66-year-old male with history of hemophilia now with right flank pain ABDOMEN:LUNG BASES: Significant interval increase in the size and number of bilateral lung nodules. These are incompletely imaged with this CT of abdomen and pelvis. New small bilateral pleural effusions.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in the size of the lytic lesion involving T8 vertebral body. There is cathodic fracture of the T 8 vertebral body secondary to this metastatic lesion. MRI may be helpful for further evaluation of the metastatic lesion and spinal canal. Small lytic lesions are also present in the lumbar vertebral bodies, suspicious for metastatic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Interval increase in the size of the right iliac bone lytic lesion, best seen on image number 113, series number 3.. New left iliac bone lesion, best seen on image number 104, series number 3.OTHER: No significant abnormality noted
Interval increase in the size of the T8 and right iliac bone lytic lesions and interval development of a new left iliac bone lytic lesion consistent with metastatic disease. Smaller lytic lesions are also present in the lumbar vertebral bodies. MRI of the thoracic and lumber spine may be helpful for better evaluation of these lesions.Interval increase in the size and number of lung lesions suspicious for metastatic disease.Dr. Bhatt was notified and acknowledged by the findings at the time of dictation.