Likely CLL assess for lymphadenopathy. CHEST:LUNGS AND PLEURA: Two small nodules posteriorly in both lower lobes, on the left about 6 mm in diameter image 53/130 and on the right smaller, image 66/130.MEDIASTINUM AND HILA: One or two upper normal sized mediastinal lymph nodes but no extensive intrathoracic lymphadenopathy.CHEST WALL: Extensive bilateral axillary lymphadenopathy is present. A representative left axillary lymph node is about 3.3 x 1.9 cm image 21/163.ABDOMEN:LIVER, BILIARY TRACT: Less than 5-mm hepatic cyst like hypodensity in the dome of the liver, and the patient has undergone cholecystectomy.SPLEEN: The spleen may be slightly large.KIDNEYS, URETERS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedPANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal and mesenteric lymphadenopathy.BOWEL, MESENTERY: Extensive mesenteric lymphadenopathy noted above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1 Extensive axillary, mesenteric and retroperitoneal lymphadenopathy, sparing the mediastinum and hila; this is consistent with the provided diagnosis of CLL.2. Two small pulmonary nodules discussed above, for which a one year follow up is recommended or follow-up as part of the patient's other treatment.