Since the previous CT scans a pigtail catheter has been placed into the right pleural space. A loculated hydropneumothorax is visualized. This has decreased in size of from the previous study.
There is a large pulmonary mass lesion centered over of the right hila. I am measuring this at 3.6 x 3 cm previous 5.1 x 3.9 cm. A second component of this mass extends inferiorly along the fissure. This is measured maximally at 2.2 x 1.9 cm previous 2.8 x 2.5 cm. Innumerable small pulmonary nodules remain visualized scattered within the lungs bilaterally. Marker lesion in the left upper lobe measures 5 mm on image 18 unchanged in size. I do get the impression that there may be fewer of these small pulmonary nodules seen within the lungs bilaterally. No pathologically enlarged mediastinal or axillary nodes are visualized. No left pleural effusion seen. No pericardial effusion identified.
There is an abnormal hepatic lesion centered in that the medial segment left lobe of the liver measuring 3.9 x 3.7 cm. This has developed since the previous CT scan of October 17, 2012. The spleen pancreas and adrenal glands are normal. Kidneys show a simple right renal cortical cyst unchanged.
There is no significant interval change in the mixed lytic and blastic lesion involving the T11 vertebral body. A new small lytic lesion in the left pedicle of T12. There is increased sclerosis within the left aspect of the T6 vertebral body and a healing fracture the posterior aspect of the left seventh rib.
Interpretation:
Mixed response. There is some interval improvement in the appearance of the lungs with decreasing size of the large lung masses and fewer small pulmonary nodules seen in both lungs.
New metastatic lesion to the liver not previously seen.
Variable response to the metastatic disease to the bones. Larger lesion in T6 appears to have be healing. There is a new lytic lesion within the T12 left pedicle.