. This examination is diagnostic for the evaluation of pulmonary embolism to the subsegmental level. No pulmonary embolus is present. There is subsegmental atelectasis within the posterior basal segments of bilateral lower lobes. Within the lateral left lower lobe, there is a groundglass focus measuring approximately 11 x 16 mm. It does appear flat on the coronal images. Ill-defined groundglass more central to this nodule. In the clinical setting of suspected endocarditis, septic embolus is a consideration. Recommend repeat CT thorax in 8 weeks or at the termination of antibiotic treatment, to ensure resolution. Other considerations include scar from prior inflammation or septic embolus. Less likely is an indolent adenocarcinoma. No pneumothorax or pleural effusion. Two ventricular ICD electrodes occupy the right ventricle. Both electrode tips appear to extend just beyond the right ventricular apex, terminating within the epicardial fat. There is no associated pericardial effusion, pericardial thickening or pneumopericardium. There is beam hardening artifact present which limits evaluation of the exact location of the electrode tips but small right ventricular apical wall perforations may be present. None. Immediately superior to the pulse generator, there is induration of the subcutaneous fat with skin thickening that extends to the superior field-of-view. There is beam hardening artifact at the level of the pulse generator however, no focal abscess at the pocket is identified. Upon discussion with the nurse caring for the patient, Carrie, the patient has suspected pocket infection and possible endocarditis. There is limited visualization of the tricuspid valve due to additional beam hardening artifact and therefore potential vegetation on this valve cannot be evaluated. No significant vegetation is identified on the pulmonic, mitral or aortic valves. Of note, this examination was not ECG gated which may limit visualization of the valves. Consider echocardiogram for further evaluation of the cardiac valves. No intracardiac thrombus is visualized. Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Evidence of fatty infiltration adjacent to the falciform ligament.
location descriptor_fin: ['subsegmental']clinical findings_fin: {'pulmonary embolism': {'clinical finding': 'pulmonary embolism', 'cf_snomed': {'pulmonary embolism': 59282003}, 'existence': 'unc_dx', 'descriptive_term': 'pulmonary', 'observation': 'embolism'}}clinical findings_fin: {'pulmonary embolus': {'clinical finding': 'pulmonary embolus', 'cf_snomed': {'embolus': 55584005}, 'existence': 'neg_dx', 'descriptive_term': 'pulmonary', 'observation': 'embolus'}}anatomical entity_fin: {'lobes': {'location descriptor': 'bilateral lower'}}location descriptor_fin: ['subsegmental', 'posterior', 'bilateral', 'lower']clinical findings_fin: {'subsegmental atelectasis': {'clinical finding': 'subsegmental atelectasis', 'cf_snomed': {'atelectasis': 46621007}, 'existence': 'pos_dx', 'descriptive_term': 'subsegmental', 'observation': 'atelectasis'}}size_fin: [{'size': '11 x 16 mm', 'size_descriptor': 'focus'}]anatomical entity_fin: {'lobe': {'location descriptor': 'left lower'}}location descriptor_fin: ['lateral', 'left', 'lower']location descriptor_fin: ['central']clinical findings_fin: {'ill-defined groundglass': {'clinical finding': 'ill-defined groundglass', 'existence': 'pos_dx', 'descriptive_term': 'ill-defined', 'observation': 'groundglass', 'strength_term': 'ill-defined'}, 'this nodule': {'clinical finding': 'this nodule', 'cf_snomed': {'nodule': 27925004}, 'existence': 'pos_dx', 'descriptive_term': 'this', 'observation': 'nodule'}}clinical findings_fin: {'suspected endocarditis': {'clinical finding': 'suspected endocarditis', 'cf_snomed': {'endocarditis': 56819008}, 'existence': 'pos_dx', 'descriptive_term': 'suspected', 'observation': 'endocarditis'}, 'septic embolus': {'clinical finding': 'septic embolus', 'cf_snomed': {'septic embolus': 72237000}, 'existence': 'unc_dx', 'descriptive_term': 'septic', 'observation': 'embolus'}}anatomical entity_fin: {'thorax': {}}non-anatomical substance_fin: ['antibiotic']procedure_fin: ['treatment']clinical findings_fin: {'resolution': {'clinical finding': 'resolution', 'existence': 'unc_dx', 'observation': 'resolution'}}clinical findings_fin: {'scar': {'clinical finding': 'scar', 'cf_snomed': {'scar': 275322007}, 'existence': 'unc_dx', 'observation': 'scar'}, 'prior inflammation': {'clinical finding': 'prior inflammation', 'existence': 'unc_dx', 'descriptive_term': 'prior', 'observation': 'inflammation'}, 'septic embolus': {'clinical finding': 'septic embolus', 'cf_snomed': {'septic embolus': 72237000}, 'existence': 'unc_dx', 'descriptive_term': 'septic', 'observation': 'embolus'}}clinical findings_fin: {'indolent adenocarcinoma': {'clinical finding': 'indolent adenocarcinoma', 'cf_snomed': {'adenocarcinoma': 1187332001}, 'existence': 'unc_dx', 'descriptive_term': 'indolent', 'observation': 'adenocarcinoma'}}clinical findings_fin: {'pneumothorax': {'clinical finding': 'pneumothorax', 'cf_snomed': {'pneumothorax': 36118008}, 'existence': 'neg_dx', 'observation': 'pneumothorax'}, 'pleural effusion': {'clinical finding': 'pleural effusion', 'cf_snomed': {'pleural effusion': 60046008}, 'existence': 'neg_dx', 'descriptive_term': 'pleural', 'observation': 'effusion'}}anatomical entity_fin: {'right ventricle': {}}clinical findings_fin: {'two ventricular icd electrodes': {'clinical finding': 'two ventricular icd electrodes', 'existence': 'pos_dx', 'descriptive_term': 'two ventricular icd', 'observation': 'electrode'}}anatomical entity_fin: {'apex': {}}imaging observation_fin: ['fat']location descriptor_fin: ['right']object_fin: ['electrode']clinical findings_fin: {'associated pericardial effusion': {'clinical finding': 'associated pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'neg_dx', 'descriptive_term': 'associated pericardial', 'observation': 'effusion'}, 'pericardial thickening': {'clinical finding': 'pericardial thickening', 'existence': 'neg_dx', 'descriptive_term': 'pericardial', 'observation': 'thickening'}, 'pneumopericardium': {'clinical finding': 'pneumopericardium', 'cf_snomed': {'pneumopericardium': 82542004}, 'existence': 'neg_dx', 'observation': 'pneumopericardium'}}anatomical entity_fin: {'wall': {}}imaging observation_fin: ['apical']location descriptor_fin: ['right']object_fin: ['electrode']clinical findings_fin: {'beam hardening artifact': {'clinical finding': 'beam hardening artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'beam hardening', 'observation': 'artifact'}, 'small right ventricular apical wall perforations': {'clinical finding': 'small right ventricular apical wall perforations', 'cf_snomed': {'perforation': 36191001}, 'existence': 'unc_dx', 'descriptive_term': 'small right ventricular apical wall', 'observation': 'perforation', 'strength_term': 'small'}}anatomical entity_fin: {'subcutaneous fat': {}}location descriptor_fin: ['superior']clinical findings_fin: {'skin thickening': {'clinical finding': 'skin thickening', 'existence': 'pos_dx', 'descriptive_term': 'skin', 'observation': 'thickening'}}clinical findings_fin: {'beam hardening artifact': {'clinical finding': 'beam hardening artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'beam hardening', 'observation': 'artifact'}, 'pulse generator': {'clinical finding': 'pulse generator', 'existence': 'pos_dx', 'descriptive_term': 'pulse', 'observation': 'generator'}, 'focal abscess': {'clinical finding': 'focal abscess', 'cf_snomed': {'abscess': 128477000}, 'existence': 'neg_dx', 'descriptive_term': 'focal', 'observation': 'abscess'}}clinical findings_fin: {'suspected pocket infection': {'clinical finding': 'suspected pocket infection', 'existence': 'unc_dx', 'descriptive_term': 'suspected pocket', 'observation': 'infection'}, 'possible endocarditis': {'clinical finding': 'possible endocarditis', 'cf_snomed': {'endocarditis': 56819008}, 'existence': 'unc_dx', 'descriptive_term': 'possible', 'observation': 'endocarditis'}}anatomical entity_fin: {'tricuspid valve': {}}object_fin: ['valve']clinical findings_fin: {'additional beam hardening artifact': {'clinical finding': 'additional beam hardening artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'additional beam hardening', 'observation': 'artifact'}, 'potential vegetation': {'clinical finding': 'potential vegetation', 'existence': 'unc_dx', 'descriptive_term': 'potential', 'observation': 'vegetation'}}anatomical entity_fin: {'aortic valves': {}}clinical findings_fin: {'significant vegetation': {'clinical finding': 'significant vegetation', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'vegetation'}}clinical findings_fin: {'intracardiac thrombus': {'clinical finding': 'intracardiac thrombus', 'cf_snomed': {'thrombus': 396339007}, 'existence': 'neg_dx', 'descriptive_term': 'intracardiac', 'observation': 'thrombus'}}anatomical entity_fin: {'abdominal': {}}clinical findings_fin: {'enteric contrast': {'clinical finding': 'enteric contrast', 'existence': 'neg_dx', 'descriptive_term': 'enteric', 'observation': 'contrast'}}imaging observation_fin: ['falciform ligament']location descriptor_fin: ['adjacent']clinical findings_fin: {'fatty infiltration': {'clinical finding': 'fatty infiltration', 'cf_snomed': {'fatty infiltration': 45752008}, 'existence': 'pos_dx', 'descriptive_term': 'fatty', 'observation': 'infiltration'}}
<s>[INST] Write the finding section for a radiology report based on the following information: location descriptor_fin: ['subsegmental']clinical findings_fin: {'pulmonary embolism': {'clinical finding': 'pulmonary embolism', 'cf_snomed': {'pulmonary embolism': 59282003}, 'existence': 'unc_dx', 'descriptive_term': 'pulmonary', 'observation': 'embolism'}}clinical findings_fin: {'pulmonary embolus': {'clinical finding': 'pulmonary embolus', 'cf_snomed': {'embolus': 55584005}, 'existence': 'neg_dx', 'descriptive_term': 'pulmonary', 'observation': 'embolus'}}anatomical entity_fin: {'lobes': {'location descriptor': 'bilateral lower'}}location descriptor_fin: ['subsegmental', 'posterior', 'bilateral', 'lower']clinical findings_fin: {'subsegmental atelectasis': {'clinical finding': 'subsegmental atelectasis', 'cf_snomed': {'atelectasis': 46621007}, 'existence': 'pos_dx', 'descriptive_term': 'subsegmental', 'observation': 'atelectasis'}}size_fin: [{'size': '11 x 16 mm', 'size_descriptor': 'focus'}]anatomical entity_fin: {'lobe': {'location descriptor': 'left lower'}}location descriptor_fin: ['lateral', 'left', 'lower']location descriptor_fin: ['central']clinical findings_fin: {'ill-defined groundglass': {'clinical finding': 'ill-defined groundglass', 'existence': 'pos_dx', 'descriptive_term': 'ill-defined', 'observation': 'groundglass', 'strength_term': 'ill-defined'}, 'this nodule': {'clinical finding': 'this nodule', 'cf_snomed': {'nodule': 27925004}, 'existence': 'pos_dx', 'descriptive_term': 'this', 'observation': 'nodule'}}clinical findings_fin: {'suspected endocarditis': {'clinical finding': 'suspected endocarditis', 'cf_snomed': {'endocarditis': 56819008}, 'existence': 'pos_dx', 'descriptive_term': 'suspected', 'observation': 'endocarditis'}, 'septic embolus': {'clinical finding': 'septic embolus', 'cf_snomed': {'septic embolus': 72237000}, 'existence': 'unc_dx', 'descriptive_term': 'septic', 'observation': 'embolus'}}anatomical entity_fin: {'thorax': {}}non-anatomical substance_fin: ['antibiotic']procedure_fin: ['treatment']clinical findings_fin: {'resolution': {'clinical finding': 'resolution', 'existence': 'unc_dx', 'observation': 'resolution'}}clinical findings_fin: {'scar': {'clinical finding': 'scar', 'cf_snomed': {'scar': 275322007}, 'existence': 'unc_dx', 'observation': 'scar'}, 'prior inflammation': {'clinical finding': 'prior inflammation', 'existence': 'unc_dx', 'descriptive_term': 'prior', 'observation': 'inflammation'}, 'septic embolus': {'clinical finding': 'septic embolus', 'cf_snomed': {'septic embolus': 72237000}, 'existence': 'unc_dx', 'descriptive_term': 'septic', 'observation': 'embolus'}}clinical findings_fin: {'indolent adenocarcinoma': {'clinical finding': 'indolent adenocarcinoma', 'cf_snomed': {'adenocarcinoma': 1187332001}, 'existence': 'unc_dx', 'descriptive_term': 'indolent', 'observation': 'adenocarcinoma'}}clinical findings_fin: {'pneumothorax': {'clinical finding': 'pneumothorax', 'cf_snomed': {'pneumothorax': 36118008}, 'existence': 'neg_dx', 'observation': 'pneumothorax'}, 'pleural effusion': {'clinical finding': 'pleural effusion', 'cf_snomed': {'pleural effusion': 60046008}, 'existence': 'neg_dx', 'descriptive_term': 'pleural', 'observation': 'effusion'}}anatomical entity_fin: {'right ventricle': {}}clinical findings_fin: {'two ventricular icd electrodes': {'clinical finding': 'two ventricular icd electrodes', 'existence': 'pos_dx', 'descriptive_term': 'two ventricular icd', 'observation': 'electrode'}}anatomical entity_fin: {'apex': {}}imaging observation_fin: ['fat']location descriptor_fin: ['right']object_fin: ['electrode']clinical findings_fin: {'associated pericardial effusion': {'clinical finding': 'associated pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'neg_dx', 'descriptive_term': 'associated pericardial', 'observation': 'effusion'}, 'pericardial thickening': {'clinical finding': 'pericardial thickening', 'existence': 'neg_dx', 'descriptive_term': 'pericardial', 'observation': 'thickening'}, 'pneumopericardium': {'clinical finding': 'pneumopericardium', 'cf_snomed': {'pneumopericardium': 82542004}, 'existence': 'neg_dx', 'observation': 'pneumopericardium'}}anatomical entity_fin: {'wall': {}}imaging observation_fin: ['apical']location descriptor_fin: ['right']object_fin: ['electrode']clinical findings_fin: {'beam hardening artifact': {'clinical finding': 'beam hardening artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'beam hardening', 'observation': 'artifact'}, 'small right ventricular apical wall perforations': {'clinical finding': 'small right ventricular apical wall perforations', 'cf_snomed': {'perforation': 36191001}, 'existence': 'unc_dx', 'descriptive_term': 'small right ventricular apical wall', 'observation': 'perforation', 'strength_term': 'small'}}anatomical entity_fin: {'subcutaneous fat': {}}location descriptor_fin: ['superior']clinical findings_fin: {'skin thickening': {'clinical finding': 'skin thickening', 'existence': 'pos_dx', 'descriptive_term': 'skin', 'observation': 'thickening'}}clinical findings_fin: {'beam hardening artifact': {'clinical finding': 'beam hardening artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'beam hardening', 'observation': 'artifact'}, 'pulse generator': {'clinical finding': 'pulse generator', 'existence': 'pos_dx', 'descriptive_term': 'pulse', 'observation': 'generator'}, 'focal abscess': {'clinical finding': 'focal abscess', 'cf_snomed': {'abscess': 128477000}, 'existence': 'neg_dx', 'descriptive_term': 'focal', 'observation': 'abscess'}}clinical findings_fin: {'suspected pocket infection': {'clinical finding': 'suspected pocket infection', 'existence': 'unc_dx', 'descriptive_term': 'suspected pocket', 'observation': 'infection'}, 'possible endocarditis': {'clinical finding': 'possible endocarditis', 'cf_snomed': {'endocarditis': 56819008}, 'existence': 'unc_dx', 'descriptive_term': 'possible', 'observation': 'endocarditis'}}anatomical entity_fin: {'tricuspid valve': {}}object_fin: ['valve']clinical findings_fin: {'additional beam hardening artifact': {'clinical finding': 'additional beam hardening artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'additional beam hardening', 'observation': 'artifact'}, 'potential vegetation': {'clinical finding': 'potential vegetation', 'existence': 'unc_dx', 'descriptive_term': 'potential', 'observation': 'vegetation'}}anatomical entity_fin: {'aortic valves': {}}clinical findings_fin: {'significant vegetation': {'clinical finding': 'significant vegetation', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'vegetation'}}clinical findings_fin: {'intracardiac thrombus': {'clinical finding': 'intracardiac thrombus', 'cf_snomed': {'thrombus': 396339007}, 'existence': 'neg_dx', 'descriptive_term': 'intracardiac', 'observation': 'thrombus'}}anatomical entity_fin: {'abdominal': {}}clinical findings_fin: {'enteric contrast': {'clinical finding': 'enteric contrast', 'existence': 'neg_dx', 'descriptive_term': 'enteric', 'observation': 'contrast'}}imaging observation_fin: ['falciform ligament']location descriptor_fin: ['adjacent']clinical findings_fin: {'fatty infiltration': {'clinical finding': 'fatty infiltration', 'cf_snomed': {'fatty infiltration': 45752008}, 'existence': 'pos_dx', 'descriptive_term': 'fatty', 'observation': 'infiltration'}} [/INST] . This examination is diagnostic for the evaluation of pulmonary embolism to the subsegmental level. No pulmonary embolus is present. There is subsegmental atelectasis within the posterior basal segments of bilateral lower lobes. Within the lateral left lower lobe, there is a groundglass focus measuring approximately 11 x 16 mm. It does appear flat on the coronal images. Ill-defined groundglass more central to this nodule. In the clinical setting of suspected endocarditis, septic embolus is a consideration. Recommend repeat CT thorax in 8 weeks or at the termination of antibiotic treatment, to ensure resolution. Other considerations include scar from prior inflammation or septic embolus. Less likely is an indolent adenocarcinoma. No pneumothorax or pleural effusion. Two ventricular ICD electrodes occupy the right ventricle. Both electrode tips appear to extend just beyond the right ventricular apex, terminating within the epicardial fat. There is no associated pericardial effusion, pericardial thickening or pneumopericardium. There is beam hardening artifact present which limits evaluation of the exact location of the electrode tips but small right ventricular apical wall perforations may be present. None. Immediately superior to the pulse generator, there is induration of the subcutaneous fat with skin thickening that extends to the superior field-of-view. There is beam hardening artifact at the level of the pulse generator however, no focal abscess at the pocket is identified. Upon discussion with the nurse caring for the patient, Carrie, the patient has suspected pocket infection and possible endocarditis. There is limited visualization of the tricuspid valve due to additional beam hardening artifact and therefore potential vegetation on this valve cannot be evaluated. No significant vegetation is identified on the pulmonic, mitral or aortic valves. Of note, this examination was not ECG gated which may limit visualization of the valves. Consider echocardiogram for further evaluation of the cardiac valves. No intracardiac thrombus is visualized. Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Evidence of fatty infiltration adjacent to the falciform ligament. </s>