63-year-old male with head and neck cancer. Compare previous. Measurements for IRB 10334. CHEST:LUNGS AND PLEURA: Mild paraseptal emphysema as seen previously. Trace pleural fluid. Mild pleural thickening consistent with tumor at the level of the right ninth rib metastasis, including a more nodular area of thickening (series 6 and image 62) that is more prominent than on prior study and is FDG avid on PET/CT performed on the same date (please refer to report for that exam).MEDIASTINUM AND HILA: Reference precarinal lymph node (series 4, image 41) measures 10 x 6 mm (stable). Mild cardiomegaly without pericardial effusion.CHEST WALL: Lucency at the sternomanubrial region (series 4, image 25) is new since prior study and is FDG avid on PET/CT performed the same date.Right ninth rib metastasis (series 4, image 66) measures 31 x 13 mm; previously measuring 46 x 22 mm. A new small lytic metastasis is seen medially at the right ninth rib fractures 4, image 60).Healing right eighth rib fracture, unchanged.Right chest port catheter with catheter tip near SVC/RA junction.ABDOMEN: LIVER, BILIARY TRACT: 1 cm hypoattenuating lesion in segment 8 is unchanged. No FDG uptake is seen on PET/CT performed on the same date.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the descending aorta and iliac arteries. Chronic dissection and stenosis of the right common iliac artery.BOWEL, MESENTERY: Gastrostomy tube in expected location.BONES, SOFT TISSUES: No significant abnormality noted.
1. New lytic metastasis in the left manubrium.2. Nodular right pleural thickening posteriorly at the level of the right ninth rib metastasis has increased since prior study and is consistent with tumoral involvement.3. Continued decrease in reference measurements in the right ninth rib metastasis and index precarinal lymph nodee. However, there is a new small lytic lesion in the medial aspect of the right rib adjacent to the pleural reaction.