Epic Patient API MCP Server

SPRINGFIELD IMAGING CENTER CT Chest, Abdomen, and Pelvis with IV Contrast Patient: Robert Chen MRN: MRN003 Date of Exam: March 18, 2024 Ordering Provider: Dr. Michael Anderson Indication: Staging of newly diagnosed sigmoid colon adenocarcinoma TECHNIQUE: CT of the chest, abdomen, and pelvis was performed following administration of intravenous contrast. Oral contrast was not administered due to concern for partial obstruction. FINDINGS: CHEST: Lungs: Multiple bilateral pulmonary nodules are identified. Largest nodule in the right lower lobe measures 1.2 cm. Additional smaller nodules measuring 4-8 mm are seen throughout both lung fields. Appearances are highly concerning for metastatic disease. Heart: Normal size. No pericardial effusion. Mediastinum: No significant lymphadenopathy. Pleura: No pleural effusion. ABDOMEN: Liver: Multiple hypodense lesions throughout the liver consistent with metastases. Largest lesion in segment 7 measures 4.2 cm. Additional lesions range from 1-3 cm. Total of 8 discrete lesions identified. Spleen, Pancreas, Adrenals: Unremarkable. Kidneys: Normal size and enhancement bilaterally. No hydronephrosis. Colon: Circumferential wall thickening in the sigmoid colon with associated fat stranding. The thickened segment measures approximately 6 cm in length. No evidence of perforation or obstruction at this time. Peritoneum: No ascites. No peritoneal implants identified. Lymph Nodes: Enlarged lymph nodes in the sigmoid mesocolon, largest measuring 1.8 cm, consistent with regional nodal metastases. PELVIS: Bladder, Prostate, Rectum: Unremarkable. Pelvic lymph nodes: No significant pelvic lymphadenopathy. BONES: No suspicious lytic or blastic lesions. No pathologic fractures. IMPRESSION: 1. Primary sigmoid colon mass consistent with known adenocarcinoma, measuring approximately 6 cm in length with regional lymphadenopathy. 2. Multiple hepatic metastases, largest 4.2 cm in segment 7. 3. Multiple bilateral pulmonary nodules highly suspicious for metastatic disease. 4. Findings consistent with Stage IV (T3 N2 M1b) colorectal carcinoma. RECOMMENDATIONS: Clinical correlation recommended. Consideration for systemic chemotherapy. Biopsy of hepatic lesions may be considered if diagnosis confirmation needed, though imaging findings are typical for metastatic disease. Radiologist: Dr. Thomas Richardson, MD Board Certified Diagnostic Radiology Date Signed: March 18, 2024