70 year-old male with metastatic gastric cancer with esophageal stricture. Evaluate GE junction prior to endoscopic stent placement for esophageal stricture. CHEST:LUNGS AND PLEURA: Interval development of small left pleural effusion with overlying atelectasis. Apical scarring. Scattered pleural nodular calcifications on the left side are unchanged. Scattered micronodules are also unchanged.MEDIASTINUM AND HILA: Previously measured cardiophrenic lymph node is slightly larger, measuring 14 x 7 mm (image 75 series 3), previously 6 x 5 mm image. Diffuse circumferential thickening of the distal esophagus is consistent with esophageal stricture (image 75 series 3).CHEST WALL: Degenerative changes in the spine without suspicious lesion.ABDOMEN: Streak artifact from residual high density barium limits evaluation of the abdomen.LIVER, BILIARY TRACT: Known hemangioma in the left lobe unchanged. Subcentimeter cysts in the left lobe unchanged. No focal lesions in the liver suspicious for metastatic disease.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal and perigastric adenopathy appears stable. Reference left para-aortic lymph node again measures 18 x 15 mm (image 114 series 3), unchanged. BOWEL, MESENTERY: Stable diffuse thickening of the gastric wall consistent with patient's known malignancy. Stable reference full-thickness of gastric wall at the site similar to previously measured is 3.2 cm (image 102 series 3), previously 3.1 cm.Previously mentioned nodular lesions in the peritoneum adjacent to stomach likely representing peritoneal carcinomatosis are less well visualized now. Reference lesion is not clearly visualized.Ascites has increased significantly increased compared to previous study. Nodular soft tissue density representing peritoneal carcinomatosis is stable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1. Interval development of distal esophageal stricture. 2. Interval increase in cardiophrenic lymph node and ascites. 3. Otherwise, stable intraperitoneal disease.