superiorly along the right lateral abdominal and chest wall with associated marked body wall edema, highly concerning for a necrotizing soft tissue infection. No discrete fluid collection. 2. Gastrostomy tube terminating in the stomach with the balloon in the stomach. Small locules of gas along the gastrostomy tube tract, however, the process responsible for the extensive subcutaneous emphysema appears distinct from the gastrostomy tube. 3. New diffuse mesenteric edema. No discrete intra-abdominal collection. 4. New small bilateral pleural effusions. The Critical results were discussed with Ashley Rozema, PA by Kapoor MD on 01/06/2023 at 3:01 PM
Findings: Chest: Right internal jugular approach port catheter tip terminating at the superior cavoatrial junction. Normal heart size. No pericardial effusion. No subclavicular, axillary, mediastinal lymphadenopathy. The lungs are clear. No pleural effusion. No pneumothorax. Central airways are patent. Abdomen/Pelvis: Mixed response of the hepatic metastatic lesions with increase in size of some lesions and decrease in size of others. For example, a hepatic segment 6 lesion is increased in size and measures 3.7 x 2.8 cm, previously measuring 2.2 cm (series 2, image 161). A left lateral hepatic lesion is decreased in size, currently measuring 1.2 cm, previously 2.4 cm (series 2, image 137). No definite new liver lesion is seen. Trace perihepatic fluid and capsular retraction of the right hemiliver. Normal gallbladder. No biliary ductal dilatation. Normal spleen, pancreas, and adrenal glands. Normal kidneys. Mild bladder wall thickening, similar to prior, which may be secondary to bladder outflow obstruction obstruction given the mild prostatomegaly. Symmetric mural calcifications of the ductus deferens, likely related to diabetes. Increase in size of multiple peritoneal and omental deposits. For example, a deposit of the inferior aspect of the right lower quadrant ileostomy measures 2.6 x 2.2 cm. Increase in an adjacent omental deposit that measures 1.4 cm, previously 2.7 cm (series 2, image 188). Multiple foci of nodularity along both paracolic gutters, overall similar in size to prior. Postoperative changes of right lower quadrant ileostomy. Interval resolution of previously seen small bowel obstruction no dilated loops of bowel. Multiple small subcentimeter short axis retroperitoneal lymph nodes, unchanged in size from prior. No free air. No suspicious osseous lesion.

Impression: Right lower quadrant anterior abdominal wall hernia at the site of the previous ileostomy with multiple dilated loops of bowel proximal to the hernia sac and decompressed terminal ileum distal to the hernia sac with a stool containing colon. Findings are concerning for a partial small bowel obstruction.
Findings: Evolving peripheral wedge-shaped consolidation in the right lower lobe, compatible with an evolving infarct. New small bilateral pleural effusions. Normal heart size. Moderate coronary artery calcifications. No pericardial effusion. There is new extensive subcutaneous air tracking from the right lateral abdominal wall to the right suprapubic region and right perineum. The greatest volume of subcutaneous gas is in the right suprapubic region. There is associated diffuse body wall edema. There is a gastrostomy tube that terminates in the stomach with the balloon in the expected position. There is a small amount of gas along the tract of the gastrostomy tube, however, the extensive subcutaneous emphysema is distinct from the gastrostomy tube and on the right side. No discrete fluid collection is seen. Metallic biliary stent in place. Pneumobilia, similar to prior. No focal liver lesion is seen. Normal spleen and adrenal glands. Coarse calcifications of the pancreas, keeping with chronic pancreatitis. No hydronephrosis or nephrolithiasis. Normal appearance of the urinary bladder. Fibroid uterus. Postsurgical changes of bowel resection and anastomosis in the pelvis. No evidence of bowel obstruction. Diffuse mesenteric edema, new from prior. No definite free fluid. No free intraperitoneal air. Tortuous abdominal aorta with severe atherosclerotic calcifications. No definite lymphadenopathy in the abdomen or pelvis. Unchanged right thigh intramuscular lipoma. No suspicious lytic or blastic osseous lesion.

Impression: 1. Distended Indiana pouch without evidence of surrounding inflammatory changes. Normally enhancing transplant kidney without hydronephrosis. No evidence of a subcutaneous or intra-abdominal abscess. 2. Geographic hyperenhancement of hepatic segment 6 with associated intrahepatic biliary ductal dilatation, in keeping with segmental cholangitis as was seen on the MRI dated 09/13/2022. 3. Redemonstrated findings of caudal regression and left-sided heterotaxy.
Findings: Imaged lung bases are clear. No pleural effusion. Normal heart size without pericardial effusion. Interval placement of a plastic biliary stent with improved but persistent mild intra and extrahepatic biliary ductal dilatation. No focal liver lesion. Normal gallbladder. Calcified granulomas of the spleen, which is otherwise normal. Normal adrenal glands. No discrete mass is seen in the periampullary region or pancreas. Fatty replacement of the pancreas. No main pancreatic ductal dilatation. Small subcentimeter periportal lymph nodes, unchanged in size compared to prior. For example a 6 mm short axis periportal lymph node is unchanged from prior (series 4, image 61). No pathologically enlarged lymph nodes in the abdomen. Small hiatal hernia. No dilated loops of bowel in the imaged abdomen. 3 mm nonobstructive left kidney lower pole stone. No hydronephrosis. Kidneys enhance symmetrically. No suspicious osseous lesion.

Impression: 1. Waxing and waning groundglass opacities in both lungs, most compatible with an atypical infectious process. 2. Unchanged multiple small mediastinal lymph nodes, which may be reactive in the setting of an infectious process or be secondary to the patient's chronic lymphocytic lymphoma.
Findings: Imaged lung bases are clear. No pleural effusion. Normal heart size without pericardial effusion. There is a right lower quadrant anterior abdominal wall hernia at the site of the previous ileostomy containing loops of bowel including the ileal anastomosis. There are multiple dilated loops of bowel proximal to the hernia sac and in the left hemiabdomen. The terminal ileum is decompressed. The colon is stool containing. The findings can be seen best on series 2, image 102. Small fat-containing umbilical hernia with a small amount of fluid. The fluid is new from prior. Small-to-moderate sized hiatal hernia. Normal noncontrast appearance of the liver. Normal gallbladder, spleen, pancreas, and adrenal glands. No hydronephrosis or nephrolithiasis. Urinary bladder is decompressed. Uterus is absent. Normal caliber abdominal aorta. No free fluid. No free air. No lymphadenopathy in the abdomen or pelvis. Right hip arthroplasty. No suspicious lytic or blastic osseous lesion. Multilevel degenerative changes of the spine.

Impression: 1. Short segment benign appearing stricture of the proximal sigmoid colon with fluid filled colon proximally and relatively decompressed distal sigmoid colon. 2. Multiple colonic diverticula, most pronounced in the sigmoid colon, without evidence of active inflammation to suggest acute diverticulitis.
Findings: Mild bibasilar atelectasis. No pleural effusion. Normal heart size without pericardial effusion. Partially imaged pacemaker leads. Bilateral breast implants is unchanged small amount of fluid along the undersurface of the right breast implant. Geographic hyperenhancement of hepatic segment 6 with associated biliary ductal dilatation, in keeping with changes of subsegmental cholangitis as was seen on MRI dated 09/13/2022. Moderate amount of pneumobilia, similar to prior. Status post cholecystectomy. Polysplenia. Fatty replacement of the pancreas. Normal adrenal glands. Atrophic bilateral native kidneys. Hydroureteronephrosis of the native kidneys, similar to prior. Right lower quadrant transplant kidney enhances normally without hydronephrosis or nephrolithiasis. Distended Indiana pouch without surrounding stranding or wall thickening. No evidence of a subcutaneous or intra-abdominal abscess. Postoperative changes of partial colectomy and end colostomy. Hartmann pouch. Normal stomach and duodenal sweep. No evidence of bowel obstruction. Interrupted anterior vena cava with azygos continuation. Abdominal aorta is normal in caliber. No free fluid. No free air. No lymphadenopathy in the abdomen or pelvis. Unchanged dysmorphic appearance of the pelvis, keeping with caudal regression syndrome.

Impression: Colonic diverticulosis without diverticulitis.
Findings: Chest: Interval resolution of the previously seen left upper lobe groundglass opacities. There are new groundglass opacities in the right lower lobe and left lower lobe. Mild bibasilar atelectasis. No pleural effusion. No pneumothorax. Normal heart size without pericardial effusion. Multiple small mediastinal and right hilar lymph nodes, unchanged in size compared to prior. A right hilar lymph node measures 12 mm in short axis diameter, unchanged from prior. No supraclavicular or axillary lymphadenopathy. Abdomen/Pelvis: Normal liver, gallbladder, spleen, pancreas, and adrenal glands. Normal kidneys. Normal urinary bladder. Normal prostate. Colonic diverticulosis without diverticulitis. Normal appendix. No evidence of bowel obstruction. No lymphadenopathy in the abdomen or pelvis. No free fluid. No free air. Normal caliber abdominal aorta with mild atherosclerotic calcifications. Portal veins are patent. No suspicious osseous lesion.

Impression: 1. Increase in size in hepatic metastatic lesions with new left portal vein thrombus, which may be due to tumor thrombus. 2. Increased peritoneal carcinomatosis and increased in size in right iliac lymphadenopathy. 3. Small volume ascites, similar to slightly increased compared to prior. The size may be due to worsening liver function and left portal vein thrombosis or a peritoneal carcinomatosis. Additionally, there is increased diffuse body wall edema.
Findings: Lung bases are clear. No pleural effusion. Normal heart size without pericardial effusion. Normal liver, gallbladder. No biliary ductal dilatation. Calcified granulomas of the spleen, which is otherwise normal. Normal pancreas and adrenal glands. Left kidney interpolar region exophytic simple cyst. No hydronephrosis or nephrolithiasis. Normal urinary bladder. Prostate is absent. Fluid is seen throughout the colon to the level of the proximal sigmoid colon where there is a short segment stricture that measures approximately 1.5 cm in length (series 4, image 34). The distal sigmoid colon is relatively decompressed. There are multiple colonic diverticula, most pronounced in the sigmoid colon, but without evidence of active inflammation to suggest acute diverticulitis. Small hiatal hernia. Ectasia of the infrarenal abdominal aorta measuring up to 2.9 cm. Portal veins are patent. No free fluid. No free air. No lymphadenopathy in the abdomen or pelvis. Surgical clips in the bilateral external iliac regions, which may related to lymph node dissection from a prostatectomy. No suspicious osseous lesion.

Impression: 1. Perforated sigmoid diverticulitis with an adjacent 2.6 x 1.4 cm fluid and gas collection consistent with an abscess. The cecum and appendix appear tethered to the area of diverticulitis with surrounding inflammation.
Findings: No focal consolidation of the lung bases. No pleural effusion. Normal heart size without pericardial effusion. Normal liver, gallbladder. No biliary ductal dilatation. Calcified granulomas in the spleen, which is otherwise normal. Normal pancreas and adrenal glands. Normal kidneys. Decompressed urinary bladder. Uterus and adnexa are absent. Colonic diverticulosis without evidence of diverticulitis. The diverticulosis is most pronounced in the sigmoid colon. Fatty replacement of the appendix, which is otherwise normal. No evidence of bowel obstruction. Normal stomach and duodenal sweep. Normal caliber abdominal aorta with mild atherosclerotic calcifications. Veins are patent. No free fluid. No free air. No lymphadenopathy in the abdomen or pelvis. No suspicious osseous lesion.

Impression: 1. Findings concerning for a partial small bowel obstruction with distortion of the mesentery and multiple loops associated of pseudo feces containing small bowel in the midabdomen. There is may be due to an adhesion. Surgical consultation is recommended. There is a 2.5 cm collection containing air and pseudo-feces adjacent to the small bowel re-anastomosis which is favored to represent a diverticulum versus less likely a contained perforation.
Findings: Chest: Right internal jugular chest port catheter terminating in the superior cavoatrial junction. Normal heart size. No mediastinal or axillary lymphadenopathy. Small subcentimeter left supraclavicular lymph nodes, unchanged in size compared to prior. Mild bibasilar atelectasis. No suspicious pulmonary nodules. No pneumonic consolidation. No pleural effusion or pneumothorax. Abdomen/Pelvis: Increased in size of the confluence heterogenous hepatic metastases that replaces the majority of the right hemiliver measures up to 24.8 x 14.1 x 27 cm. Increase in size of a mass in the left lateral liver that measures up to 7.7 x 5.8 cm. There is left portal vein thrombosis, new from prior, which may be due to tumor thrombus. The right portal vein is markedly compressed as it appears patent. Cholelithiasis without cholecystitis. No biliary ductal dilatation. There is peritoneal carcinomatosis, increased from prior. For example a 13 mm peritoneal deposit along the splenic flexure is increased in size to prior (series 2, image 177). There is small volume ascites, similar to slightly increased from prior. There is a soft tissue attenuation mass along the right external iliac artery, right representing right iliac lymphadenopathy has increased in size from prior and measures up to 4.0 x 3.0 cm (series 2, image 238). Normal spleen, pancreas, and adrenal glands. Normal kidneys and urinary bladder. Status post hysterectomy. No evidence of bowel obstruction. Mild diffuse body wall edema, increased from prior. No suspicious osseous lesion is seen.

Impression: 1. 4 mm stone located either in the bladder at the right ureterovesical junction with mild right hydroureteronephrosis and mild stranding surrounding the right-sided ureter. This may represent findings of recent stone passage with inflammatory changes or an obstructing stone at the right ureterovesical junction. Additionally, there are multiple right-sided nonobstructing stones, the largest of which is in the right kidney upper pole and measures 5 mm.
Findings: Mild bibasilar atelectasis. No pleural effusion. Normal heart size. Mild diffuse hepatic steatosis unchanged. Normal gallbladder. No biliary ductal dilatation. Normal spleen, pancreas, and adrenal glands. Normal kidneys. Normal urinary bladder. There is perforated sigmoid diverticulitis with an adjacent pericolonic gas and fluid collection measuring 2.6 x 1.4 cm. There is tethering of the cecum and appendix with surrounding inflammatory changes. There are multiple small cystic lesions in the cervix, likely representing nabothian cysts. No evidence of bowel obstruction. Normal caliber abdominal aorta. Portal veins are patent. No lymphadenopathy in the abdomen or pelvis. No suspicious osseous lesion. No acute fracture is seen.

Impression: No acute process in the abdomen or pelvis.
Findings: Small cyst in the inferior right liver. No other focal liver lesion. Normal gallbladder. No biliary ductal dilatation. Normal spleen, pancreas, and adrenal glands. Normal kidneys. Normal urinary bladder. There is distortion of the mesentery in the midabdomen with findings concerning for a partial small bowel obstruction. There are multiple loops of small bowel with pseudo feces in this area. There is mild mesenteric stranding and small mesenteric lymph nodes in this area. There is a 2.5 cm collection that contains air and pseudo feces which is favored to represent a small bowel diverticulum versus less likely contained perforation. Continuity with an adjacent bowel loop can be seen on series 4, image 33. There are no surrounding inflammatory changes. Colonic diverticulosis. Normal stomach and duodenal sweep. Normal caliber abdominal aorta. Portal, splenic, and superior mesenteric veins are patent. No suspicious osseous lesion.

Impression: 1. Periportal edema and mild generalized peritoneal inflammation with small volume ascites in the pelvis as well as the hepatorenal fossa. Findings could be seen with a pelvic inflammatory disease or acute hepatitis. Can consider correlation with gynecologic exam. 2. Left corpus luteum cyst. No evidence of a tubo-ovarian abscess.
Findings: The lung bases are clear. No pleural effusion. Normal heart size. Normal noncontrast appearance of the liver. Normal gallbladder, spleen, pancreas, and adrenal glands. There is a 4 mm stone either in the urinary bladder floor at the right ureterovesical junction. There is mild right hydronephrosis with stranding surrounding the right collecting system. There are multiple right-sided nonobstructing stones. The largest of which is in the superior pole of the right kidney and measures 5 mm. There are multiple right simple renal cysts and a few hyperdense hemorrhagic/proteinaceous cysts. Normal left kidney and left ureter. No evidence of bowel obstruction. Normal appendix. No free fluid. No free air. Normal caliber abdominal aorta. No lymphadenopathy in the abdomen or pelvis. No suspicious osseous lesion. No acute fracture is seen.

Impression: Stable diffuse sclerotic osseous metastatic disease. No evidence of visceral metastatic disease in the chest, abdomen, or pelvis.
Findings: Mild left basilar atelectasis. No pleural effusion. Normal heart size without pericardial effusion. Normal liver, gallbladder, spleen, pancreas, and adrenal glands. Multiple small cysts of both kidneys into small to characterize lesions bilaterally, likely cysts as well. No hydronephrosis. Kidneys enhance symmetrically. Normal urinary bladder. Mild colonic diverticulosis without diverticulitis. No evidence of bowel obstruction. Normal appendix. Normal stomach and duodenal sweep. Normal caliber abdominal aorta. Portal veins are patent. No free fluid. No free air. No suspicious osseous lesion. No acute fracture is seen.

Impression: 1. Pulmonary embolism in the right upper lobe pulmonary artery extending into segmental branches and the left upper lobe pulmonary artery extending to the segmental branches. No CT evidence of right heart strain. 2. New moderate right pleural effusion with pleural nodularity, consistent with a malignant pleural effusion. 3. Interval placement of a left pleural catheter with decrease in a small left pleural effusion but with increased left pleural nodularity 4. Stable to slight increase in a right superficial breast mass. Stable mediastinal lymphadenopathy. The Critical results were discussed with Gibson M.D. by Kapoor M.D. on 01/09/2023 at 1:54 PM.