Both lungs demonstrate multiple regions of mosaic attenuation, most prominent in both lower lobes. This is associated with enlargement of the central pulmonary arteries, with the pulmonary trunk measuring up to 3.7cm in maximum transverse diameter. There is cardiomegaly with significant right heart enlargement. No pericardial effusion. No pleural effusion.
Bibasal atelectasis. No pulmonary nodules. No evidence of bronchiectasis or interstitial lung disease.
Numerous mildly enlarged mediastinal lymph nodes are demonstrated, with an aortopulmonary node measuring up to 18.5 x 11.5 mm. Hilar lymph nodes are difficult to evaluate on this non-contrast study. No axillary or retrocrural lymphadenopathy.
Beneath the hemidiaphragm, multiple low attenuation liver lesions are seen, as noted previously, in keeping with multiple hepatic cysts. A coarse focus of calcification in association with one of the cysts in the superior right lobe measuring 6.6mm has increased in size but has a benign appearance.
A gastric Lap band is in situ.
No suspicious bony lesion.
Conclusion: Enlargement of the pulmonary arterial tree with cardiomegaly and right heart enlargement. Mosaic attenuation in both lungs is likely due to pulmonary hypertension, rather than a pulmonary parenchymal disease.