88-year-old male with spiculated left upper lobe opacity on chest x-ray. LUNGS AND PLEURA: Emphysema. Adjacent to the aortic arch and right perihilar region is a spiculated mass with areas of cavitation measuring 2.7 x 4.7 cm call (image 32, series 5), consistent with a primary lung neoplasm. Adjacent region of right upper lobe septal thickening may present local lymphangitic spread, (image 43, series 5).Probable intrapulmonary lymph node coma (image 50, series 5).Hilar calcifications compatible with prior granulomatous disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Enhancing right adrenal mass measures 2.2 x 1.6 mm (image 12, series 3) is nonspecific but suspicious for metastatic disease. Further follow-up may be considered with PET/CT, dedicated adrenal CT or MRI as clinically indicated.Well-defined hypodense lesion within the midpole of the right kidney is incompletely evaluated but most likely represents a simple cyst.
1. Right parahilar mass consistent with primary neoplasm.2. Enhancing right adrenal mass suspicious for metastatic disease.Further follow-up may be considered with PET/CT, dedicated adrenal CT or MRI as clinically indicated.