. Severe apical predominant centrilobular emphysema. Spiculated lesion in the lateral aspect of the superior segment of the right lower lobe measuring approximately 7 x 9 mm , previously 7 x 6 mm and also appears more solid than on previous study, suggestive of pulmonary pulmonary neoplasm. A smaller satellite lesion slightly more inferior in the right lower lobe measures 5 mm , previously 4 mm, suspicious for metastatic disease. Additional micronodules are seen along the posterior right lower lobe, nonspecific, but metastatic disease cant be excluded. No suspicious mass or lesion is identified in the left lung. Scarring along the right paramediastinum likely represents posttreatment changes. The heart size is within normal limits, no significant pericardial effusion. Scattered subcentimeter mediastinal and hilar lymph nodes. Small hiatal hernia. Mild. No significant axillary lymphadenopathy. Scattered mild multilevel degenerative changes of the thoracolumbar spine. Absence of enteric contrast material limits sensitivity for abdominal pathology. Please report of concurrent CT abdomen or pelvis for dedicated findings.
imaging observation_fin: ['apical']clinical findings_fin: {'severe apical predominant centrilobular emphysema': {'clinical finding': 'severe apical predominant centrilobular emphysema', 'cf_snomed': {'emphysema': 49158009}, 'existence': 'pos_dx', 'descriptive_term': 'severe apical predominant centrilobular', 'observation': 'emphysema', 'strength_term': 'severe'}}size_fin: [{'size': '7 x 9 mm'}, {'size': '7 x 6 mm'}]anatomical entity_fin: {'lobe': {'location descriptor': 'right lower'}}location descriptor_fin: ['lateral', 'superior', 'right', 'lower']clinical findings_fin: {'spiculated lesion': {'clinical finding': 'spiculated lesion', 'cf_snomed': {'spiculated lesion': 129742005}, 'existence': 'pos_dx', 'descriptive_term': 'spiculated', 'observation': 'lesion'}, 'pulmonary pulmonary neoplasm': {'clinical finding': 'pulmonary pulmonary neoplasm', 'cf_snomed': {'neoplasm': 108369006}, 'existence': 'unc_dx', 'descriptive_term': 'pulmonary pulmonary', 'observation': 'neoplasm'}}size_fin: [{'size': '5 mm'}, {'size': '4 mm'}]anatomical entity_fin: {'lobe': {'location descriptor': 'right lower'}}location descriptor_fin: ['inferior', 'right', 'lower']clinical findings_fin: {'smaller satellite lesion': {'clinical finding': 'smaller satellite lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'smaller satellite', 'observation': 'lesion'}, 'metastatic disease': {'clinical finding': 'metastatic disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'unc_dx', 'descriptive_term': 'metastatic', 'observation': 'disease'}}anatomical entity_fin: {'lobe': {'location descriptor': 'right lower'}}location descriptor_fin: ['posterior', 'right', 'lower']clinical findings_fin: {'additional micronodules': {'clinical finding': 'additional micronodules', 'existence': 'pos_dx', 'descriptive_term': 'additional', 'observation': 'micronodule'}, 'metastatic disease': {'clinical finding': 'metastatic disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'unc_dx', 'descriptive_term': 'metastatic', 'observation': 'disease'}}anatomical entity_fin: {'left lung': {}}clinical findings_fin: {'suspicious mass': {'clinical finding': 'suspicious mass', 'existence': 'neg_dx', 'descriptive_term': 'suspicious', 'observation': 'mass'}, 'lesion': {'clinical finding': 'lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'neg_dx', 'observation': 'lesion'}}location descriptor_fin: ['right']clinical findings_fin: {'posttreatment changes': {'clinical finding': 'posttreatment changes', 'existence': 'pos_dx', 'descriptive_term': 'posttreatment', 'observation': 'change'}}anatomical entity_fin: {'heart': {}}clinical findings_fin: {'significant pericardial effusion': {'clinical finding': 'significant pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'neg_dx', 'descriptive_term': 'significant pericardial', 'observation': 'effusion'}}clinical findings_fin: {'scattered subcentimeter mediastinal and hilar lymph nodes': {'clinical finding': 'scattered subcentimeter mediastinal and hilar lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'scattered subcentimeter mediastinal and hilar lymph', 'observation': 'node'}}clinical findings_fin: {'small hiatal hernia': {'clinical finding': 'small hiatal hernia', 'cf_snomed': {'hiatal hernia': 84089009}, 'existence': 'pos_dx', 'descriptive_term': 'small hiatal', 'observation': 'hernia', 'strength_term': 'small'}}clinical findings_fin: {'significant axillary lymphadenopathy': {'clinical finding': 'significant axillary lymphadenopathy', 'cf_snomed': {'axillary lymphadenopathy': 127189005}, 'existence': 'neg_dx', 'descriptive_term': 'significant axillary', 'observation': 'lymphadenopathy'}}anatomical entity_fin: {'spine': {}}clinical findings_fin: {'mild multilevel degenerative changes': {'clinical finding': 'mild multilevel degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'mild multilevel degenerative', 'observation': 'change', 'strength_term': 'mild'}}anatomical entity_fin: {'abdominal': {}}clinical findings_fin: {'enteric contrast': {'clinical finding': 'enteric contrast', 'existence': 'neg_dx', 'descriptive_term': 'enteric', 'observation': 'contrast'}}anatomical entity_fin: {'abdomen': {}, 'pelvis': {}}
<s>[INST] Write the finding section for a radiology report based on the following information: imaging observation_fin: ['apical']clinical findings_fin: {'severe apical predominant centrilobular emphysema': {'clinical finding': 'severe apical predominant centrilobular emphysema', 'cf_snomed': {'emphysema': 49158009}, 'existence': 'pos_dx', 'descriptive_term': 'severe apical predominant centrilobular', 'observation': 'emphysema', 'strength_term': 'severe'}}size_fin: [{'size': '7 x 9 mm'}, {'size': '7 x 6 mm'}]anatomical entity_fin: {'lobe': {'location descriptor': 'right lower'}}location descriptor_fin: ['lateral', 'superior', 'right', 'lower']clinical findings_fin: {'spiculated lesion': {'clinical finding': 'spiculated lesion', 'cf_snomed': {'spiculated lesion': 129742005}, 'existence': 'pos_dx', 'descriptive_term': 'spiculated', 'observation': 'lesion'}, 'pulmonary pulmonary neoplasm': {'clinical finding': 'pulmonary pulmonary neoplasm', 'cf_snomed': {'neoplasm': 108369006}, 'existence': 'unc_dx', 'descriptive_term': 'pulmonary pulmonary', 'observation': 'neoplasm'}}size_fin: [{'size': '5 mm'}, {'size': '4 mm'}]anatomical entity_fin: {'lobe': {'location descriptor': 'right lower'}}location descriptor_fin: ['inferior', 'right', 'lower']clinical findings_fin: {'smaller satellite lesion': {'clinical finding': 'smaller satellite lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'smaller satellite', 'observation': 'lesion'}, 'metastatic disease': {'clinical finding': 'metastatic disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'unc_dx', 'descriptive_term': 'metastatic', 'observation': 'disease'}}anatomical entity_fin: {'lobe': {'location descriptor': 'right lower'}}location descriptor_fin: ['posterior', 'right', 'lower']clinical findings_fin: {'additional micronodules': {'clinical finding': 'additional micronodules', 'existence': 'pos_dx', 'descriptive_term': 'additional', 'observation': 'micronodule'}, 'metastatic disease': {'clinical finding': 'metastatic disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'unc_dx', 'descriptive_term': 'metastatic', 'observation': 'disease'}}anatomical entity_fin: {'left lung': {}}clinical findings_fin: {'suspicious mass': {'clinical finding': 'suspicious mass', 'existence': 'neg_dx', 'descriptive_term': 'suspicious', 'observation': 'mass'}, 'lesion': {'clinical finding': 'lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'neg_dx', 'observation': 'lesion'}}location descriptor_fin: ['right']clinical findings_fin: {'posttreatment changes': {'clinical finding': 'posttreatment changes', 'existence': 'pos_dx', 'descriptive_term': 'posttreatment', 'observation': 'change'}}anatomical entity_fin: {'heart': {}}clinical findings_fin: {'significant pericardial effusion': {'clinical finding': 'significant pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'neg_dx', 'descriptive_term': 'significant pericardial', 'observation': 'effusion'}}clinical findings_fin: {'scattered subcentimeter mediastinal and hilar lymph nodes': {'clinical finding': 'scattered subcentimeter mediastinal and hilar lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'scattered subcentimeter mediastinal and hilar lymph', 'observation': 'node'}}clinical findings_fin: {'small hiatal hernia': {'clinical finding': 'small hiatal hernia', 'cf_snomed': {'hiatal hernia': 84089009}, 'existence': 'pos_dx', 'descriptive_term': 'small hiatal', 'observation': 'hernia', 'strength_term': 'small'}}clinical findings_fin: {'significant axillary lymphadenopathy': {'clinical finding': 'significant axillary lymphadenopathy', 'cf_snomed': {'axillary lymphadenopathy': 127189005}, 'existence': 'neg_dx', 'descriptive_term': 'significant axillary', 'observation': 'lymphadenopathy'}}anatomical entity_fin: {'spine': {}}clinical findings_fin: {'mild multilevel degenerative changes': {'clinical finding': 'mild multilevel degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'mild multilevel degenerative', 'observation': 'change', 'strength_term': 'mild'}}anatomical entity_fin: {'abdominal': {}}clinical findings_fin: {'enteric contrast': {'clinical finding': 'enteric contrast', 'existence': 'neg_dx', 'descriptive_term': 'enteric', 'observation': 'contrast'}}anatomical entity_fin: {'abdomen': {}, 'pelvis': {}} [/INST] . Severe apical predominant centrilobular emphysema. Spiculated lesion in the lateral aspect of the superior segment of the right lower lobe measuring approximately 7 x 9 mm , previously 7 x 6 mm and also appears more solid than on previous study, suggestive of pulmonary pulmonary neoplasm. A smaller satellite lesion slightly more inferior in the right lower lobe measures 5 mm , previously 4 mm, suspicious for metastatic disease. Additional micronodules are seen along the posterior right lower lobe, nonspecific, but metastatic disease cant be excluded. No suspicious mass or lesion is identified in the left lung. Scarring along the right paramediastinum likely represents posttreatment changes. The heart size is within normal limits, no significant pericardial effusion. Scattered subcentimeter mediastinal and hilar lymph nodes. Small hiatal hernia. Mild. No significant axillary lymphadenopathy. Scattered mild multilevel degenerative changes of the thoracolumbar spine. Absence of enteric contrast material limits sensitivity for abdominal pathology. Please report of concurrent CT abdomen or pelvis for dedicated findings. </s>