Richard J. Katz, M.D. Steven A. Albert, M.D. Stephen D. Greenberg, M.D Douglas R. DeCorato, M.D. Gavin L Duke, M.D. Paul S. Choi, M.D. Sean K. Herman, M.D. Robert L. Ludwig, M.D. EAST RIVER MEDICAL IMAGING, PC Timothy W. Deyer, M.D. James W. Brady, M.D. Gwen N. Harris, M.D. Adam J. Wilner, M.D. Mark H. Pinals, M.D. George Stassa, M.D. (ret.) Morton Schneider, M.D. (ret.) Alison Bender Halmes, MD. (ret.) 519& 523 East 72nd Street • New York. NY 10021.3 East 75th Street. At Fifth Avenue • New York. NY 10021 430 East 59th Street, Sutton Place • Ncw York. NY 10022 Tel • www.castriverimaging.com BRUCE W MOSKOWITZ, M.D. 1411 NORTH FLAGLER DRIVE SUITE 7100 WEST PALM BEACH, FL 33401 Patient EPSTEIN, JEFFREY Exam Date: 6/5/18 Acc No: 7156124 Dear Dr. Moskowitz, MRI SCAN OF THE LEFT CLAVICLE Clinical History: 65-year-old male with left sided lipoma, increase in size. Techniaue: MRN: 0315192 Magnetic resonance imaging of the left clavicle was performed using T1 and T2 weighted axial sagittal and corona! images. Fat suppression was selectively used. Comparison: The study is compared to an MRI of the neck dated 11/30/2016. Findinas: A marker was placed over the region of interest prior to initiation of the study. Evaluation of the left supraclavicular fossa once again demonstrates a lesion identified, inferior to the subclavian vein, and displacing the roots of the brachial plexus inferiorly. This lesion measures approximately 5.8 cm in transverse dimension by 2.8 cm in anterior-posterior dimension by 3.6 cm in craniocaudad dimension. This lesion is isointense to fat on all pulse sequences, consistent with a lipoma. When measured at a similar location on the prior study this it measured approximately 6.0 x 2.5 x 3.4 cm in size. Allowing for the overall difference in technique this is without significant change. No discrete soft tissue components are identified There are small vascular structures, which permeate the lipoma. EPSTEIN, JEFFREY ACC: 7156124 Exam Date: 6/5/18 DOB: 01/20/1953 ACCESS YOUR PATIENTS IMAGES AND REPORTS (re, PET/CT • !UGH FIELD MI • °FEMUR, • MULTIDETECTOR VOLUME CT (1 CT) • BONE DENSITY • NUCLEAR 111EDICINE ULTRASOUND • DIGITAL X-RAY • CORONARY CTANGIOGRAPHY • VIRTUAL COLONOSCOPY • CT/AIRANGIOGRA PRY EFTA00811733 There is no evidence of adenopathy identified. The osseous structures demonstrates some degenerative change noted at the acromioclavicular joint No destructive lesions are seen. JMPRESSION Lipoma identified within the left supraclavicular fossa, allowing for the difference in technique without significant change from the prior study of 11/30/2016. Very truly yours, DOUGLAS DECORATO, M.D. Electronically Signed By DOUGLAS DECORATO, M.D. Date/Time Transcribed: 6/5/18 10:06 am REPORT CC: CC PATIENT EPSTEIN, JEFFREY ACC:7156124 Exam Date: 6/5/16 DOB: 01/20/1953 EAST RIVER MEDICAL IMAGING, PC www.eastriverimaging.com PET/CT • 111G11 FIELD MR! • OPEN MR I • MULTIDETECTOR VOLUME CT (VCT) • BONE DENSITY • NUCLEAR MEDICINE ULTRASOUND • DIGITAL X-RAY • CORONARY CT ANGIOGRA PUY • VIRTUAL COLONOSCOPY • CT/MR ANGIOGRAPHY EFTA00811734 ut EAST - - RIVER MEDICAL IMAGING. PC 519 East 72nd Street, Suite 103 New York, NY 10021 itscErvED lUti 11 9113 JEFFREY EPSTEIN 6100 RED HOOK QUARTERS, APT B3 SAINT THOMAS, VI 00802 OO6O2 -i7.14e2S U.S POSTAGE*PiThE7 BOWES (1/4r ,== ZIP 10021 $ 000.47 °02 IW 000138739 4 JUN 07 2018 7156124 11111 I ill al 1'1 A 11111111111111 11 III II I EFTA00811735