Mechanisms are provided to implement a fine-grained finding descriptor generation computing tool that automatically generates fine-grained labels for downstream computer system operations. The mechanisms process medical report content based on a core finding lexicon, to extract core finding instances from the medical report content. The mechanisms execute, for each core finding instance, automated computer NLP operations that generate a parse tree for the portion of the medical report content corresponding to the core finding instance, perform phrasal grouping on the parse tree to thereby associate one or more modifiers of core findings specified in the portion of the medical report content with the core finding instance, and generate a fine-grained finding descriptor data structure for the core finding instance based on the association of one or more modifiers of the core finding with the core finding instance.