Previous right-sided mastectomy. No mass in the underlying chest wall to suggest recurrent or residual disease. No bone lesion.
Mild enlargement of the subcarinal and precarinal lymph nodes. Smaller nodes at the right hilum and anterior mediastinum. No axillary nodal enlargement.
Multiple nodules of varying size are seen throughout both lungs. The largest measures up to 7mm at the apex of the left lower lobe. A large left-sided pleural effusion is associated with compressive atelectasis in the underlying left lung, predominantly involving the left lower lobe which is almost completely collapsed. Mild nodularity at the mediastinal pleura superiorly, which raises concern for pleural metastatic disease.
The adrenal glands are normal. Ill-defined hepatic low density adjacent to the falciform ligament likely relates to steatosis.
IMPRESSION
Large left-sided pleural effusion. Innumerable nodules throughout both lungs with nodularity along the left mediastinal pleura superiorly. Associated mediastinal lymphadenopathy. Overall features are of diffuse metastatic disease.