Male; 81 years old. Reason: hx left vocal cord paralysis, concern for RLN injury, special attention to LEFT RLN History: hx left vocal cord paralysis, concern for RLN injury, special attention to LEFT RLN CHEST:LUNGS AND PLEURA: Redemonstration of a left upper lobe lobectomy and accompanying post surgical changes with volume loss, bronchiectasis, and pleural thickening, similar when comparing to prior CT on 8/11/14. In retrospect, there was mild interval increased fibrotic changes in the left apex when comparing CT from 1/28/14. Dense left paramediastinal post radiation fibrotic changes, similar when comparing to prior CT on 8/11/14.Pleural thickening and fibrotic changes demonstrate mild contrast enhancement and restricted diffusion, but there is no focal, suspicious lesion seen.No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Cardiac size is normal without evidence of pericardial effusion.No hilar or mediastinal lymphadenopathy.Small hiatal hernia.CHEST WALL: As described on MRI neck exam from 4/13/15, there is T2 hyperintense lesion within the central canal at the level of T7, most likely due to an arachnoid cyst and similar in size when comparing to prior CT.UPPER ABDOMEN: Stable small, nonspecific cystic lesions in the pancreatic body, which may be due to sidebranch IPMN(s). Small, faint T2 hyperintense splenic lesion, most likely benign in etiology.
1. No evidence of residual or recurrent disease. 2. Stable postoperative and radiation changes in the left upper thorax since prior CT on 8/11/14. 3. No specific finding to account for the patient's symptoms, though as described above, there was mild interval increased fibrotic changes in the left apex when comparing CT from 1/28/14 .