 The image quality is degraded by motion artifact. There is a right supraclavicular mass measuring approximately 3.7 x 5.0 x 4.9 cm (AP x TR x CC) with central necrosis and infiltration of a portion of the brachial plexus. It is difficult to make a direct comparison due to differences in technique, but the lesion measured approximately 3.1 x 4.3 cm (AP x TR) on the CT neck of 10/21/2014 and 5.2 x 5.8 cm (AP x TR) on the MRI brachial plexus of 7/7/2014. There is interval increase in diffuse high T2 signal and enhancement involving the right trapezius, pectoralis major and minor, supraspinatus, infraspinatus, and subscapularis muscles and overlying subcutaneous tissues. There is a 1.4 x 0.8 cm right level 2A lymph node, which is unchanged from CT neck dated 10/21/2014. There are partially imaged right upper lobe post-radiation change and/or atelectasis as well as a small right pleural effusion. The cervical and upper thoracic spine appear grossly unremarkable. There is a right glenohumeral joint effusion.
1. A necrotic right supraclavicular mass with infiltration of the brachial plexus, measures up to 5 cm, which is slightly increased in size compared to CT neck of 10/21/2014, but smaller compared to MR brachial plexus of 7/7/2014. 2. Diffuse signal abnormality elsewhere in the right shoulder region likely represent denervation changes and treatment effects, although smaller foci of tumor deposition cannot be entirely excluded.3. The right pulmonary consolidation and pleural effusion are partially imaged. Please refer to the separate chest CT report for additional details.