Todays CT portion grossly demonstrates multiple bilateral small to medium-sized pulmonary nodules, some of which are cavitary. Multiple hypodense hepatic lesions are present. A punctate calcification is noted in the left central kidney. Regional thickening of the rectal wall is also identified. Todays PET examination demonstrates a large markedly hypermetabolic rectal mass , consistent with the patients diagnosis of rectal cancer. It is similar in activity but has increased slightly increased slightly in size from previous. Hypermetabolic regional lymph nodes involving left inguinal, left iliac, just below the iliac bifurcation, and at the left periaortic pelvic retroperitoneum have increased in size, number, and activity from previous, indicating progression of metastatic disease. The abnormal left inguinal nodes are provided for reference. Multiple markedly hypermetabolic hepatic metastases have increased in size, number, and metabolic activity from previous, indicating additional metastatic progression. The largest lesion in the right inferior hepatic lobe is provided for reference. Again, some of the larger hepatic metastases appear centrally necrotic. Multiple markedly hypermetabolic pulmonary parenchymal metastases have increased in size, number, and metabolic activity, indicating additional metastatic progression. The largest lesion in the right perihilar region is provided for reference. Hypermetabolic activity again surrounding the left shoulder is consistent with inflammation.
location descriptor_fin: ['bilateral']clinical findings_fin: {'multiple bilateral small to medium-sized pulmonary nodules': {'clinical finding': 'multiple bilateral small to medium-sized pulmonary nodules', 'cf_snomed': {'nodule': 27925004}, 'existence': 'pos_dx', 'descriptive_term': 'multiple bilateral small to medium-sized pulmonary', 'observation': 'nodule', 'strength_term': 'small - medium', 'quantity_term': 'multiple'}}clinical findings_fin: {'multiple hypodense hepatic lesions': {'clinical finding': 'multiple hypodense hepatic lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'multiple hypodense hepatic', 'observation': 'lesion', 'quantity_term': 'multiple'}}anatomical entity_fin: {'kidney': {'location descriptor': 'left central'}}location descriptor_fin: ['left', 'central']clinical findings_fin: {'punctate calcification': {'clinical finding': 'punctate calcification', 'cf_snomed': {'punctate calcification': 129755006}, 'existence': 'pos_dx', 'descriptive_term': 'punctate', 'observation': 'calcification'}}anatomical entity_fin: {'wall': {}}clinical findings_fin: {'regional thickening': {'clinical finding': 'regional thickening', 'existence': 'pos_dx', 'descriptive_term': 'regional', 'observation': 'thickening'}}clinical findings_fin: {'large markedly hypermetabolic rectal mass': {'clinical finding': 'large markedly hypermetabolic rectal mass', 'cf_snomed': {'rectal mass': 248523006}, 'existence': 'pos_dx', 'descriptive_term': 'large markedly hypermetabolic rectal', 'observation': 'mass', 'strength_term': 'large'}, 'rectal cancer': {'clinical finding': 'rectal cancer', 'existence': 'pos_dx', 'descriptive_term': 'rectal', 'observation': 'cancer'}}clinical findings_fin: {'it is similar in activity but has increased': {'clinical finding': 'it is similar in activity but has increased', 'change_term': 'increased'}}anatomical entity_fin: {'retroperitoneum': {}}location descriptor_fin: ['left']clinical findings_fin: {'hypermetabolic regional lymph nodes': {'clinical finding': 'hypermetabolic regional lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'hypermetabolic regional lymph', 'observation': 'node'}, 'progression': {'clinical finding': 'progression', 'existence': 'unc_dx', 'observation': 'progression'}, 'metastatic disease': {'clinical finding': 'metastatic disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'metastatic', 'observation': 'disease'}}location descriptor_fin: ['left']clinical findings_fin: {'abnormal left inguinal nodes': {'clinical finding': 'abnormal left inguinal nodes', 'existence': 'pos_dx', 'descriptive_term': 'abnormal left inguinal', 'observation': 'node'}}clinical findings_fin: {'multiple markedly hypermetabolic hepatic metastases': {'clinical finding': 'multiple markedly hypermetabolic hepatic metastases', 'existence': 'pos_dx', 'descriptive_term': 'multiple markedly hypermetabolic hepatic', 'observation': 'metastase', 'quantity_term': 'multiple'}, 'metabolic activity': {'clinical finding': 'metabolic activity', 'existence': 'pos_dx', 'descriptive_term': 'metabolic', 'observation': 'activity'}, 'additional metastatic progression': {'clinical finding': 'additional metastatic progression', 'existence': 'pos_dx', 'descriptive_term': 'additional metastatic', 'observation': 'progression'}}anatomical entity_fin: {'lobe': {}}location descriptor_fin: ['right', 'inferior']clinical findings_fin: {'largest lesion': {'clinical finding': 'largest lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'largest', 'observation': 'lesion'}}clinical findings_fin: {'larger hepatic metastases': {'clinical finding': 'larger hepatic metastases', 'existence': 'pos_dx', 'descriptive_term': 'larger hepatic', 'observation': 'metastase'}}clinical findings_fin: {'multiple markedly hypermetabolic pulmonary parenchymal metastases': {'clinical finding': 'multiple markedly hypermetabolic pulmonary parenchymal metastases', 'existence': 'pos_dx', 'descriptive_term': 'multiple markedly hypermetabolic pulmonary parenchymal', 'observation': 'metastase', 'quantity_term': 'multiple'}, 'metabolic activity': {'clinical finding': 'metabolic activity', 'existence': 'pos_dx', 'descriptive_term': 'metabolic', 'observation': 'activity'}, 'additional metastatic progression': {'clinical finding': 'additional metastatic progression', 'existence': 'pos_dx', 'descriptive_term': 'additional metastatic', 'observation': 'progression'}}location descriptor_fin: ['right']clinical findings_fin: {'largest lesion': {'clinical finding': 'largest lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'largest', 'observation': 'lesion'}}anatomical entity_fin: {'shoulder': {'location descriptor': 'left'}}location descriptor_fin: ['left']clinical findings_fin: {'inflammation': {'clinical finding': 'inflammation', 'existence': 'pos_dx', 'observation': 'inflammation'}}
<s>[INST] Write the finding section for a radiology report based on the following information: location descriptor_fin: ['bilateral']clinical findings_fin: {'multiple bilateral small to medium-sized pulmonary nodules': {'clinical finding': 'multiple bilateral small to medium-sized pulmonary nodules', 'cf_snomed': {'nodule': 27925004}, 'existence': 'pos_dx', 'descriptive_term': 'multiple bilateral small to medium-sized pulmonary', 'observation': 'nodule', 'strength_term': 'small - medium', 'quantity_term': 'multiple'}}clinical findings_fin: {'multiple hypodense hepatic lesions': {'clinical finding': 'multiple hypodense hepatic lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'multiple hypodense hepatic', 'observation': 'lesion', 'quantity_term': 'multiple'}}anatomical entity_fin: {'kidney': {'location descriptor': 'left central'}}location descriptor_fin: ['left', 'central']clinical findings_fin: {'punctate calcification': {'clinical finding': 'punctate calcification', 'cf_snomed': {'punctate calcification': 129755006}, 'existence': 'pos_dx', 'descriptive_term': 'punctate', 'observation': 'calcification'}}anatomical entity_fin: {'wall': {}}clinical findings_fin: {'regional thickening': {'clinical finding': 'regional thickening', 'existence': 'pos_dx', 'descriptive_term': 'regional', 'observation': 'thickening'}}clinical findings_fin: {'large markedly hypermetabolic rectal mass': {'clinical finding': 'large markedly hypermetabolic rectal mass', 'cf_snomed': {'rectal mass': 248523006}, 'existence': 'pos_dx', 'descriptive_term': 'large markedly hypermetabolic rectal', 'observation': 'mass', 'strength_term': 'large'}, 'rectal cancer': {'clinical finding': 'rectal cancer', 'existence': 'pos_dx', 'descriptive_term': 'rectal', 'observation': 'cancer'}}clinical findings_fin: {'it is similar in activity but has increased': {'clinical finding': 'it is similar in activity but has increased', 'change_term': 'increased'}}anatomical entity_fin: {'retroperitoneum': {}}location descriptor_fin: ['left']clinical findings_fin: {'hypermetabolic regional lymph nodes': {'clinical finding': 'hypermetabolic regional lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'hypermetabolic regional lymph', 'observation': 'node'}, 'progression': {'clinical finding': 'progression', 'existence': 'unc_dx', 'observation': 'progression'}, 'metastatic disease': {'clinical finding': 'metastatic disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'metastatic', 'observation': 'disease'}}location descriptor_fin: ['left']clinical findings_fin: {'abnormal left inguinal nodes': {'clinical finding': 'abnormal left inguinal nodes', 'existence': 'pos_dx', 'descriptive_term': 'abnormal left inguinal', 'observation': 'node'}}clinical findings_fin: {'multiple markedly hypermetabolic hepatic metastases': {'clinical finding': 'multiple markedly hypermetabolic hepatic metastases', 'existence': 'pos_dx', 'descriptive_term': 'multiple markedly hypermetabolic hepatic', 'observation': 'metastase', 'quantity_term': 'multiple'}, 'metabolic activity': {'clinical finding': 'metabolic activity', 'existence': 'pos_dx', 'descriptive_term': 'metabolic', 'observation': 'activity'}, 'additional metastatic progression': {'clinical finding': 'additional metastatic progression', 'existence': 'pos_dx', 'descriptive_term': 'additional metastatic', 'observation': 'progression'}}anatomical entity_fin: {'lobe': {}}location descriptor_fin: ['right', 'inferior']clinical findings_fin: {'largest lesion': {'clinical finding': 'largest lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'largest', 'observation': 'lesion'}}clinical findings_fin: {'larger hepatic metastases': {'clinical finding': 'larger hepatic metastases', 'existence': 'pos_dx', 'descriptive_term': 'larger hepatic', 'observation': 'metastase'}}clinical findings_fin: {'multiple markedly hypermetabolic pulmonary parenchymal metastases': {'clinical finding': 'multiple markedly hypermetabolic pulmonary parenchymal metastases', 'existence': 'pos_dx', 'descriptive_term': 'multiple markedly hypermetabolic pulmonary parenchymal', 'observation': 'metastase', 'quantity_term': 'multiple'}, 'metabolic activity': {'clinical finding': 'metabolic activity', 'existence': 'pos_dx', 'descriptive_term': 'metabolic', 'observation': 'activity'}, 'additional metastatic progression': {'clinical finding': 'additional metastatic progression', 'existence': 'pos_dx', 'descriptive_term': 'additional metastatic', 'observation': 'progression'}}location descriptor_fin: ['right']clinical findings_fin: {'largest lesion': {'clinical finding': 'largest lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'largest', 'observation': 'lesion'}}anatomical entity_fin: {'shoulder': {'location descriptor': 'left'}}location descriptor_fin: ['left']clinical findings_fin: {'inflammation': {'clinical finding': 'inflammation', 'existence': 'pos_dx', 'observation': 'inflammation'}} [/INST] Todays CT portion grossly demonstrates multiple bilateral small to medium-sized pulmonary nodules, some of which are cavitary. Multiple hypodense hepatic lesions are present. A punctate calcification is noted in the left central kidney. Regional thickening of the rectal wall is also identified. Todays PET examination demonstrates a large markedly hypermetabolic rectal mass , consistent with the patients diagnosis of rectal cancer. It is similar in activity but has increased slightly increased slightly in size from previous. Hypermetabolic regional lymph nodes involving left inguinal, left iliac, just below the iliac bifurcation, and at the left periaortic pelvic retroperitoneum have increased in size, number, and activity from previous, indicating progression of metastatic disease. The abnormal left inguinal nodes are provided for reference. Multiple markedly hypermetabolic hepatic metastases have increased in size, number, and metabolic activity from previous, indicating additional metastatic progression. The largest lesion in the right inferior hepatic lobe is provided for reference. Again, some of the larger hepatic metastases appear centrally necrotic. Multiple markedly hypermetabolic pulmonary parenchymal metastases have increased in size, number, and metabolic activity, indicating additional metastatic progression. The largest lesion in the right perihilar region is provided for reference. Hypermetabolic activity again surrounding the left shoulder is consistent with inflammation. </s>