. New small bilateral pleural effusions and associated atelectasis. Additional scattered pulmonary micronodules are unchanged. The heart is upper limits of normal, without significant pericardial effusion. Right chest port tip terminates in the distal SVC. No mediastinal or hilar lymphadenopathy. Enteric tube terminates in the distal esophagus. Severe. Additionally, coronary stents are presumed. Scattered degenerative changes. No focal hepatic masses identified. No intra or extra hepatic biliary dilatation. The gallbladder is within normal limits. Free air is seen within the falciform ligament. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. Unchanged left renal cyst. Subcentimeter right renal hypodensities are too small to characterize. No hydronephrosis or nephrolithiasis. Interval enlargement of multiple periportal and superior peripancreatic lymph nodes, many of which appear centrally necrotic. The reference portal lymph node measures 16 mm , previously 14 mm. Tumor continues to encase the hepatic artery and portal vein, but these vessels remain patent. Mild. Again seen is asymmetric heterogeneous thickening of the gastric antropyloric region, compatible with known gastric carcinoma. Although the margins of which are poorly defined, this appears to be more extensive than on previous study. Additionally, there are multiple clustered gaseous foci at the level of the mass, suggesting that this is the site of perforation. There is no progression of contrast beyond the level of the mass or suspected perforation, although no free intraperitoneal contrast is identified. Multifocal nodularity in the peritoneum and mesentery suggestive of peritoneal or mesenteric carcinomatosis. The previously described abnormal lymph node in the greater omentum currently measures 8 mm in short axis , previously 6 mm. No significant abnormality noted. Extensive pneumoperitoneum tracking along the anterior abdominal wall as well as the lesser sac, the falciform ligament, and the pelvis. New abdominopelvic ascites, measuring simple fluid density. The prostate is enlarged measuring 5.2 x 4.4 cm. No significant abnormality noted. No significant abnormality noted. The small bowel is normal in caliber and thickness without evidence of obstruction or inflammatory changes. Diverticulosis without evidence of acute diverticulitis. Normal-appearing appendix. Stable degenerative changes. Subtle peritoneal thickening in the pelvis suggests carcinomatosis.
location descriptor_fin: ['bilateral']clinical findings_fin: {'new small bilateral pleural effusions': {'clinical finding': 'new small bilateral pleural effusions', 'cf_snomed': {'bilateral pleural effusion': 425802001}, 'existence': 'pos_dx', 'descriptive_term': 'new small bilateral pleural', 'observation': 'effusion', 'strength_term': 'small', 'temporal_term': 'new'}, 'associated atelectasis': {'clinical finding': 'associated atelectasis', 'cf_snomed': {'atelectasis': 46621007}, 'existence': 'pos_dx', 'descriptive_term': 'associated', 'observation': 'atelectasis'}}clinical findings_fin: {'additional scattered pulmonary micronodules': {'clinical finding': 'additional scattered pulmonary micronodules', 'existence': 'pos_dx', 'descriptive_term': 'additional scattered pulmonary', 'observation': 'micronodule'}}anatomical entity_fin: {'heart': {}}location descriptor_fin: ['upper']clinical findings_fin: {'significant pericardial effusion': {'clinical finding': 'significant pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'pos_dx', 'descriptive_term': 'significant pericardial', 'observation': 'effusion'}}anatomical entity_fin: {'chest': {'location descriptor': 'right'}}location descriptor_fin: ['right', 'distal']object_fin: ['port']clinical findings_fin: {'mediastinal or hilar lymphadenopathy': {'clinical finding': 'mediastinal or hilar lymphadenopathy', 'cf_snomed': {'hilar lymphadenopathy': 87500009}, 'existence': 'neg_dx', 'descriptive_term': 'mediastinal or hilar', 'observation': 'lymphadenopathy'}}anatomical entity_fin: {'esophagus': {'location descriptor': 'distal'}}location descriptor_fin: ['distal']object_fin: ['tube']clinical findings_fin: {'coronary stents': {'clinical finding': 'coronary stents', 'existence': 'unc_dx', 'descriptive_term': 'coronary', 'observation': 'stent'}}clinical findings_fin: {'scattered degenerative changes': {'clinical finding': 'scattered degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'scattered degenerative', 'observation': 'change'}}clinical findings_fin: {'focal hepatic masses': {'clinical finding': 'focal hepatic masses', 'existence': 'neg_dx', 'descriptive_term': 'focal hepatic', 'observation': 'mass'}}anatomical entity_fin: {'gallbladder': {}}clinical findings_fin: {'gallbladder is within normal limits': {'clinical finding': 'gallbladder is within normal limits'}}imaging observation_fin: ['falciform ligament']clinical findings_fin: {'free air': {'clinical finding': 'free air', 'existence': 'pos_dx', 'descriptive_term': 'free', 'observation': 'air'}}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'}}location descriptor_fin: ['left']clinical findings_fin: {'unchanged left renal cyst': {'clinical finding': 'unchanged left renal cyst', 'cf_snomed': {'cyst': 441457006}, 'existence': 'pos_dx', 'descriptive_term': 'unchanged left renal', 'observation': 'cyst', 'strength_term': 'unchanged', 'change_term': 'unchanged'}}location descriptor_fin: ['right']clinical findings_fin: {'renal hypodensities': {'clinical finding': 'renal hypodensities', 'existence': 'pos_dx', 'descriptive_term': 'renal', 'observation': 'hypodensity'}}clinical findings_fin: {'hydronephrosis': {'clinical finding': 'hydronephrosis', 'cf_snomed': {'hydronephrosis': 43064006}, 'existence': 'neg_dx', 'observation': 'hydronephrosis'}, 'nephrolithiasis': {'clinical finding': 'nephrolithiasis', 'existence': 'neg_dx', 'observation': 'nephrolithiasis'}}location descriptor_fin: ['superior']clinical findings_fin: {'multiple periportal and superior peripancreatic lymph nodes': {'clinical finding': 'multiple periportal and superior peripancreatic lymph nodes', 'cf_snomed': {'peripancreatic lymph node': 245346008}, 'existence': 'pos_dx', 'descriptive_term': 'multiple periportal and superior peripancreatic lymph', 'observation': 'node', 'strength_term': 'superior', 'quantity_term': 'multiple'}}size_fin: [{'size': '16 mm'}, {'size': '14 mm'}]clinical findings_fin: {'reference portal lymph node': {'clinical finding': 'reference portal lymph node', 'existence': 'pos_dx', 'descriptive_term': 'reference portal lymph', 'observation': 'node'}}anatomical entity_fin: {'hepatic artery': {}, 'portal vein': {}}clinical findings_fin: {'tumor': {'clinical finding': 'tumor', 'existence': 'pos_dx', 'observation': 'tumor'}, 'patent': {'clinical finding': 'patent', 'existence': 'pos_dx', 'observation': 'patent'}}clinical findings_fin: {'asymmetric heterogeneous thickening': {'clinical finding': 'asymmetric heterogeneous thickening', 'existence': 'pos_dx', 'descriptive_term': 'asymmetric heterogeneous', 'observation': 'thickening'}, 'known gastric carcinoma': {'clinical finding': 'known gastric carcinoma', 'cf_snomed': {'carcinoma': 1187425009}, 'existence': 'pos_dx', 'descriptive_term': 'known gastric', 'observation': 'carcinoma'}}imaging observation_fin: ['margins']clinical findings_fin: {'margins of which are poorly defined , this appears to be more extensive than on previous study': {'clinical finding': 'margins of which are poorly defined , this appears to be more extensive than on previous study'}}imaging observation_fin: ['foci']clinical findings_fin: {'multiple clustered gaseous foci': {'clinical finding': 'multiple clustered gaseous foci', 'existence': 'pos_dx', 'descriptive_term': 'multiple clustered gaseous', 'observation': 'foci', 'quantity_term': 'multiple'}, 'mass': {'clinical finding': 'mass', 'existence': 'pos_dx', 'observation': 'mass'}, 'perforation': {'clinical finding': 'perforation', 'cf_snomed': {'perforation': 36191001}, 'existence': 'unc_dx', 'observation': 'perforation'}}clinical findings_fin: {'progression': {'clinical finding': 'progression', 'existence': 'neg_dx', 'observation': 'progression'}, 'contrast': {'clinical finding': 'contrast', 'existence': 'neg_dx', 'observation': 'contrast'}, 'mass': {'clinical finding': 'mass', 'existence': 'neg_dx', 'observation': 'mass'}, 'suspected perforation': {'clinical finding': 'suspected perforation', 'cf_snomed': {'perforation': 36191001}, 'existence': 'neg_dx', 'descriptive_term': 'suspected', 'observation': 'perforation'}, 'free intraperitoneal contrast': {'clinical finding': 'free intraperitoneal contrast', 'existence': 'neg_dx', 'descriptive_term': 'free intraperitoneal', 'observation': 'contrast'}}anatomical entity_fin: {'peritoneum': {}, 'mesentery': {}}clinical findings_fin: {'multifocal nodularity': {'clinical finding': 'multifocal nodularity', 'existence': 'pos_dx', 'descriptive_term': 'multifocal', 'observation': 'nodularity'}, 'peritoneal or mesenteric carcinomatosis': {'clinical finding': 'peritoneal or mesenteric carcinomatosis', 'cf_snomed': {'carcinomatosis': 307593001}, 'existence': 'unc_dx', 'descriptive_term': 'peritoneal or mesenteric', 'observation': 'carcinomatosis'}}size_fin: [{'size': '8 mm'}, {'size': '6 mm'}]anatomical entity_fin: {'greater omentum': {}, 'axis': {}}clinical findings_fin: {'previously described abnormal lymph node': {'clinical finding': 'previously described abnormal lymph node', 'existence': 'pos_dx', 'descriptive_term': 'previously described abnormal lymph', 'observation': 'node'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}anatomical entity_fin: {'anterior abdominal wall': {}, 'lesser sac': {}, 'pelvis': {}}imaging observation_fin: ['falciform ligament']clinical findings_fin: {'extensive pneumoperitoneum': {'clinical finding': 'extensive pneumoperitoneum', 'cf_snomed': {'pneumoperitoneum': 17204006}, 'existence': 'pos_dx', 'descriptive_term': 'extensive', 'observation': 'pneumoperitoneum', 'strength_term': 'extensive'}}anatomical entity_fin: {'fluid': {}}clinical findings_fin: {'new abdominopelvic ascites': {'clinical finding': 'new abdominopelvic ascites', 'cf_snomed': {'ascites': 389026000}, 'existence': 'pos_dx', 'descriptive_term': 'new abdominopelvic', 'observation': 'ascite', 'temporal_term': 'new'}}size_fin: [{'size': '5.2 x 4.4 cm'}]anatomical entity_fin: {'prostate': {}}clinical findings_fin: {'enlarged': {'clinical finding': 'enlarged', 'existence': 'pos_dx', 'observation': 'enlarged'}}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'}}anatomical entity_fin: {'bowel': {}}clinical findings_fin: {'obstruction': {'clinical finding': 'obstruction', 'cf_snomed': {'obstruction': 26036001}, 'existence': 'neg_dx', 'observation': 'obstruction'}, 'inflammatory changes': {'clinical finding': 'inflammatory changes', 'existence': 'neg_dx', 'descriptive_term': 'inflammatory', 'observation': 'change'}}clinical findings_fin: {'diverticulosis': {'clinical finding': 'diverticulosis', 'existence': 'pos_dx', 'observation': 'diverticulosis'}, 'acute diverticulitis': {'clinical finding': 'acute diverticulitis', 'cf_snomed': {'diverticulitis': 307496006}, 'existence': 'neg_dx', 'descriptive_term': 'acute', 'observation': 'diverticulitis', 'strength_term': 'acute', 'temporal_term': 'acute'}}anatomical entity_fin: {'appendix': {}}clinical findings_fin: {'normal -appearing appendix': {'clinical finding': 'normal -appearing appendix'}}clinical findings_fin: {'stable degenerative changes': {'clinical finding': 'stable degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'stable degenerative', 'observation': 'change', 'strength_term': 'stable', 'change_term': 'stable'}}anatomical entity_fin: {'pelvis': {}}clinical findings_fin: {'subtle peritoneal thickening': {'clinical finding': 'subtle peritoneal thickening', 'existence': 'pos_dx', 'descriptive_term': 'subtle peritoneal', 'observation': 'thickening', 'strength_term': 'subtle'}, 'carcinomatosis': {'clinical finding': 'carcinomatosis', 'cf_snomed': {'carcinomatosis': 307593001}, 'existence': 'pos_dx', 'observation': 'carcinomatosis'}}
<s>[INST] Write the finding section for a radiology report based on the following information: location descriptor_fin: ['bilateral']clinical findings_fin: {'new small bilateral pleural effusions': {'clinical finding': 'new small bilateral pleural effusions', 'cf_snomed': {'bilateral pleural effusion': 425802001}, 'existence': 'pos_dx', 'descriptive_term': 'new small bilateral pleural', 'observation': 'effusion', 'strength_term': 'small', 'temporal_term': 'new'}, 'associated atelectasis': {'clinical finding': 'associated atelectasis', 'cf_snomed': {'atelectasis': 46621007}, 'existence': 'pos_dx', 'descriptive_term': 'associated', 'observation': 'atelectasis'}}clinical findings_fin: {'additional scattered pulmonary micronodules': {'clinical finding': 'additional scattered pulmonary micronodules', 'existence': 'pos_dx', 'descriptive_term': 'additional scattered pulmonary', 'observation': 'micronodule'}}anatomical entity_fin: {'heart': {}}location descriptor_fin: ['upper']clinical findings_fin: {'significant pericardial effusion': {'clinical finding': 'significant pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'pos_dx', 'descriptive_term': 'significant pericardial', 'observation': 'effusion'}}anatomical entity_fin: {'chest': {'location descriptor': 'right'}}location descriptor_fin: ['right', 'distal']object_fin: ['port']clinical findings_fin: {'mediastinal or hilar lymphadenopathy': {'clinical finding': 'mediastinal or hilar lymphadenopathy', 'cf_snomed': {'hilar lymphadenopathy': 87500009}, 'existence': 'neg_dx', 'descriptive_term': 'mediastinal or hilar', 'observation': 'lymphadenopathy'}}anatomical entity_fin: {'esophagus': {'location descriptor': 'distal'}}location descriptor_fin: ['distal']object_fin: ['tube']clinical findings_fin: {'coronary stents': {'clinical finding': 'coronary stents', 'existence': 'unc_dx', 'descriptive_term': 'coronary', 'observation': 'stent'}}clinical findings_fin: {'scattered degenerative changes': {'clinical finding': 'scattered degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'scattered degenerative', 'observation': 'change'}}clinical findings_fin: {'focal hepatic masses': {'clinical finding': 'focal hepatic masses', 'existence': 'neg_dx', 'descriptive_term': 'focal hepatic', 'observation': 'mass'}}anatomical entity_fin: {'gallbladder': {}}clinical findings_fin: {'gallbladder is within normal limits': {'clinical finding': 'gallbladder is within normal limits'}}imaging observation_fin: ['falciform ligament']clinical findings_fin: {'free air': {'clinical finding': 'free air', 'existence': 'pos_dx', 'descriptive_term': 'free', 'observation': 'air'}}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'}}location descriptor_fin: ['left']clinical findings_fin: {'unchanged left renal cyst': {'clinical finding': 'unchanged left renal cyst', 'cf_snomed': {'cyst': 441457006}, 'existence': 'pos_dx', 'descriptive_term': 'unchanged left renal', 'observation': 'cyst', 'strength_term': 'unchanged', 'change_term': 'unchanged'}}location descriptor_fin: ['right']clinical findings_fin: {'renal hypodensities': {'clinical finding': 'renal hypodensities', 'existence': 'pos_dx', 'descriptive_term': 'renal', 'observation': 'hypodensity'}}clinical findings_fin: {'hydronephrosis': {'clinical finding': 'hydronephrosis', 'cf_snomed': {'hydronephrosis': 43064006}, 'existence': 'neg_dx', 'observation': 'hydronephrosis'}, 'nephrolithiasis': {'clinical finding': 'nephrolithiasis', 'existence': 'neg_dx', 'observation': 'nephrolithiasis'}}location descriptor_fin: ['superior']clinical findings_fin: {'multiple periportal and superior peripancreatic lymph nodes': {'clinical finding': 'multiple periportal and superior peripancreatic lymph nodes', 'cf_snomed': {'peripancreatic lymph node': 245346008}, 'existence': 'pos_dx', 'descriptive_term': 'multiple periportal and superior peripancreatic lymph', 'observation': 'node', 'strength_term': 'superior', 'quantity_term': 'multiple'}}size_fin: [{'size': '16 mm'}, {'size': '14 mm'}]clinical findings_fin: {'reference portal lymph node': {'clinical finding': 'reference portal lymph node', 'existence': 'pos_dx', 'descriptive_term': 'reference portal lymph', 'observation': 'node'}}anatomical entity_fin: {'hepatic artery': {}, 'portal vein': {}}clinical findings_fin: {'tumor': {'clinical finding': 'tumor', 'existence': 'pos_dx', 'observation': 'tumor'}, 'patent': {'clinical finding': 'patent', 'existence': 'pos_dx', 'observation': 'patent'}}clinical findings_fin: {'asymmetric heterogeneous thickening': {'clinical finding': 'asymmetric heterogeneous thickening', 'existence': 'pos_dx', 'descriptive_term': 'asymmetric heterogeneous', 'observation': 'thickening'}, 'known gastric carcinoma': {'clinical finding': 'known gastric carcinoma', 'cf_snomed': {'carcinoma': 1187425009}, 'existence': 'pos_dx', 'descriptive_term': 'known gastric', 'observation': 'carcinoma'}}imaging observation_fin: ['margins']clinical findings_fin: {'margins of which are poorly defined , this appears to be more extensive than on previous study': {'clinical finding': 'margins of which are poorly defined , this appears to be more extensive than on previous study'}}imaging observation_fin: ['foci']clinical findings_fin: {'multiple clustered gaseous foci': {'clinical finding': 'multiple clustered gaseous foci', 'existence': 'pos_dx', 'descriptive_term': 'multiple clustered gaseous', 'observation': 'foci', 'quantity_term': 'multiple'}, 'mass': {'clinical finding': 'mass', 'existence': 'pos_dx', 'observation': 'mass'}, 'perforation': {'clinical finding': 'perforation', 'cf_snomed': {'perforation': 36191001}, 'existence': 'unc_dx', 'observation': 'perforation'}}clinical findings_fin: {'progression': {'clinical finding': 'progression', 'existence': 'neg_dx', 'observation': 'progression'}, 'contrast': {'clinical finding': 'contrast', 'existence': 'neg_dx', 'observation': 'contrast'}, 'mass': {'clinical finding': 'mass', 'existence': 'neg_dx', 'observation': 'mass'}, 'suspected perforation': {'clinical finding': 'suspected perforation', 'cf_snomed': {'perforation': 36191001}, 'existence': 'neg_dx', 'descriptive_term': 'suspected', 'observation': 'perforation'}, 'free intraperitoneal contrast': {'clinical finding': 'free intraperitoneal contrast', 'existence': 'neg_dx', 'descriptive_term': 'free intraperitoneal', 'observation': 'contrast'}}anatomical entity_fin: {'peritoneum': {}, 'mesentery': {}}clinical findings_fin: {'multifocal nodularity': {'clinical finding': 'multifocal nodularity', 'existence': 'pos_dx', 'descriptive_term': 'multifocal', 'observation': 'nodularity'}, 'peritoneal or mesenteric carcinomatosis': {'clinical finding': 'peritoneal or mesenteric carcinomatosis', 'cf_snomed': {'carcinomatosis': 307593001}, 'existence': 'unc_dx', 'descriptive_term': 'peritoneal or mesenteric', 'observation': 'carcinomatosis'}}size_fin: [{'size': '8 mm'}, {'size': '6 mm'}]anatomical entity_fin: {'greater omentum': {}, 'axis': {}}clinical findings_fin: {'previously described abnormal lymph node': {'clinical finding': 'previously described abnormal lymph node', 'existence': 'pos_dx', 'descriptive_term': 'previously described abnormal lymph', 'observation': 'node'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}anatomical entity_fin: {'anterior abdominal wall': {}, 'lesser sac': {}, 'pelvis': {}}imaging observation_fin: ['falciform ligament']clinical findings_fin: {'extensive pneumoperitoneum': {'clinical finding': 'extensive pneumoperitoneum', 'cf_snomed': {'pneumoperitoneum': 17204006}, 'existence': 'pos_dx', 'descriptive_term': 'extensive', 'observation': 'pneumoperitoneum', 'strength_term': 'extensive'}}anatomical entity_fin: {'fluid': {}}clinical findings_fin: {'new abdominopelvic ascites': {'clinical finding': 'new abdominopelvic ascites', 'cf_snomed': {'ascites': 389026000}, 'existence': 'pos_dx', 'descriptive_term': 'new abdominopelvic', 'observation': 'ascite', 'temporal_term': 'new'}}size_fin: [{'size': '5.2 x 4.4 cm'}]anatomical entity_fin: {'prostate': {}}clinical findings_fin: {'enlarged': {'clinical finding': 'enlarged', 'existence': 'pos_dx', 'observation': 'enlarged'}}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'}}anatomical entity_fin: {'bowel': {}}clinical findings_fin: {'obstruction': {'clinical finding': 'obstruction', 'cf_snomed': {'obstruction': 26036001}, 'existence': 'neg_dx', 'observation': 'obstruction'}, 'inflammatory changes': {'clinical finding': 'inflammatory changes', 'existence': 'neg_dx', 'descriptive_term': 'inflammatory', 'observation': 'change'}}clinical findings_fin: {'diverticulosis': {'clinical finding': 'diverticulosis', 'existence': 'pos_dx', 'observation': 'diverticulosis'}, 'acute diverticulitis': {'clinical finding': 'acute diverticulitis', 'cf_snomed': {'diverticulitis': 307496006}, 'existence': 'neg_dx', 'descriptive_term': 'acute', 'observation': 'diverticulitis', 'strength_term': 'acute', 'temporal_term': 'acute'}}anatomical entity_fin: {'appendix': {}}clinical findings_fin: {'normal -appearing appendix': {'clinical finding': 'normal -appearing appendix'}}clinical findings_fin: {'stable degenerative changes': {'clinical finding': 'stable degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'stable degenerative', 'observation': 'change', 'strength_term': 'stable', 'change_term': 'stable'}}anatomical entity_fin: {'pelvis': {}}clinical findings_fin: {'subtle peritoneal thickening': {'clinical finding': 'subtle peritoneal thickening', 'existence': 'pos_dx', 'descriptive_term': 'subtle peritoneal', 'observation': 'thickening', 'strength_term': 'subtle'}, 'carcinomatosis': {'clinical finding': 'carcinomatosis', 'cf_snomed': {'carcinomatosis': 307593001}, 'existence': 'pos_dx', 'observation': 'carcinomatosis'}} [/INST] . New small bilateral pleural effusions and associated atelectasis. Additional scattered pulmonary micronodules are unchanged. The heart is upper limits of normal, without significant pericardial effusion. Right chest port tip terminates in the distal SVC. No mediastinal or hilar lymphadenopathy. Enteric tube terminates in the distal esophagus. Severe. Additionally, coronary stents are presumed. Scattered degenerative changes. No focal hepatic masses identified. No intra or extra hepatic biliary dilatation. The gallbladder is within normal limits. Free air is seen within the falciform ligament. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. Unchanged left renal cyst. Subcentimeter right renal hypodensities are too small to characterize. No hydronephrosis or nephrolithiasis. Interval enlargement of multiple periportal and superior peripancreatic lymph nodes, many of which appear centrally necrotic. The reference portal lymph node measures 16 mm , previously 14 mm. Tumor continues to encase the hepatic artery and portal vein, but these vessels remain patent. Mild. Again seen is asymmetric heterogeneous thickening of the gastric antropyloric region, compatible with known gastric carcinoma. Although the margins of which are poorly defined, this appears to be more extensive than on previous study. Additionally, there are multiple clustered gaseous foci at the level of the mass, suggesting that this is the site of perforation. There is no progression of contrast beyond the level of the mass or suspected perforation, although no free intraperitoneal contrast is identified. Multifocal nodularity in the peritoneum and mesentery suggestive of peritoneal or mesenteric carcinomatosis. The previously described abnormal lymph node in the greater omentum currently measures 8 mm in short axis , previously 6 mm. No significant abnormality noted. Extensive pneumoperitoneum tracking along the anterior abdominal wall as well as the lesser sac, the falciform ligament, and the pelvis. New abdominopelvic ascites, measuring simple fluid density. The prostate is enlarged measuring 5.2 x 4.4 cm. No significant abnormality noted. No significant abnormality noted. The small bowel is normal in caliber and thickness without evidence of obstruction or inflammatory changes. Diverticulosis without evidence of acute diverticulitis. Normal-appearing appendix. Stable degenerative changes. Subtle peritoneal thickening in the pelvis suggests carcinomatosis. </s>