. Marked worsening of right greater than left pleural and extrapleural nodularity and thickening. The index lesion in the left upper lobe on image 27 of series 4 currently measures approximately 2.4 cm in short axis diameter compared to 2 cm on previous study. Index lesion in the posterior aspect of the right hemithorax on image 49 of series 4 is slightly smaller now measuring 1.5 cm compared to 1.9 cm previous study though numerous other lesions are worse. There is obvious right posterior chest wall invasion on image 47 of series Right basilar pleural drain again noted. Right-sided hemidiaphragmatic mesh again noted. Small loculated pleural effusions again noted. New diffuse groundglass abnormality throughout the lungs with focal areas of bronchovascular consolidation within the central aspect of the right lung. Very large necrotic mediastinal lymphadenopathy with infiltration of mediastinal fat has progressed since previous study. The largest lymph node is again within the paraesophageal region present on image 57 of 145 measuring 4.7 cm compared to 4.3 cm in short axis. None. Right posterior chest wall invasion, as above. Small nodular lesions again noted in the subcutaneous fat of the lower abdomen which could represent injection granulomas versus malignant disease. Small breast nodules, unchanged. Absence of enteric contrast material limits sensitivity for abdominal pathology. New amorphous hypodense lesion in the anterior lateral aspect of the liver on image 94 of series 4 measuring 2.1 x 1.2 cm. Cholelithiasis. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. Absence of enteric contrast material limits sensitivity for GI pathology. No gross abnormalities noted. New mild superior endplate compression deformity at T5. No significant abnormality noted.
imaging observation_fin: ['extrapleural']location descriptor_fin: ['right', 'left']clinical findings_fin: {'left pleural and extrapleural nodularity': {'clinical finding': 'left pleural and extrapleural nodularity', 'existence': 'pos_dx', 'descriptive_term': 'left pleural and extrapleural', 'observation': 'nodularity'}, 'thickening': {'clinical finding': 'thickening', 'existence': 'pos_dx', 'observation': 'thickening'}}size_fin: [{'size': '2.4 cm'}, {'size': '2 cm'}]anatomical entity_fin: {'lobe': {'location descriptor': 'left upper'}, 'axis': {}}location descriptor_fin: ['left', 'upper']clinical findings_fin: {'index lesion': {'clinical finding': 'index lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'index', 'observation': 'lesion'}}size_fin: [{'size': '1.5 cm'}, {'size': '1.9 cm'}]anatomical entity_fin: {'right hemithorax': {}}location descriptor_fin: ['posterior']clinical findings_fin: {'index lesion': {'clinical finding': 'index lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'index', 'observation': 'lesion'}, 'numerous other lesions': {'clinical finding': 'numerous other lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'numerous other', 'observation': 'lesion', 'quantity_term': 'numerous'}}imaging observation_fin: ['chest wall invasion']location descriptor_fin: ['right', 'posterior']clinical findings_fin: {'obvious right posterior chest wall invasion on image 47 of series right basilar pleural drain again noted': {'clinical finding': 'obvious right posterior chest wall invasion on image 47 of series right basilar pleural drain again noted'}}location descriptor_fin: ['right']clinical findings_fin: {'right-sided hemidiaphragmatic': {'clinical finding': 'right-sided hemidiaphragmatic', 'existence': 'pos_dx', 'descriptive_term': 'right-sided', 'observation': 'hemidiaphragmatic'}}clinical findings_fin: {'small loculated pleural effusions': {'clinical finding': 'small loculated pleural effusions', 'cf_snomed': {'loculated pleural effusion': 427895005}, 'existence': 'pos_dx', 'descriptive_term': 'small loculated pleural', 'observation': 'effusion', 'strength_term': 'small'}}anatomical entity_fin: {'lungs': {}, 'right lung': {}}location descriptor_fin: ['central']clinical findings_fin: {'new diffuse groundglass abnormality': {'clinical finding': 'new diffuse groundglass abnormality', 'existence': 'pos_dx', 'descriptive_term': 'new diffuse groundglass', 'observation': 'abnormality', 'temporal_term': 'new'}, 'bronchovascular consolidation': {'clinical finding': 'bronchovascular consolidation', 'cf_snomed': {'consolidation': 9656002}, 'existence': 'pos_dx', 'descriptive_term': 'bronchovascular', 'observation': 'consolidation'}}imaging observation_fin: ['fat']clinical findings_fin: {'very large necrotic mediastinal lymphadenopathy': {'clinical finding': 'very large necrotic mediastinal lymphadenopathy', 'cf_snomed': {'mediastinal lymphadenopathy': 52324001}, 'existence': 'pos_dx', 'descriptive_term': 'very large necrotic mediastinal', 'observation': 'lymphadenopathy', 'strength_term': 'large'}, 'mediastinal fat': {'clinical finding': 'mediastinal fat', 'existence': 'pos_dx', 'descriptive_term': 'mediastinal', 'observation': 'fat'}}size_fin: [{'size': '4.7 cm'}, {'size': '4.3 cm'}]anatomical entity_fin: {'axis': {}}clinical findings_fin: {'largest lymph node': {'clinical finding': 'largest lymph node', 'existence': 'pos_dx', 'descriptive_term': 'largest lymph', 'observation': 'node'}}imaging observation_fin: ['chest wall invasion']location descriptor_fin: ['right', 'posterior']anatomical entity_fin: {'subcutaneous fat': {}, 'lower abdomen': {}}clinical findings_fin: {'small nodular lesions': {'clinical finding': 'small nodular lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'small nodular', 'observation': 'lesion', 'strength_term': 'small'}, 'injection granulomas': {'clinical finding': 'injection granulomas', 'cf_snomed': {'granuloma': 45647009}, 'existence': 'unc_dx', 'descriptive_term': 'injection', 'observation': 'granuloma'}, 'malignant disease': {'clinical finding': 'malignant disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'malignant', 'observation': 'disease'}}anatomical entity_fin: {'breast': {}}clinical findings_fin: {'small breast nodules': {'clinical finding': 'small breast nodules', 'cf_snomed': {'small breast': 248811009}, 'existence': 'pos_dx', 'descriptive_term': 'small breast', 'observation': 'nodule', 'strength_term': 'small'}}anatomical entity_fin: {'abdominal': {}}clinical findings_fin: {'enteric contrast': {'clinical finding': 'enteric contrast', 'existence': 'neg_dx', 'descriptive_term': 'enteric', 'observation': 'contrast'}}size_fin: [{'size': '2.1 x 1.2 cm', 'size_descriptor': 'lesion'}]anatomical entity_fin: {'liver': {}}location descriptor_fin: ['anterior', 'lateral']clinical findings_fin: {'new amorphous hypodense lesion': {'clinical finding': 'new amorphous hypodense lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'new amorphous hypodense', 'observation': 'lesion', 'temporal_term': 'new'}}clinical findings_fin: {'cholelithiasis': {'clinical finding': 'cholelithiasis', 'existence': 'pos_dx', 'observation': 'cholelithiasis'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'gi': {'clinical finding': 'gi', 'existence': 'unc_dx', 'observation': 'gi'}}clinical findings_fin: {'gross abnormalities': {'clinical finding': 'gross abnormalities', 'existence': 'neg_dx', 'descriptive_term': 'gross', 'observation': 'abnormality'}}anatomical entity_fin: {'endplate': {'location descriptor': 'superior'}}location descriptor_fin: ['superior']clinical findings_fin: {'new mild superior endplate compression deformity': {'clinical finding': 'new mild superior endplate compression deformity', 'cf_snomed': {'compression': 71173004, 'deformity': 417893002}, 'existence': 'pos_dx', 'descriptive_term': 'new mild superior endplate compression', 'observation': 'deformity', 'strength_term': 'mild - superior', 'temporal_term': 'new'}}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: imaging observation_fin: ['extrapleural']location descriptor_fin: ['right', 'left']clinical findings_fin: {'left pleural and extrapleural nodularity': {'clinical finding': 'left pleural and extrapleural nodularity', 'existence': 'pos_dx', 'descriptive_term': 'left pleural and extrapleural', 'observation': 'nodularity'}, 'thickening': {'clinical finding': 'thickening', 'existence': 'pos_dx', 'observation': 'thickening'}}size_fin: [{'size': '2.4 cm'}, {'size': '2 cm'}]anatomical entity_fin: {'lobe': {'location descriptor': 'left upper'}, 'axis': {}}location descriptor_fin: ['left', 'upper']clinical findings_fin: {'index lesion': {'clinical finding': 'index lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'index', 'observation': 'lesion'}}size_fin: [{'size': '1.5 cm'}, {'size': '1.9 cm'}]anatomical entity_fin: {'right hemithorax': {}}location descriptor_fin: ['posterior']clinical findings_fin: {'index lesion': {'clinical finding': 'index lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'index', 'observation': 'lesion'}, 'numerous other lesions': {'clinical finding': 'numerous other lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'numerous other', 'observation': 'lesion', 'quantity_term': 'numerous'}}imaging observation_fin: ['chest wall invasion']location descriptor_fin: ['right', 'posterior']clinical findings_fin: {'obvious right posterior chest wall invasion on image 47 of series right basilar pleural drain again noted': {'clinical finding': 'obvious right posterior chest wall invasion on image 47 of series right basilar pleural drain again noted'}}location descriptor_fin: ['right']clinical findings_fin: {'right-sided hemidiaphragmatic': {'clinical finding': 'right-sided hemidiaphragmatic', 'existence': 'pos_dx', 'descriptive_term': 'right-sided', 'observation': 'hemidiaphragmatic'}}clinical findings_fin: {'small loculated pleural effusions': {'clinical finding': 'small loculated pleural effusions', 'cf_snomed': {'loculated pleural effusion': 427895005}, 'existence': 'pos_dx', 'descriptive_term': 'small loculated pleural', 'observation': 'effusion', 'strength_term': 'small'}}anatomical entity_fin: {'lungs': {}, 'right lung': {}}location descriptor_fin: ['central']clinical findings_fin: {'new diffuse groundglass abnormality': {'clinical finding': 'new diffuse groundglass abnormality', 'existence': 'pos_dx', 'descriptive_term': 'new diffuse groundglass', 'observation': 'abnormality', 'temporal_term': 'new'}, 'bronchovascular consolidation': {'clinical finding': 'bronchovascular consolidation', 'cf_snomed': {'consolidation': 9656002}, 'existence': 'pos_dx', 'descriptive_term': 'bronchovascular', 'observation': 'consolidation'}}imaging observation_fin: ['fat']clinical findings_fin: {'very large necrotic mediastinal lymphadenopathy': {'clinical finding': 'very large necrotic mediastinal lymphadenopathy', 'cf_snomed': {'mediastinal lymphadenopathy': 52324001}, 'existence': 'pos_dx', 'descriptive_term': 'very large necrotic mediastinal', 'observation': 'lymphadenopathy', 'strength_term': 'large'}, 'mediastinal fat': {'clinical finding': 'mediastinal fat', 'existence': 'pos_dx', 'descriptive_term': 'mediastinal', 'observation': 'fat'}}size_fin: [{'size': '4.7 cm'}, {'size': '4.3 cm'}]anatomical entity_fin: {'axis': {}}clinical findings_fin: {'largest lymph node': {'clinical finding': 'largest lymph node', 'existence': 'pos_dx', 'descriptive_term': 'largest lymph', 'observation': 'node'}}imaging observation_fin: ['chest wall invasion']location descriptor_fin: ['right', 'posterior']anatomical entity_fin: {'subcutaneous fat': {}, 'lower abdomen': {}}clinical findings_fin: {'small nodular lesions': {'clinical finding': 'small nodular lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'small nodular', 'observation': 'lesion', 'strength_term': 'small'}, 'injection granulomas': {'clinical finding': 'injection granulomas', 'cf_snomed': {'granuloma': 45647009}, 'existence': 'unc_dx', 'descriptive_term': 'injection', 'observation': 'granuloma'}, 'malignant disease': {'clinical finding': 'malignant disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'malignant', 'observation': 'disease'}}anatomical entity_fin: {'breast': {}}clinical findings_fin: {'small breast nodules': {'clinical finding': 'small breast nodules', 'cf_snomed': {'small breast': 248811009}, 'existence': 'pos_dx', 'descriptive_term': 'small breast', 'observation': 'nodule', 'strength_term': 'small'}}anatomical entity_fin: {'abdominal': {}}clinical findings_fin: {'enteric contrast': {'clinical finding': 'enteric contrast', 'existence': 'neg_dx', 'descriptive_term': 'enteric', 'observation': 'contrast'}}size_fin: [{'size': '2.1 x 1.2 cm', 'size_descriptor': 'lesion'}]anatomical entity_fin: {'liver': {}}location descriptor_fin: ['anterior', 'lateral']clinical findings_fin: {'new amorphous hypodense lesion': {'clinical finding': 'new amorphous hypodense lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'new amorphous hypodense', 'observation': 'lesion', 'temporal_term': 'new'}}clinical findings_fin: {'cholelithiasis': {'clinical finding': 'cholelithiasis', 'existence': 'pos_dx', 'observation': 'cholelithiasis'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}clinical findings_fin: {'gi': {'clinical finding': 'gi', 'existence': 'unc_dx', 'observation': 'gi'}}clinical findings_fin: {'gross abnormalities': {'clinical finding': 'gross abnormalities', 'existence': 'neg_dx', 'descriptive_term': 'gross', 'observation': 'abnormality'}}anatomical entity_fin: {'endplate': {'location descriptor': 'superior'}}location descriptor_fin: ['superior']clinical findings_fin: {'new mild superior endplate compression deformity': {'clinical finding': 'new mild superior endplate compression deformity', 'cf_snomed': {'compression': 71173004, 'deformity': 417893002}, 'existence': 'pos_dx', 'descriptive_term': 'new mild superior endplate compression', 'observation': 'deformity', 'strength_term': 'mild - superior', 'temporal_term': 'new'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}} [/INST] . Marked worsening of right greater than left pleural and extrapleural nodularity and thickening. The index lesion in the left upper lobe on image 27 of series 4 currently measures approximately 2.4 cm in short axis diameter compared to 2 cm on previous study. Index lesion in the posterior aspect of the right hemithorax on image 49 of series 4 is slightly smaller now measuring 1.5 cm compared to 1.9 cm previous study though numerous other lesions are worse. There is obvious right posterior chest wall invasion on image 47 of series Right basilar pleural drain again noted. Right-sided hemidiaphragmatic mesh again noted. Small loculated pleural effusions again noted. New diffuse groundglass abnormality throughout the lungs with focal areas of bronchovascular consolidation within the central aspect of the right lung. Very large necrotic mediastinal lymphadenopathy with infiltration of mediastinal fat has progressed since previous study. The largest lymph node is again within the paraesophageal region present on image 57 of 145 measuring 4.7 cm compared to 4.3 cm in short axis. None. Right posterior chest wall invasion, as above. Small nodular lesions again noted in the subcutaneous fat of the lower abdomen which could represent injection granulomas versus malignant disease. Small breast nodules, unchanged. Absence of enteric contrast material limits sensitivity for abdominal pathology. New amorphous hypodense lesion in the anterior lateral aspect of the liver on image 94 of series 4 measuring 2.1 x 1.2 cm. Cholelithiasis. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. Absence of enteric contrast material limits sensitivity for GI pathology. No gross abnormalities noted. New mild superior endplate compression deformity at T5. No significant abnormality noted. </s>