Document Bv76wvnBKj7xgrRKGbeNDGOwm

CHC 000065 MM IM4WI I niVO.44 WdSlllliyiMKI tttMIJIIMJ OWVIUtt, uw ii/.miMH r*j|w< WASHINGTON IMAGING SERVICES, LLC USE MARIE REICHERT, NP 13033 BEL-RED RD STE 230 BELLEVUE, WA 98005 ACCESSION: MODALITY: EXAMINATION: 2149247 XRAY XRAY CHEST 1 VIEW RE: SMITH, DEANE DOB: 10/19/1927 SEX: M ACCT#: 72998 Exam Date: 2011-06-09 Exam Location: Bellevue Patient Phone: /- CHEST ONE VIEW: ' HISTORY: Shortness of breath and cough. Left lateral decubitus radiograph is requested. COMPARISON: pa and lateral chest 06/03/2011 and 08/18/2003. findings: As before, there is a moderate left pleural effusion. The effusion is at least largely free-flowing. The fluid flows over the whole left lateral aspect of the chest but remains greatest in apparent thickness anteriorly. There is persistent left lower lobe consolidation. The upper left lung is clear. The right lung is clear. The heart size is unchanged. Pacemaker electrode remains in the right ventricular apex. Aortic arch calcification indicates atherosclerosis. There is no gross radiographic evidence of lymphadenopathy. impression: Persistent moderate to large left pleural effusion which is at least predominately free-flowing. The appearance is nonspecific. There Is underlying airspace consolidation in the left base. Findings may reflect pneumonia with parapneumonic effusion. A neoplastic process is not completely excluded, clinical correlation is requested. Diagnostic thoracentesis may be of value. Followup chest radiographs and/or CT (particularly after thoracentesis) would be of value. Thank you for referring this patient to Washington Imaging Services Dictated by DANIEL W. SMOOTS, MD Electronically signed by DANIEL w. SMOOTS, MD 06/09/2011 18:20 JoiuCumtLUO FisiacKaraJrtwm MD vwwm&Ciwwnwr MD HanldPaM.MD O*aoelittitt MB Diie) Smarts.MO BiyaaLerton.UO n>apUm.MD Sfermfelling. MO Pretaiiana] Sttvfcm Pmftldad by Omriaka Imaging Auociataa. PC Phone: 425-86S-0100 Fax. 425-454-8611 ftfchlMHet. UD Katbsina^Wer.UQ Mart, Metef. WO MarieZobti MD CHC 000065 D-1093