Female 29 years old Reason: r/o CA History: sz \T\ brain tumor CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: There is an enlarged superior mediastinal, right paratracheal lymph node measuring 1.7 x 1.2 cm (series 3, image 10)CHEST WALL: Small axillary lymph nodes all measure less than 1 cm in short axis dimension. Nodular enhancing focus in the right breast (series 6, image 64) is nonspecific and would be better evaluated with mammography/ultrasound.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: 3.2 x 2.6 cm right adrenal mass (series 15, image 27) which does not meet criteria for lipid rich adenoma. There is a 1.5 x 1.2 cm left adrenal nodule (series 15, image 29) which does not meet criteria for lipid rich adenoma. KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple nonenlarged retroperitoneal lymph nodes. A reference aortocaval node measures 1.6 x 1.0 cm (series 6, image 110).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. PELVIS:UTERUS, ADNEXA: Fetus within the uterus. The study was not optimized for evaluation of fetal anatomy. BLADDER: No significant abnormality noted.LYMPH NODES: Pelvic lymphadenopathy. A reference right external iliac node measures 2.2 x 1.3 cm (series 11, image 52).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Mediastinal, retroperitoneal and pelvic lymphadenopathy as well as bilateral adrenal lesions. Findings are suspicious for metastatic disease with no primary malignancy identified although breast or melanoma would be differential considerations. The right adrenal lesion would be amenable to percutaneous biopsy under CT/MRI guidance.