findings : as compared to the previous CT chest on 26/02/2016, this study reveals on pulmonary nodule, pleural effusion or pericardial effusion. There are two mediastinal lymph nodes at left lower paratracheal and paraesophageal regions,causing pressure effect to compress the esophagus. The size of lymph nodes are measured about 2.2x2.9 cm and 1.6x2.8 cm. trachea and main bronchus appear unremarkable. The visualized liver and bilateral adrenal glands are normal. No bony destruction is noted.