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Variant aortic arch anatomy with origin of the left common carotid artery from the brachiocephalic trunk ('bovine' configuration). In addition, there is a variant origin of the splenic artery and hepatic artery directly from the abdominal aorta.
No evidence of thoracic aortic dissection. Lungs and pleural spaces appear clear. No pleural or pericardial effusion. No pneumothorax. Multiple small axillary lymph nodes measure up to 1 cm diameter, non-specific in appearance. No mediastinal lymphadenopathy. No suspicious bony abnormality seen. Distended stomach. Other upper abdominal organs are of unremarkable appearance.