59-year-old female with a lytic lesions concerning for malignancy CHEST:LUNGS AND PLEURA: Bilateral pleural effusions and dependent atelectasis. Pleural effusions have increased in sizeMEDIASTINUM AND HILA: Cardiomegaly. Bilateral thyroid nodules. Tubular fat density structure along the proximal and mid esophagus it is indeterminate etiology but may represent a lipoma.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter focal lesions, too small to accurate characterize but are more likely to be cysts.High density material within the gallbladder likely representing stones. Gallbladder mass cannot be entirely excluded and ultrasound may be helpful for further evaluation of the gallbladder. Proximal common bile duct is mildly dilated measuring 11 mm. Distal common bile duct is normal in size.SPLEEN: 13 x 10 mm cyst is unchanged. Multiple other, smaller, subcentimeter hypodense lesions in the spleen are better seen on today's contrast enhanced study. Their etiology is unknown.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral atrophic kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: A 3.8 x 3.1 cm adenopathy in the left obturator region on image number 17/205. On the right side there is also fullness in the right obturator region with ill-defined soft tissue density likely representing adenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Fracture of the left ischial bone and pubic bone as well as the mildly displaced left iliac bone fracture.OTHER: A small amount of free fluid in the pelvis.
Left-sided pelvic fractures as described above. Bilateral obturator adenopathy.Possible lipoma in the esophagus.Indeterminate splenic lesions.Ultrasound a helpful for further evaluation of the gallbladder.