63-year-old male with history of metastatic thyroid cancer CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary nodules have not significantly changed. Reference left lower lobe nodule measures 13 x 10 mm (series 4; image 60), unchanged. A small left pleural effusion is identified, mildly increased in size. Small enhancing lesion along the left visceral pleura is seen (for example, series 3; image 90), compatible with metastatic disease.MEDIASTINUM AND HILA: A surgical clip in enhancing soft tissue lesion is seen in the region of a unopacified right internal jugular vein, unchanged.Anterior mediastinal lymph node measuring 2.4 x 1.6 cm (series 2; image 28), previously 2.4 x 1.8 cm. Paratracheal lymph node measures 2.3 x 1.6 cm (series 3; image 29), previously 2.4 x 1.7 cm. Reference subcarinal lymph node measures 2.2 x 1.6 cm (series 3; mid 46), previously 2.0 x 1.6 cm. Bilateral hilar and paraspinal adenopathy/lesions are identified, not significantly changed.Hiatal hernia.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Small nonspecific lesions at the dome of the liver (series 3; images 76 and 80), not significantly changed.Cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst. Other subcentimeter hypodensities in the kidney are too small to definitely characterize, but likely cysts.RETROPERITONEUM, LYMPH NODES: Small mesenteric lymph nodes with hazy mesentery are seen, not significantly changed.BOWEL, MESENTERY: Small duodenal diverticulum, air-filled.BONES, SOFT TISSUES: Soft tissue metastases along the posterior abdominal wall adjacent to the right 11th and 12th ribs remain (series 3; image 108)OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mild diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
No significant change in the diffuse metastatic disease.