Case #23

Case #22

• Lower chest
  • Mild centrilobular emphysema
  • 4 mm nodule in the lingula
  • Left lower lobe calcified granulomas
  • Moderate coronary artery calcification
• Abdomen/Pelvis
  • Dilation of multiple loops of proximal and mid small bowel with transition point in the mid abdomen adjacent to a partially calcified 3 x 2 cm soft tissue mass in the small bowel mesentery with surrounding desmoplastic reaction
  • Diffuse stranding in the small bowel mesentery with interloop fluid and multiple enlarged lymph nodes
  • Multiple enlarged retroperitoneal lymph nodes with an index left para-aortic node measuring 2.6 cm in short axis
  • Small volume abdominopelvic ascites
  • Hepatomegaly with nodular surface contour of the anterior right hepatic lobe
  • Multiple hypodense hepatic lesions with ill-defined margins
  • Small amount of layering high density material in the gallbladder which could represent sludge or small stones
  • Calcified granulomas in the spleen
  • Mild diffuse pancreatic atrophy
  • Punctate nonobstructing calculus in the upper pole of the right kidney
  • Subcentimeter hypodense lesions in the left kidney are too small to characterize
  • Small volume free intraperitoneal fluid layering in the pelvis
  • Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
• MSK
  • No acute osseous findings
  • Mild degenerative changes of the spine
  • Mild body wall edema

• Small bowel obstruction due to intestinal carcinoid