45-year-old female with history of breast cancer status post radiation, chemo, and right mastectomy presents with seizure and newly discovered lung nodule, MR of the brain is suspicious for metastatic disease (information obtained from EPIC) CHEST:LUNGS AND PLEURA: Post radiation changes in the right apex. Subsegmental atelectasis associated with areas of groundglass opacities and septal thickening are noted in right middle lobe and right upper lobe.Right lower lobe solid lung nodule measuring 11.2 x 11 .5 mm (series 4 image 158).MEDIASTINUM AND HILA: Significant mediastinal lymphadenopathy including right hilar, subcarinal, and peritracheal associated with center hypoattenuation suggestive of necrosis.Right hilar lymphadenopathy measuring 33.8 x 30.7mm compressing the right upper lobe bronchus (series 3 image 41).Right hilar lymphadenopathy measuring 29.9 x 21 .5 mm compressing the right middle bronchus (series 3 image 39).CHEST WALL: Postsurgical changes post known history of right mastectomy and reconstruction surgery are noted. Right axillary surgical clips are noted. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.LYMPH NODES: No abnormal lymphadenopathy is identified within abdomen or pelvis.VASCULATURE: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:REPRODUCTIVE TRACT: Intrauterine device is seen in the uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1.Subcarinal, pretracheal, and right hilar with compression of right upper and middle lobe main stem bronchi associated with ground glass opacities and subsegmental atelectasis in right upper and middle lobes as detailed above. 2.Right lower lobe solid nodule.3.Constellation of findings highly suspicious of metastatic disease.