### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Last year had a L-Spine MRI which showed A well circumscribed 1 cm T2 hyperintense lesion on left mid kidney. Back pain for years. Pain got severe 3 days ago, when to patient first have in infection by urine or blood test, but +3 blood in urine and low blood count in labs. What could this mean?

### output:

HI THANKS FOR YOUR QUERY.1cms HYPERINTENSIVE LESION IN YOUR LEFT KIDNEY COULD BE SUGGESTIVE OF THE FOLLOWING :1.RENAL CANCER.2.CYSTS WITH BLEED.3.ANGIOMYOLIPOMA-FAT CONTAINING LESION.4.METASTATIC DEPOSIT FROM UNKNOWN PRIMARY.SINCE YOU SEEM TO HAVE BACKACHE FROM 3 YEARS, IT SUGGESTS A CHRONIC PROCESS/LONGSTANDING DISEASE PROCESS.IN YOUR CASE THERE IS HIGH POSSIBILITY OF A MALIGNANT/CANCER PROCESS OPERATING DUE TO SUDDEN ONSET OF GROSS HEMATURIA(BLOOD IN URINE).IT IS EXTREMELY IMPORTANT TO RULE OUT THIS DIAGNOSIS IN YOUR CASE.SUDDEN ONSET OR SEVERITY OF PAIN CAN ARISE BECAUSE OF BLEED WITHIN THE Tumor.ALL YOU NEED RIGHT NOW IS AN ULTRASOUND GUIDED BIOPSY OF THIS MASS TO REVEAL ITS PATHOLOGY.THIS HAS TO BE ASSISTED WITH URINE FOR MALIGNANT CELLS.RENAL CANCER IS MANAGED BY PARTIAL OR COMPLETE REMOVAL OF THE KIDNEY, DEPENDING ON ITS STAGE WITH OR WITHOUT CHEMOTHERAPY.IF MALIGNANCY IS EXCLUDED, THE OUTCOME IMPROVES FOR ALL CYSTIC AND BENIGN LESIONS.CT ABDOMEN WILL HELP TO IDENTIFY ANY METASTATIC DEPOSIT/DISSEMINATED CANCEROUS GROWTH FROM AN UNKNOWN PRIMARY SITECONSULT AN EXPERT UROLOGIST Alongside A NEPHROLOGIST FOR FURTHER MANAGEMENT.CONCLUSIVE IMPRESSION:RENAL CANCER EXCLUSION IS HIGHLY ESSENTIAL.THANK YOU.