Reason: mycosis fungoides with new onset chest pain History: pleuritic chest pain LUNGS AND PLEURA: Mild streaky basilar opacities compatible with subsegmental atelectasis. The examination was not optimized for evaluation of pulmonary medicine. However at least one subsegmental filling defect is visible in the right lower lobe on the source images and other questionable very small defects are visible in left lower lobe arteries. In the presence of chest pain and unexplained basilar atelectasis this is suspicious for pulmonary embolism. A text page was sent to Dr. Sadiq at the time of interpretation.MEDIASTINUM AND HILA: Multiple small collateral vessels are present.No significant lymphadenopathy.CHEST WALL: Decrease in the size of an enlarged left axillary node which now measures 16 x 14 mm.Obstruction of the left axillary and subclavian veins of uncertain etiology with extensive collateral formation suggesting chronicity.New focal area of sclerosis or contrast pooling in the posterior T2 vertebral body, not visible on the recent CT of 11/3/2010, all of uncertain significance. If clinically indicated this could be further evaluated by MRI.UPPER ABDOMEN: Very limited evaluation with no gross abnormalities.
1. Subsegmental right lower lobe pulmonary embolus and possibly additional small emboli in the left lower lobe. A repeat examination could be performed with CTA technique for more optimal evaluation if clinically indicated.2. Focal area of sclerosis or contrast pooling in the posterior T2 vertebral body of uncertain significance. 