60-year-old female with supraglottic larynx cancer. Initial staging scan. LUNGS AND PLEURA: Peribronchial thickening and right basilar mild reticular nodular pattern compatible with aspiration bronchiolitis. Scattered micronodules largest of which measures 3 mm, (image 62, series 5) too small to characterize. Mild bilateral apical emphysema.MEDIASTINUM AND HILA: Tracheostomy tube in appropriate position. Mediastinal lymph nodes are not enlarged by CT criteria. Debris in the right mainstem bronchus. Elongated right thyroid lobe extends inferiorly to the right of the trachea and contains cystic areas, nonspecific by CT. Small adjacent lymph nodes (2R) just below this area, image 18. Mild inflammatory change of the proximal intrathoracic esophagus. 1cm right hilar lymph node image 57 could be reactive.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Left adrenal nodule is measuring 7 x 12 mm, (image 23, series 3) is too small to characterize but does not contain measurable fat, atypical for an adenoma. This may be further evaluated with MRI.
1. Bronchiolitis pattern compatible with aspiration.2. No conclusive evidence of metastatic disease, however several small 2R lymph nodes are ill defined and enhance. Short term CT or PET follow up suggested to rule out nodal metastases.3. Indeterminate left adrenal nodule as above may be evaluated with in and out of phase MRI if it would affect clinical management of the patient.4. Probable radiation esophagitis of the proximal intrathoracic segment. 