62-year-old male with history of intraventricular hemorrhage. Now with fever and abdominal pain. Exam is somewhat limited by motion artifact.CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions and basilar atelectasis. Right apical scarring also present.MEDIASTINUM AND HILA: Calcified hilar lymph nodes without any pathologically enlarged lymph nodes. Small pericardial effusion. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Calcified granuloma indicative of prior granulomatous infection. There is a likely gallstone in the gallbladder neck but this is unclear due to the motion artifact. No pericolicystic fluid or biliary ductal dilatation.SPLEEN: Calcified granuloma without any other abnormality.PANCREAS: No significant abnormality notedADRENAL GLANDS: 3 x 1.8 centimeter left adrenal nodule. 1.3 x 1.7 cm right adrenal nodule. These are nonspecific on this examination but likely represent adenomas given the patient has no primary malignancy. Dedicated adrenal CT or MRI may be performed for further characterization as clinically indicated.KIDNEYS, URETERS: Atrophic. Hypodense lesions in both kidneys are too small to characterize but likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate is slightly enlarged.BLADDER: The bladder is distended without any focal abnormalities.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1. No specific source of fever as clinically queried.2. Bilateral pleural effusions and pericardial effusion.3. Distended bladder with enlarged prostate. Consider Foley catheter for drainage.4. Bilateral adrenal nodules which are nonspecific on this examination but likely represent bilateral adenomas. Dedicated imaging of the adrenals with either CT or MR could be obtained for more specific diagnosis if clinically indicated.These findings were communicated to the clinical service at 9:15 a.m.