. There is no acute pulmonary or pleural abnormality. No mediastinal or hilar lymphadenopathy. Heart size is within normal limits with note made of a trace pericardial effusion. Moderate. A central venous catheter terminates in the distal SVC. There is subcentimeter mediastinal lymphadenopathy. There is streaky atelectasis or scarring at the left lung base. Evaluation of the lower abdomen and pelvis is significantly limited secondary to metal artifact caused by bilateral hip arthroplasty devices. There are multiple hypodense lesions within the liver that were not seen on the prior CT scan. A reference lesion measures 2.8 x 2.5 cm , which was seen on the previous MR dated 6/23/2015 and at that time measured 1.4 x 1.1 cm. There is omental and peritoneal disease and studding of the left hepatic lobe surface , with present maximal thickness measures approximately 5 mm. The right hepatic artery is noted to originate directly off the celiac artery, a normal variant. A caudate lobe metastatic lesion appears to displace the common hepatic artery anteriorly. There are numerous punctate and nodular calcifications within the spleen measuring up to 8 mm. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. There is a conglomerate of lymph nodes with reference porta hepatis lymph node measuring 2.8 x 2.5 cm not seen on prior comparison CT scan. A reference aortocaval lymph node measures 1.6 x 1.4 cm and is difficult to visualize clearly on the prior MR for comparison. There is a right upper quadrant lesion consistent with cystic serosal implant which appears to come off a thickened loop of bowel. There is increased thickening of this loop of bowel compared to the prior CT, likely worsening metastatic disease. There is severe degenerative disc disease as well as significant leftward scoliosis of the lumbar spine. There is no evidence of metastatic lesions to the bone. No significant abnormality noted. The patient is status post total abdominal hysterectomy with bilateral salpingo-oophorectomy. No significant abnormality noted. There are multiple enlarged pelvic lymph nodes including a reference partially calcified node along the left pelvic sidewall measuring 1.9 x 1.5 cm. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted.
clinical findings_fin: {'acute pulmonary or pleural abnormality': {'clinical finding': 'acute pulmonary or pleural abnormality', 'existence': 'neg_dx', 'descriptive_term': 'acute pulmonary or pleural', 'observation': 'abnormality', 'strength_term': 'acute', 'temporal_term': 'acute'}}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: {'heart': {}}clinical findings_fin: {'trace pericardial effusion': {'clinical finding': 'trace pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'pos_dx', 'descriptive_term': 'trace pericardial', 'observation': 'effusion'}}location descriptor_fin: ['distal']object_fin: ['central venous catheter']clinical findings_fin: {'central venous catheter': {'clinical finding': 'central venous catheter', 'existence': 'pos_dx', 'descriptive_term': 'central venous', 'observation': 'catheter'}}clinical findings_fin: {'subcentimeter mediastinal lymphadenopathy': {'clinical finding': 'subcentimeter mediastinal lymphadenopathy', 'cf_snomed': {'mediastinal lymphadenopathy': 52324001}, 'existence': 'pos_dx', 'descriptive_term': 'subcentimeter mediastinal', 'observation': 'lymphadenopathy'}}anatomical entity_fin: {'left lung': {}, 'base': {}}clinical findings_fin: {'streaky atelectasis': {'clinical finding': 'streaky atelectasis', 'cf_snomed': {'atelectasis': 46621007}, 'existence': 'unc_dx', 'descriptive_term': 'streaky', 'observation': 'atelectasis'}, 'scarring': {'clinical finding': 'scarring', 'existence': 'unc_dx', 'observation': 'scarr'}}anatomical entity_fin: {'lower abdomen': {}, 'pelvis': {}, 'hip': {'location descriptor': 'bilateral'}}location descriptor_fin: ['bilateral']procedure_fin: ['arthroplasty']clinical findings_fin: {'metal artifact': {'clinical finding': 'metal artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'metal', 'observation': 'artifact'}}anatomical entity_fin: {'liver': {}}clinical findings_fin: {'multiple hypodense lesions': {'clinical finding': 'multiple hypodense lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'multiple hypodense', 'observation': 'lesion', 'quantity_term': 'multiple'}}size_fin: [{'size': '2.8 x 2.5 cm'}, {'size': '1.4 x 1.1 cm'}]clinical findings_fin: {'reference lesion': {'clinical finding': 'reference lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'reference', 'observation': 'lesion'}}size_fin: [{'size': '5 mm', 'size_descriptor': 'disease'}]anatomical entity_fin: {'lobe': {}}location descriptor_fin: ['left']clinical findings_fin: {'omental and peritoneal disease': {'clinical finding': 'omental and peritoneal disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'omental and peritoneal', 'observation': 'disease'}, 'studding': {'clinical finding': 'studding', 'existence': 'pos_dx', 'observation': 'studding'}}anatomical entity_fin: {'right hepatic artery': {}, 'celiac artery': {}, 'normal variant': {}}clinical findings_fin: {'normal variant': {'clinical finding': 'normal variant', 'existence': 'pos_dx', 'descriptive_term': 'normal', 'observation': 'variant', 'strength_term': 'normal'}}anatomical entity_fin: {'lobe': {}, 'common hepatic artery': {}}clinical findings_fin: {'caudate lobe metastatic lesion': {'clinical finding': 'caudate lobe metastatic lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'caudate lobe metastatic', 'observation': 'lesion'}}size_fin: [{'size': '8 mm', 'size_descriptor': 'calcifications'}]anatomical entity_fin: {'spleen': {}}clinical findings_fin: {'numerous punctate and nodular calcifications': {'clinical finding': 'numerous punctate and nodular calcifications', 'existence': 'pos_dx', 'descriptive_term': 'numerous punctate and nodular', 'observation': 'calcification', 'quantity_term': 'numerous'}}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'}}size_fin: [{'size': '2.8 x 2.5 cm', 'size_descriptor': 'conglomerate'}]anatomical entity_fin: {'porta hepatis': {}}clinical findings_fin: {'lymph nodes': {'clinical finding': 'lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'lymph', 'observation': 'node'}, 'reference porta hepatis lymph node': {'clinical finding': 'reference porta hepatis lymph node', 'existence': 'pos_dx', 'descriptive_term': 'reference porta hepatis lymph', 'observation': 'node'}}size_fin: [{'size': '1.6 x 1.4 cm', 'size_descriptor': 'node'}]clinical findings_fin: {'reference aortocaval lymph node': {'clinical finding': 'reference aortocaval lymph node', 'existence': 'pos_dx', 'descriptive_term': 'reference aortocaval lymph', 'observation': 'node'}}anatomical entity_fin: {'quadrant': {'location descriptor': 'right upper'}, 'bowel': {}}location descriptor_fin: ['right', 'upper']object_fin: ['implant']clinical findings_fin: {'right upper quadrant lesion': {'clinical finding': 'right upper quadrant lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'right upper quadrant', 'observation': 'lesion'}, 'thickened': {'clinical finding': 'thickened', 'existence': 'unc_dx', 'observation': 'thickened'}}anatomical entity_fin: {'bowel': {}}clinical findings_fin: {'increased thickening': {'clinical finding': 'increased thickening', 'existence': 'pos_dx', 'descriptive_term': 'increased', 'observation': 'thickening', 'strength_term': 'increased', 'change_term': 'increased'}, 'metastatic disease': {'clinical finding': 'metastatic disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'metastatic', 'observation': 'disease'}}anatomical entity_fin: {'spine': {}}clinical findings_fin: {'severe degenerative disc disease': {'clinical finding': 'severe degenerative disc disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'severe degenerative disc', 'observation': 'disease', 'strength_term': 'severe'}, 'significant leftward scoliosis': {'clinical finding': 'significant leftward scoliosis', 'existence': 'pos_dx', 'descriptive_term': 'significant leftward', 'observation': 'scoliosis'}}clinical findings_fin: {'metastatic lesions': {'clinical finding': 'metastatic lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'neg_dx', 'descriptive_term': 'metastatic', 'observation': 'lesion'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}anatomical entity_fin: {'abdominal': {}}location descriptor_fin: ['bilateral']procedure_fin: ['hysterectomy', 'salpingo-oophorectomy']clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}size_fin: [{'size': '1.9 x 1.5 cm', 'size_descriptor': 'nodes'}]location descriptor_fin: ['left']clinical findings_fin: {'multiple enlarged pelvic lymph nodes': {'clinical finding': 'multiple enlarged pelvic lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'multiple enlarged pelvic lymph', 'observation': 'node', 'strength_term': 'enlarged', 'quantity_term': 'multiple', 'change_term': 'enlarged'}, 'reference partially calcified node': {'clinical finding': 'reference partially calcified node', 'existence': 'pos_dx', 'descriptive_term': 'reference partially calcified', 'observation': 'node', 'strength_term': 'partially', 'change_term': 'calcified'}}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'}}
<s>[INST] Write the finding section for a radiology report based on the following information: clinical findings_fin: {'acute pulmonary or pleural abnormality': {'clinical finding': 'acute pulmonary or pleural abnormality', 'existence': 'neg_dx', 'descriptive_term': 'acute pulmonary or pleural', 'observation': 'abnormality', 'strength_term': 'acute', 'temporal_term': 'acute'}}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: {'heart': {}}clinical findings_fin: {'trace pericardial effusion': {'clinical finding': 'trace pericardial effusion', 'cf_snomed': {'pericardial effusion': 373945007}, 'existence': 'pos_dx', 'descriptive_term': 'trace pericardial', 'observation': 'effusion'}}location descriptor_fin: ['distal']object_fin: ['central venous catheter']clinical findings_fin: {'central venous catheter': {'clinical finding': 'central venous catheter', 'existence': 'pos_dx', 'descriptive_term': 'central venous', 'observation': 'catheter'}}clinical findings_fin: {'subcentimeter mediastinal lymphadenopathy': {'clinical finding': 'subcentimeter mediastinal lymphadenopathy', 'cf_snomed': {'mediastinal lymphadenopathy': 52324001}, 'existence': 'pos_dx', 'descriptive_term': 'subcentimeter mediastinal', 'observation': 'lymphadenopathy'}}anatomical entity_fin: {'left lung': {}, 'base': {}}clinical findings_fin: {'streaky atelectasis': {'clinical finding': 'streaky atelectasis', 'cf_snomed': {'atelectasis': 46621007}, 'existence': 'unc_dx', 'descriptive_term': 'streaky', 'observation': 'atelectasis'}, 'scarring': {'clinical finding': 'scarring', 'existence': 'unc_dx', 'observation': 'scarr'}}anatomical entity_fin: {'lower abdomen': {}, 'pelvis': {}, 'hip': {'location descriptor': 'bilateral'}}location descriptor_fin: ['bilateral']procedure_fin: ['arthroplasty']clinical findings_fin: {'metal artifact': {'clinical finding': 'metal artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'descriptive_term': 'metal', 'observation': 'artifact'}}anatomical entity_fin: {'liver': {}}clinical findings_fin: {'multiple hypodense lesions': {'clinical finding': 'multiple hypodense lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'multiple hypodense', 'observation': 'lesion', 'quantity_term': 'multiple'}}size_fin: [{'size': '2.8 x 2.5 cm'}, {'size': '1.4 x 1.1 cm'}]clinical findings_fin: {'reference lesion': {'clinical finding': 'reference lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'reference', 'observation': 'lesion'}}size_fin: [{'size': '5 mm', 'size_descriptor': 'disease'}]anatomical entity_fin: {'lobe': {}}location descriptor_fin: ['left']clinical findings_fin: {'omental and peritoneal disease': {'clinical finding': 'omental and peritoneal disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'omental and peritoneal', 'observation': 'disease'}, 'studding': {'clinical finding': 'studding', 'existence': 'pos_dx', 'observation': 'studding'}}anatomical entity_fin: {'right hepatic artery': {}, 'celiac artery': {}, 'normal variant': {}}clinical findings_fin: {'normal variant': {'clinical finding': 'normal variant', 'existence': 'pos_dx', 'descriptive_term': 'normal', 'observation': 'variant', 'strength_term': 'normal'}}anatomical entity_fin: {'lobe': {}, 'common hepatic artery': {}}clinical findings_fin: {'caudate lobe metastatic lesion': {'clinical finding': 'caudate lobe metastatic lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'caudate lobe metastatic', 'observation': 'lesion'}}size_fin: [{'size': '8 mm', 'size_descriptor': 'calcifications'}]anatomical entity_fin: {'spleen': {}}clinical findings_fin: {'numerous punctate and nodular calcifications': {'clinical finding': 'numerous punctate and nodular calcifications', 'existence': 'pos_dx', 'descriptive_term': 'numerous punctate and nodular', 'observation': 'calcification', 'quantity_term': 'numerous'}}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'}}size_fin: [{'size': '2.8 x 2.5 cm', 'size_descriptor': 'conglomerate'}]anatomical entity_fin: {'porta hepatis': {}}clinical findings_fin: {'lymph nodes': {'clinical finding': 'lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'lymph', 'observation': 'node'}, 'reference porta hepatis lymph node': {'clinical finding': 'reference porta hepatis lymph node', 'existence': 'pos_dx', 'descriptive_term': 'reference porta hepatis lymph', 'observation': 'node'}}size_fin: [{'size': '1.6 x 1.4 cm', 'size_descriptor': 'node'}]clinical findings_fin: {'reference aortocaval lymph node': {'clinical finding': 'reference aortocaval lymph node', 'existence': 'pos_dx', 'descriptive_term': 'reference aortocaval lymph', 'observation': 'node'}}anatomical entity_fin: {'quadrant': {'location descriptor': 'right upper'}, 'bowel': {}}location descriptor_fin: ['right', 'upper']object_fin: ['implant']clinical findings_fin: {'right upper quadrant lesion': {'clinical finding': 'right upper quadrant lesion', 'cf_snomed': {'lesion': 52988006}, 'existence': 'pos_dx', 'descriptive_term': 'right upper quadrant', 'observation': 'lesion'}, 'thickened': {'clinical finding': 'thickened', 'existence': 'unc_dx', 'observation': 'thickened'}}anatomical entity_fin: {'bowel': {}}clinical findings_fin: {'increased thickening': {'clinical finding': 'increased thickening', 'existence': 'pos_dx', 'descriptive_term': 'increased', 'observation': 'thickening', 'strength_term': 'increased', 'change_term': 'increased'}, 'metastatic disease': {'clinical finding': 'metastatic disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'metastatic', 'observation': 'disease'}}anatomical entity_fin: {'spine': {}}clinical findings_fin: {'severe degenerative disc disease': {'clinical finding': 'severe degenerative disc disease', 'cf_snomed': {'disease': 64572001}, 'existence': 'pos_dx', 'descriptive_term': 'severe degenerative disc', 'observation': 'disease', 'strength_term': 'severe'}, 'significant leftward scoliosis': {'clinical finding': 'significant leftward scoliosis', 'existence': 'pos_dx', 'descriptive_term': 'significant leftward', 'observation': 'scoliosis'}}clinical findings_fin: {'metastatic lesions': {'clinical finding': 'metastatic lesions', 'cf_snomed': {'lesion': 52988006}, 'existence': 'neg_dx', 'descriptive_term': 'metastatic', 'observation': 'lesion'}}clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}anatomical entity_fin: {'abdominal': {}}location descriptor_fin: ['bilateral']procedure_fin: ['hysterectomy', 'salpingo-oophorectomy']clinical findings_fin: {'significant abnormality': {'clinical finding': 'significant abnormality', 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'abnormality'}}size_fin: [{'size': '1.9 x 1.5 cm', 'size_descriptor': 'nodes'}]location descriptor_fin: ['left']clinical findings_fin: {'multiple enlarged pelvic lymph nodes': {'clinical finding': 'multiple enlarged pelvic lymph nodes', 'existence': 'pos_dx', 'descriptive_term': 'multiple enlarged pelvic lymph', 'observation': 'node', 'strength_term': 'enlarged', 'quantity_term': 'multiple', 'change_term': 'enlarged'}, 'reference partially calcified node': {'clinical finding': 'reference partially calcified node', 'existence': 'pos_dx', 'descriptive_term': 'reference partially calcified', 'observation': 'node', 'strength_term': 'partially', 'change_term': 'calcified'}}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'}} [/INST] . There is no acute pulmonary or pleural abnormality. No mediastinal or hilar lymphadenopathy. Heart size is within normal limits with note made of a trace pericardial effusion. Moderate. A central venous catheter terminates in the distal SVC. There is subcentimeter mediastinal lymphadenopathy. There is streaky atelectasis or scarring at the left lung base. Evaluation of the lower abdomen and pelvis is significantly limited secondary to metal artifact caused by bilateral hip arthroplasty devices. There are multiple hypodense lesions within the liver that were not seen on the prior CT scan. A reference lesion measures 2.8 x 2.5 cm , which was seen on the previous MR dated 6/23/2015 and at that time measured 1.4 x 1.1 cm. There is omental and peritoneal disease and studding of the left hepatic lobe surface , with present maximal thickness measures approximately 5 mm. The right hepatic artery is noted to originate directly off the celiac artery, a normal variant. A caudate lobe metastatic lesion appears to displace the common hepatic artery anteriorly. There are numerous punctate and nodular calcifications within the spleen measuring up to 8 mm. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. There is a conglomerate of lymph nodes with reference porta hepatis lymph node measuring 2.8 x 2.5 cm not seen on prior comparison CT scan. A reference aortocaval lymph node measures 1.6 x 1.4 cm and is difficult to visualize clearly on the prior MR for comparison. There is a right upper quadrant lesion consistent with cystic serosal implant which appears to come off a thickened loop of bowel. There is increased thickening of this loop of bowel compared to the prior CT, likely worsening metastatic disease. There is severe degenerative disc disease as well as significant leftward scoliosis of the lumbar spine. There is no evidence of metastatic lesions to the bone. No significant abnormality noted. The patient is status post total abdominal hysterectomy with bilateral salpingo-oophorectomy. No significant abnormality noted. There are multiple enlarged pelvic lymph nodes including a reference partially calcified node along the left pelvic sidewall measuring 1.9 x 1.5 cm. No significant abnormality noted. No significant abnormality noted. No significant abnormality noted. </s>