·         There is 5.3x4.4x4cm sized ill-defined heterogeneously enhancing lesion with spiculated margin noted in right upper lobe , few non enhancing areas noted with few tiny foci of calcification are noted within this lesion s/o necrosis. It is causing abrupt cut off of anterior segmental bronchus of right upper lobe; Antero-laterally it is related to chest wall with effacement of extra pleural fat plane (III and IVth rib) which is seen encasing segmental branches of right upper lobar artery.

·         Heterogeneously enhancing pleural thickening is noted involving right upper lobe and basal segment of right lower lobe. Multiple nodular opacities are noted in bilateral lung parenchyma. Minimal pleural effusion is noted bilaterally.

·         Plate atelectasis is noted in basal segment of right lower lobe  ,

·         Fissural thickening is noted involving oblique and horizontal fissure on right side.

·         Pneumatocyst are noted in posterobasal segment of right lower lobe  and anterior segment of left upper lobe  

·         Pericardial effusion is noted with maximum thickness measuring 1.5cm.

·         Changes of volume loss are noted on right side in the form of crowding of ribs on right side. Mediastinal and tracheal shift towards right side compensatory hyperinflation and retrosternal herniation of left lung parenchyma.

·         There are fairly defined multiple varying sized heterogeneously enhancing lesions are noted in the right lateral aspect of thorax in the subcutaneous plane.

·         Right pectoralis major muscle appears bulky and heterogenous contrast enhancement. There is 1.3x1.1cm sized enhancing deposit is noted in the anterior part of thorax in subcutaneous plane on right side.

·         Trachea and major bronchi are normal. 

·         Multiple subcentimetric heterogeneously enhancing lymphnodes are noted in pre/para tracheal and prevascular, subcarinal region.

·         Cardiac chambers are normal in size. Mediastinal vasculature appears normal.

·         Predominantly sclerotic lesion is noted in manubrium, multiple vertebral bodies largest seen at D10 vertebral body likely s/o metastasis.

·         Visualized bones show degenerative changes in the form of anterior   and posterior marginal osteophytes disc calcifications and end plate changes.

·         Atherosclerotic changes are noted in visualised abdominal and thoracic aorta in the form of wall calcification.

·         Persistence of right upper lobar mass, size of the mass remains the same ( compared with previous report dated 16/04/2018).

·         Skeletal and muscular metastasis as described above.

·         Pericardial effusion. 

·         Bilateral minimal pleural effusion.