77-year-old male with metastatic prostate cancer and history of lung cancer. CHEST:LUNGS AND PLEURA: Postsurgical changes with volume loss from prior right lower lobectomy noted.No new infiltrates, nodules, masses or effusions seen. Elevation of the right hemidiaphragm persists.MEDIASTINUM AND HILA: Calcifications from prior granulomatous disease again noted. No enlarged lymph nodes identified. No other abnormalities.CHEST WALL: Again noted are diffuse sclerotic skeletal metastases there sclerotic in nature. Previous lesions identified have increased in size and there are scattered newer foci.ABDOMEN:LIVER, BILIARY TRACT: Diffuse low-attenuation liver is present indicative of diffuse fatty infiltration. This obscures metastatic lesions on CT and if concern over metastases to liver exists, ultrasound or MRI would be recommended. No such lesions are identified. Patient is status post cholecystectomy. No intrahepatic or extrahepatic bile duct dilatation is seen.SPLEEN: No significant abnormality notedPANCREAS: Resection of the pancreatic head mass noted on 2005 CT is present. The pancreatic duct has returned to near normal diameter compared to the marked dilatation previously. No evidence of recurrent tumor is seen in surgical bed. No other abnormalities are noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Enlarged retroperitoneal lymph node posterior to the aorta seen inferiorly at the abdominal/pelvic junction (series 4, image 127) measuring 1.7 x 1.2 cm. This was not present on the December, 2005 examination.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostatectomy. No evidence of tumor recurrence in surgical bed.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse sclerotic metastases seen throughout the bony skeleton. These were not present on 2005 CT examination. New since 2005 examination right inguinal hernia containing small bowel and mesenteric fat/vessels without apparent complication.OTHER: No significant abnormality noted
1. Prior right lower lobe lung resection. Diffuse thoracic skeletal metastases with slight increase number and size of sclerotic lesions noted previously. 2. Diffuse fatty infiltration of the liver. This obscures the ability to detect liver metastases as described above. 3. New lymphadenopathy in retroperitoneum of the abdomen measured above. 4. Resection of prior noted pancreatic neuroendocrine tumor without evidence of recurrence. 5. Diffuse sclerotic metastases in the abdomen and pelvis. 6. New right inguinal hernia with small bowel without complication evident.