Status post right pleurectomy decortication. Evaluate for postop changes. CHEST:LUNGS AND PLEURA: The extensive opacity in the right hemithorax consistent with atelectasis and a non-specific consolidation, mainly in a peripheral location.There is probably some loculated fluid at the apex and I cannot exclude residual pleural disease.Radiopaque surgical material is present at the right base probably at the site of partial diaphragmatic resection.A moderately large loculated subpulmonic effusion this present.MEDIASTINUM AND HILA: Lower right and left paratracheal lymphadenopathy with several nodes measuring greater than 10 mm in short axis, unchanged from the previous scan and suspicious for metastatic involvement.Extensive coronary artery calcification.CHEST WALL: No specific evidence of chest wall invasion.Extensive degenerative abnormalities in the spine.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific hypodense lesion measuring about 10 mm x 25 mm in segment 4 B.. This was not visible previously but likely obscured by respiratory motion. The differential diagnosis includes hemangioma, atypical cyst and, less likely, metastasis. If clinically indicated this could be further evaluated with by dedicated CT with multiphase contrast, or MRI scan. Alternatively, a follow-up scan could be performed to confirm stability.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal calculi which may be in the collecting systems. Irregular renal margins with perirenal fat stranding.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Loculated right pleural effusion and atelectasis. 2. Mediastinal lymphadenopathy, unchanged.