. Technically adequate examination. No evidence of acute pulmonary embolism. Markedly attenuated right main pulmonary artery into a mediastinal soft tissue mass with no contrast opacification identified peripherally within the right lung. Main pulmonary artery is normal in caliber. No evidence of right heart strain. Narrowing of the right mainstem bronchus and anterior and posterior segmental bronchi of the right upper lobe by a mediastinal soft tissue mass. Chronic interstitial disease with diffuse severe right-sided bronchial wall thickening. Extensive fibrotic changes and traction bronchiectasis involving the right middle lobe. Pleural thickening in the right hemithorax with associated very small right-sided pleural effusion. Right upper lobe solid nodule with indistinct margins measures 11 x 11 mm. Additional anterior solid sharply marginated right upper lobe nodule measures 5 mm. Pulmonary nodules are most likely related to underlying inflammatory process. Cardiac size is mildly enlarged without significant pericardial effusion. Aorta is normal in caliber. Soft tissue mass with irregular margins and internal calcifications in the middle mediastinum extending from the thoracic inlet to the subcarinal or right hilar area most consistent with conglomerate lymphadenopathy. The mass measures 46 x 58 mm causing narrowing of the right mainstem bronchus, attenuation of the right main pulmonary artery and pulmonary veins, and obstruction of the SVC with multiple collaterals. Mediastinal fat extends inferior into the mass and there is a question of lipomatous hypertrophy extending into the right atrium. Additional soft tissue density in the superior mediastinum is likely contiguous with the mass measuring 23 x 25 mm encasing the origin of the brachiocephalic and left common carotid arteries. Multiple small and large mediastinal lymph nodes. Enlarged cardiophrenic lymph nodes. Small left-sided Bochdalek hernia. None. Bilateral prominent supraclavicular lymph nodes are noted. Enlarged bilateral subpectoral lymph nodes. Mild to moderate degenerative changes of the thoracic spine. Well-circumscribed sclerotic focus in T11 and T12 vertebral bodies which may represent bone islands. Absence of enteric contrast material markedly limits sensitivity abdominal pathology. No significant abnormality noted.
clinical findings_fin: {'acute pulmonary embolism': {'clinical finding': 'acute pulmonary embolism', 'cf_snomed': {'acute pulmonary embolism': 706870000}, 'existence': 'neg_dx', 'descriptive_term': 'acute pulmonary', 'observation': 'embolism', 'strength_term': 'acute', 'temporal_term': 'acute'}}anatomical entity_fin: {'main pulmonary artery': {'location descriptor': 'right'}, 'right lung': {}}location descriptor_fin: ['right']clinical findings_fin: {'markedly attenuated': {'clinical finding': 'markedly attenuated', 'existence': 'pos_dx', 'descriptive_term': 'markedly', 'observation': 'attenuated'}, 'mediastinal soft tissue mass': {'clinical finding': 'mediastinal soft tissue mass', 'cf_snomed': {'soft tissue mass': 278002000}, 'existence': 'pos_dx', 'descriptive_term': 'mediastinal soft tissue', 'observation': 'mass'}, 'contrast opacification': {'clinical finding': 'contrast opacification', 'existence': 'neg_dx', 'descriptive_term': 'contrast', 'observation': 'opacification'}}anatomical entity_fin: {'main pulmonary artery': {}}clinical findings_fin: {'main pulmonary artery is normal in caliber': {'clinical finding': 'main pulmonary artery is normal in caliber'}}anatomical entity_fin: {'heart': {'location descriptor': 'right'}}location descriptor_fin: ['right']clinical findings_fin: {'right heart strain': {'clinical finding': 'right heart strain', 'existence': 'neg_dx', 'descriptive_term': 'right heart', 'observation': 'strain'}}anatomical entity_fin: {'bronchus': {}, 'lobe': {'location descriptor': 'right upper'}}location descriptor_fin: ['right', 'anterior', 'posterior', 'upper']clinical findings_fin: {'narrowing': {'clinical finding': 'narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'observation': 'narrowing'}, 'mediastinal soft tissue mass': {'clinical finding': 'mediastinal soft tissue mass', 'cf_snomed': {'soft tissue mass': 278002000}, 'existence': 'pos_dx', 'descriptive_term': 'mediastinal soft tissue', 'observation': 'mass'}}location descriptor_fin: ['right']clinical findings_fin: {'chronic interstitial disease': {'clinical finding': 'chronic interstitial disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'chronic interstitial', 'observation': 'disease', 'temporal_term': 'chronic'}, 'diffuse severe right-sided bronchial wall thickening': {'clinical finding': 'diffuse severe right-sided bronchial wall thickening', 'existence': 'pos_dx', 'descriptive_term': 'diffuse severe right-sided bronchial wall', 'observation': 'thickening', 'strength_term': 'severe'}}anatomical entity_fin: {'middle': {'location descriptor': 'right'}, 'lobe': {}}location descriptor_fin: ['right']clinical findings_fin: {'extensive fibrotic changes': {'clinical finding': 'extensive fibrotic changes', 'existence': 'pos_dx', 'descriptive_term': 'extensive fibrotic', 'observation': 'change', 'strength_term': 'extensive'}, 'traction bronchiectasis': {'clinical finding': 'traction bronchiectasis', 'cf_snomed': {'traction bronchiectasis': 19325002}, 'existence': 'pos_dx', 'descriptive_term': 'traction', 'observation': 'bronchiectasis'}}anatomical entity_fin: {'right hemithorax': {}}location descriptor_fin: ['right']clinical findings_fin: {'pleural thickening': {'clinical finding': 'pleural thickening', 'existence': 'pos_dx', 'descriptive_term': 'pleural', 'observation': 'thickening'}, 'associated very small right-sided pleural effusion': {'clinical finding': 'associated very small right-sided pleural effusion', 'cf_snomed': {'pleural effusion': 60046008}, 'existence': 'pos_dx', 'descriptive_term': 'associated very small right-sided pleural', 'observation': 'effusion', 'strength_term': 'small'}}size_fin: [{'size': '11 x 11 mm', 'size_descriptor': 'nodule'}]anatomical entity_fin: {'lobe': {'location descriptor': 'right upper'}}imaging observation_fin: ['indistinct margins']location descriptor_fin: ['right', 'upper']clinical findings_fin: {'right upper lobe solid nodule': {'clinical finding': 'right upper lobe solid nodule', 'cf_snomed': {'nodule': 27925004}, 'existence': 'pos_dx', 'descriptive_term': 'right upper lobe solid', 'observation': 'nodule'}}size_fin: [{'size': '5 mm', 'size_descriptor': 'nodule'}]anatomical entity_fin: {'lobe': {'location descriptor': 'right upper'}}location descriptor_fin: ['anterior', 'right', 'upper']clinical findings_fin: {'additional anterior solid sharply marginated right upper lobe nodule': {'clinical finding': 'additional anterior solid sharply marginated right upper lobe nodule', 'cf_snomed': {'nodule': 27925004}, 'existence': 'pos_dx', 'descriptive_term': 'additional anterior solid sharply marginated right upper lobe', 'observation': 'nodule'}}clinical findings_fin: {'pulmonary nodules': {'clinical finding': 'pulmonary nodules', 'cf_snomed': {'nodule': 27925004}, 'existence': 'unc_dx', 'descriptive_term': 'pulmonary', 'observation': 'nodule'}}clinical findings_fin: {'enlarged': {'clinical finding': 'enlarged', 'existence': 'pos_dx', 'observation': 'enlarged'}, 'significant pericardial effusion': {'clinical finding': 'significant pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'neg_dx', 'descriptive_term': 'significant pericardial', 'observation': 'effusion'}}anatomical entity_fin: {'aorta': {}}clinical findings_fin: {'aorta is normal in caliber': {'clinical finding': 'aorta is normal in caliber'}}anatomical entity_fin: {'middle': {}, 'mediastinum': {}, 'thoracic inlet': {}}imaging observation_fin: ['irregular margins']location descriptor_fin: ['right']clinical findings_fin: {'soft tissue mass': {'clinical finding': 'soft tissue mass', 'cf_snomed': {'soft tissue mass': 278002000}, 'existence': 'pos_dx', 'descriptive_term': 'soft tissue', 'observation': 'mass'}, 'internal calcifications': {'clinical finding': 'internal calcifications', 'existence': 'pos_dx', 'descriptive_term': 'internal', 'observation': 'calcification'}, 'conglomerate lymphadenopathy': {'clinical finding': 'conglomerate lymphadenopathy', 'cf_snomed': {'lymphadenopathy': 30746006}, 'existence': 'pos_dx', 'descriptive_term': 'conglomerate', 'observation': 'lymphadenopathy'}}size_fin: [{'size': '46 x 58 mm', 'size_descriptor': 'mass'}]anatomical entity_fin: {'bronchus': {}, 'main pulmonary artery': {'location descriptor': 'right'}, 'pulmonary veins': {}}location descriptor_fin: ['right']clinical findings_fin: {'mass': {'clinical finding': 'mass', 'existence': 'pos_dx', 'observation': 'mass'}, 'narrowing': {'clinical finding': 'narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'observation': 'narrowing'}, 'obstruction': {'clinical finding': 'obstruction', 'cf_snomed': {'obstruction': 26036001}, 'existence': 'pos_dx', 'observation': 'obstruction'}, 'multiple collaterals': {'clinical finding': 'multiple collaterals', 'existence': 'pos_dx', 'descriptive_term': 'multiple', 'observation': 'collateral', 'quantity_term': 'multiple'}}anatomical entity_fin: {'right atrium': {}}imaging observation_fin: ['fat']location descriptor_fin: ['inferior']clinical findings_fin: {'mediastinal fat': {'clinical finding': 'mediastinal fat', 'existence': 'pos_dx', 'descriptive_term': 'mediastinal', 'observation': 'fat'}, 'mass': {'clinical finding': 'mass', 'existence': 'pos_dx', 'observation': 'mass'}, 'lipomatous hypertrophy': {'clinical finding': 'lipomatous hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'unc_dx', 'descriptive_term': 'lipomatous', 'observation': 'hypertrophy'}}size_fin: [{'size': '23 x 25 mm', 'size_descriptor': 'density'}]anatomical entity_fin: {'superior mediastinum': {}, 'origin': {}, 'common carotid arteries': {'location descriptor': 'left'}}imaging observation_fin: ['soft tissue density']location descriptor_fin: ['left']clinical findings_fin: {'additional soft tissue density': {'clinical finding': 'additional soft tissue density', 'existence': 'pos_dx', 'descriptive_term': 'additional soft tissue', 'observation': 'density'}, 'mass': {'clinical finding': 'mass', 'existence': 'pos_dx', 'observation': 'mass'}, 'brachiocephalic': {'clinical finding': 'brachiocephalic', 'existence': 'pos_dx', 'observation': 'brachiocephalic'}}anatomical entity_fin: {'mediastinal lymph nodes': {}}clinical findings_fin: {'multiple small and large mediastinal lymph nodes': {'clinical finding': 'multiple small and large mediastinal lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'multiple small and large mediastinal lymph', 'observation': 'node', 'strength_term': 'small - large', 'quantity_term': 'multiple'}}clinical findings_fin: {'enlarged cardiophrenic lymph nodes': {'clinical finding': 'enlarged cardiophrenic lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'enlarged cardiophrenic lymph', 'observation': 'node', 'strength_term': 'enlarged', 'change_term': 'enlarged'}}location descriptor_fin: ['left']clinical findings_fin: {'small left-sided bochdalek hernia': {'clinical finding': 'small left-sided bochdalek hernia', 'cf_snomed': {'hernia': 414403008}, 'existence': 'pos_dx', 'descriptive_term': 'small left-sided bochdalek', 'observation': 'hernia', 'strength_term': 'small'}}anatomical entity_fin: {'supraclavicular lymph nodes': {}}location descriptor_fin: ['bilateral']clinical findings_fin: {'bilateral prominent supraclavicular lymph nodes': {'clinical finding': 'bilateral prominent supraclavicular lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'bilateral prominent supraclavicular lymph', 'observation': 'node', 'strength_term': 'prominent'}}location descriptor_fin: ['bilateral']clinical findings_fin: {'enlarged bilateral subpectoral lymph nodes': {'clinical finding': 'enlarged bilateral subpectoral lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'enlarged bilateral subpectoral lymph', 'observation': 'node', 'strength_term': 'enlarged', 'change_term': 'enlarged'}}anatomical entity_fin: {'spine': {}}clinical findings_fin: {'mild to moderate degenerative changes': {'clinical finding': 'mild to moderate degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'mild to moderate degenerative', 'observation': 'change', 'strength_term': 'mild - moderate'}}anatomical entity_fin: {'t12 vertebral bodies': {}, 'bone': {}}clinical findings_fin: {'well-circumscribed sclerotic focus': {'clinical finding': 'well-circumscribed sclerotic focus', 'existence': 'pos_dx', 'descriptive_term': 'well-circumscribed sclerotic', 'observation': 'focus'}}anatomical entity_fin: {'abdominal': {}}clinical findings_fin: {'enteric contrast': {'clinical finding': 'enteric contrast', 'existence': 'neg_dx', 'descriptive_term': 'enteric', 'observation': 'contrast'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}
<s>[INST] Write the finding section for a radiology report based on the following information: clinical findings_fin: {'acute pulmonary embolism': {'clinical finding': 'acute pulmonary embolism', 'cf_snomed': {'acute pulmonary embolism': 706870000}, 'existence': 'neg_dx', 'descriptive_term': 'acute pulmonary', 'observation': 'embolism', 'strength_term': 'acute', 'temporal_term': 'acute'}}anatomical entity_fin: {'main pulmonary artery': {'location descriptor': 'right'}, 'right lung': {}}location descriptor_fin: ['right']clinical findings_fin: {'markedly attenuated': {'clinical finding': 'markedly attenuated', 'existence': 'pos_dx', 'descriptive_term': 'markedly', 'observation': 'attenuated'}, 'mediastinal soft tissue mass': {'clinical finding': 'mediastinal soft tissue mass', 'cf_snomed': {'soft tissue mass': 278002000}, 'existence': 'pos_dx', 'descriptive_term': 'mediastinal soft tissue', 'observation': 'mass'}, 'contrast opacification': {'clinical finding': 'contrast opacification', 'existence': 'neg_dx', 'descriptive_term': 'contrast', 'observation': 'opacification'}}anatomical entity_fin: {'main pulmonary artery': {}}clinical findings_fin: {'main pulmonary artery is normal in caliber': {'clinical finding': 'main pulmonary artery is normal in caliber'}}anatomical entity_fin: {'heart': {'location descriptor': 'right'}}location descriptor_fin: ['right']clinical findings_fin: {'right heart strain': {'clinical finding': 'right heart strain', 'existence': 'neg_dx', 'descriptive_term': 'right heart', 'observation': 'strain'}}anatomical entity_fin: {'bronchus': {}, 'lobe': {'location descriptor': 'right upper'}}location descriptor_fin: ['right', 'anterior', 'posterior', 'upper']clinical findings_fin: {'narrowing': {'clinical finding': 'narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'observation': 'narrowing'}, 'mediastinal soft tissue mass': {'clinical finding': 'mediastinal soft tissue mass', 'cf_snomed': {'soft tissue mass': 278002000}, 'existence': 'pos_dx', 'descriptive_term': 'mediastinal soft tissue', 'observation': 'mass'}}location descriptor_fin: ['right']clinical findings_fin: {'chronic interstitial disease': {'clinical finding': 'chronic interstitial disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'chronic interstitial', 'observation': 'disease', 'temporal_term': 'chronic'}, 'diffuse severe right-sided bronchial wall thickening': {'clinical finding': 'diffuse severe right-sided bronchial wall thickening', 'existence': 'pos_dx', 'descriptive_term': 'diffuse severe right-sided bronchial wall', 'observation': 'thickening', 'strength_term': 'severe'}}anatomical entity_fin: {'middle': {'location descriptor': 'right'}, 'lobe': {}}location descriptor_fin: ['right']clinical findings_fin: {'extensive fibrotic changes': {'clinical finding': 'extensive fibrotic changes', 'existence': 'pos_dx', 'descriptive_term': 'extensive fibrotic', 'observation': 'change', 'strength_term': 'extensive'}, 'traction bronchiectasis': {'clinical finding': 'traction bronchiectasis', 'cf_snomed': {'traction bronchiectasis': 19325002}, 'existence': 'pos_dx', 'descriptive_term': 'traction', 'observation': 'bronchiectasis'}}anatomical entity_fin: {'right hemithorax': {}}location descriptor_fin: ['right']clinical findings_fin: {'pleural thickening': {'clinical finding': 'pleural thickening', 'existence': 'pos_dx', 'descriptive_term': 'pleural', 'observation': 'thickening'}, 'associated very small right-sided pleural effusion': {'clinical finding': 'associated very small right-sided pleural effusion', 'cf_snomed': {'pleural effusion': 60046008}, 'existence': 'pos_dx', 'descriptive_term': 'associated very small right-sided pleural', 'observation': 'effusion', 'strength_term': 'small'}}size_fin: [{'size': '11 x 11 mm', 'size_descriptor': 'nodule'}]anatomical entity_fin: {'lobe': {'location descriptor': 'right upper'}}imaging observation_fin: ['indistinct margins']location descriptor_fin: ['right', 'upper']clinical findings_fin: {'right upper lobe solid nodule': {'clinical finding': 'right upper lobe solid nodule', 'cf_snomed': {'nodule': 27925004}, 'existence': 'pos_dx', 'descriptive_term': 'right upper lobe solid', 'observation': 'nodule'}}size_fin: [{'size': '5 mm', 'size_descriptor': 'nodule'}]anatomical entity_fin: {'lobe': {'location descriptor': 'right upper'}}location descriptor_fin: ['anterior', 'right', 'upper']clinical findings_fin: {'additional anterior solid sharply marginated right upper lobe nodule': {'clinical finding': 'additional anterior solid sharply marginated right upper lobe nodule', 'cf_snomed': {'nodule': 27925004}, 'existence': 'pos_dx', 'descriptive_term': 'additional anterior solid sharply marginated right upper lobe', 'observation': 'nodule'}}clinical findings_fin: {'pulmonary nodules': {'clinical finding': 'pulmonary nodules', 'cf_snomed': {'nodule': 27925004}, 'existence': 'unc_dx', 'descriptive_term': 'pulmonary', 'observation': 'nodule'}}clinical findings_fin: {'enlarged': {'clinical finding': 'enlarged', 'existence': 'pos_dx', 'observation': 'enlarged'}, 'significant pericardial effusion': {'clinical finding': 'significant pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'neg_dx', 'descriptive_term': 'significant pericardial', 'observation': 'effusion'}}anatomical entity_fin: {'aorta': {}}clinical findings_fin: {'aorta is normal in caliber': {'clinical finding': 'aorta is normal in caliber'}}anatomical entity_fin: {'middle': {}, 'mediastinum': {}, 'thoracic inlet': {}}imaging observation_fin: ['irregular margins']location descriptor_fin: ['right']clinical findings_fin: {'soft tissue mass': {'clinical finding': 'soft tissue mass', 'cf_snomed': {'soft tissue mass': 278002000}, 'existence': 'pos_dx', 'descriptive_term': 'soft tissue', 'observation': 'mass'}, 'internal calcifications': {'clinical finding': 'internal calcifications', 'existence': 'pos_dx', 'descriptive_term': 'internal', 'observation': 'calcification'}, 'conglomerate lymphadenopathy': {'clinical finding': 'conglomerate lymphadenopathy', 'cf_snomed': {'lymphadenopathy': 30746006}, 'existence': 'pos_dx', 'descriptive_term': 'conglomerate', 'observation': 'lymphadenopathy'}}size_fin: [{'size': '46 x 58 mm', 'size_descriptor': 'mass'}]anatomical entity_fin: {'bronchus': {}, 'main pulmonary artery': {'location descriptor': 'right'}, 'pulmonary veins': {}}location descriptor_fin: ['right']clinical findings_fin: {'mass': {'clinical finding': 'mass', 'existence': 'pos_dx', 'observation': 'mass'}, 'narrowing': {'clinical finding': 'narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'observation': 'narrowing'}, 'obstruction': {'clinical finding': 'obstruction', 'cf_snomed': {'obstruction': 26036001}, 'existence': 'pos_dx', 'observation': 'obstruction'}, 'multiple collaterals': {'clinical finding': 'multiple collaterals', 'existence': 'pos_dx', 'descriptive_term': 'multiple', 'observation': 'collateral', 'quantity_term': 'multiple'}}anatomical entity_fin: {'right atrium': {}}imaging observation_fin: ['fat']location descriptor_fin: ['inferior']clinical findings_fin: {'mediastinal fat': {'clinical finding': 'mediastinal fat', 'existence': 'pos_dx', 'descriptive_term': 'mediastinal', 'observation': 'fat'}, 'mass': {'clinical finding': 'mass', 'existence': 'pos_dx', 'observation': 'mass'}, 'lipomatous hypertrophy': {'clinical finding': 'lipomatous hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'unc_dx', 'descriptive_term': 'lipomatous', 'observation': 'hypertrophy'}}size_fin: [{'size': '23 x 25 mm', 'size_descriptor': 'density'}]anatomical entity_fin: {'superior mediastinum': {}, 'origin': {}, 'common carotid arteries': {'location descriptor': 'left'}}imaging observation_fin: ['soft tissue density']location descriptor_fin: ['left']clinical findings_fin: {'additional soft tissue density': {'clinical finding': 'additional soft tissue density', 'existence': 'pos_dx', 'descriptive_term': 'additional soft tissue', 'observation': 'density'}, 'mass': {'clinical finding': 'mass', 'existence': 'pos_dx', 'observation': 'mass'}, 'brachiocephalic': {'clinical finding': 'brachiocephalic', 'existence': 'pos_dx', 'observation': 'brachiocephalic'}}anatomical entity_fin: {'mediastinal lymph nodes': {}}clinical findings_fin: {'multiple small and large mediastinal lymph nodes': {'clinical finding': 'multiple small and large mediastinal lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'multiple small and large mediastinal lymph', 'observation': 'node', 'strength_term': 'small - large', 'quantity_term': 'multiple'}}clinical findings_fin: {'enlarged cardiophrenic lymph nodes': {'clinical finding': 'enlarged cardiophrenic lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'enlarged cardiophrenic lymph', 'observation': 'node', 'strength_term': 'enlarged', 'change_term': 'enlarged'}}location descriptor_fin: ['left']clinical findings_fin: {'small left-sided bochdalek hernia': {'clinical finding': 'small left-sided bochdalek hernia', 'cf_snomed': {'hernia': 414403008}, 'existence': 'pos_dx', 'descriptive_term': 'small left-sided bochdalek', 'observation': 'hernia', 'strength_term': 'small'}}anatomical entity_fin: {'supraclavicular lymph nodes': {}}location descriptor_fin: ['bilateral']clinical findings_fin: {'bilateral prominent supraclavicular lymph nodes': {'clinical finding': 'bilateral prominent supraclavicular lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'bilateral prominent supraclavicular lymph', 'observation': 'node', 'strength_term': 'prominent'}}location descriptor_fin: ['bilateral']clinical findings_fin: {'enlarged bilateral subpectoral lymph nodes': {'clinical finding': 'enlarged bilateral subpectoral lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'enlarged bilateral subpectoral lymph', 'observation': 'node', 'strength_term': 'enlarged', 'change_term': 'enlarged'}}anatomical entity_fin: {'spine': {}}clinical findings_fin: {'mild to moderate degenerative changes': {'clinical finding': 'mild to moderate degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'mild to moderate degenerative', 'observation': 'change', 'strength_term': 'mild - moderate'}}anatomical entity_fin: {'t12 vertebral bodies': {}, 'bone': {}}clinical findings_fin: {'well-circumscribed sclerotic focus': {'clinical finding': 'well-circumscribed sclerotic focus', 'existence': 'pos_dx', 'descriptive_term': 'well-circumscribed sclerotic', 'observation': 'focus'}}anatomical entity_fin: {'abdominal': {}}clinical findings_fin: {'enteric contrast': {'clinical finding': 'enteric contrast', 'existence': 'neg_dx', 'descriptive_term': 'enteric', 'observation': 'contrast'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}} [/INST] . Technically adequate examination. No evidence of acute pulmonary embolism. Markedly attenuated right main pulmonary artery into a mediastinal soft tissue mass with no contrast opacification identified peripherally within the right lung. Main pulmonary artery is normal in caliber. No evidence of right heart strain. Narrowing of the right mainstem bronchus and anterior and posterior segmental bronchi of the right upper lobe by a mediastinal soft tissue mass. Chronic interstitial disease with diffuse severe right-sided bronchial wall thickening. Extensive fibrotic changes and traction bronchiectasis involving the right middle lobe. Pleural thickening in the right hemithorax with associated very small right-sided pleural effusion. Right upper lobe solid nodule with indistinct margins measures 11 x 11 mm. Additional anterior solid sharply marginated right upper lobe nodule measures 5 mm. Pulmonary nodules are most likely related to underlying inflammatory process. Cardiac size is mildly enlarged without significant pericardial effusion. Aorta is normal in caliber. Soft tissue mass with irregular margins and internal calcifications in the middle mediastinum extending from the thoracic inlet to the subcarinal or right hilar area most consistent with conglomerate lymphadenopathy. The mass measures 46 x 58 mm causing narrowing of the right mainstem bronchus, attenuation of the right main pulmonary artery and pulmonary veins, and obstruction of the SVC with multiple collaterals. Mediastinal fat extends inferior into the mass and there is a question of lipomatous hypertrophy extending into the right atrium. Additional soft tissue density in the superior mediastinum is likely contiguous with the mass measuring 23 x 25 mm encasing the origin of the brachiocephalic and left common carotid arteries. Multiple small and large mediastinal lymph nodes. Enlarged cardiophrenic lymph nodes. Small left-sided Bochdalek hernia. None. Bilateral prominent supraclavicular lymph nodes are noted. Enlarged bilateral subpectoral lymph nodes. Mild to moderate degenerative changes of the thoracic spine. Well-circumscribed sclerotic focus in T11 and T12 vertebral bodies which may represent bone islands. Absence of enteric contrast material markedly limits sensitivity abdominal pathology. No significant abnormality noted. </s>