33-year-old male with a history of testicular carcinoma. Evaluate for recurrance. ABDOMEN: Lack of intravenous contrast limits evaluation for lymphadenopathy and of solid organs.LIVER, BILIARY TRACT: There is decreased T2 signal abnormality with associated loss of signal on in phase sequences throughout the liver and spleen, consistent with hemosiderosis.SPLEEN: There is decreased T2 signal abnormality with associated loss of signal on in phase sequences throughout the liver and spleen, consistent with hemosiderosis.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic right kidney. Focus of fluid signal intensity with peripheral decreased T1 and T2 signal abnormality likely represents a failed transplanted left iliac fossa kidney.Right iliac fossa transplant kidney in place. There is a small collection along the posterior margin of the superior pole of the transplant measuring 2.4 x 1.0 cm, consistent with the known history of hematoma, appearing decreased in size when compared to the prior study. Note is made of multiple linear and wedge-shaped foci of decreased T2 signal abnormality along the superior and inferior poles of the transplant kidney. Differential considerations include scarring, small infarcts and pyelonephritis. This is incompletely evaluated on this noncontrast examination. The ureter of the transplant kidney is difficult to evaluate secondary to extensive metallic susceptibility artifact from the surgical clips in the surrounding area, however, it appears to insert on the bladder.RETROPERITONEUM, LYMPH NODES: Prominent inguinal lymph nodes are nonspecific, but may be reactive.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive collaterals are identified in the soft tissues overlying the abdomen and pelvis. Heterogeneous bone marrow signal abnormality.OTHER: No significant abnormality.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Prominent inguinal lymph nodes are nonspecific, but may be reactive.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: The left testicle is not visualized and may be surgically absent.OTHER: Right iliac fossa transplant kidney in place. There is a small collection along the posterior margin of the superior pole of the transplant measuring 2.4 x 1.0 cm, consistent with the known history of hematoma, appearing decreased in size when compared to the prior study. Note is made of multiple linear and wedge-shaped foci of decreased T2 signal abnormality along the superior and inferior poles of the transplant kidney. Differential considerations include scarring, small infarcts and pyelonephritis. This is incompletely evaluated on this noncontrast examination. The ureter of the transplant kidney is difficult to evaluate secondary to extensive metallic susceptibility artifact from the surgical clips in the surrounding area, however, it appears to insert on the bladder.
1.No convincing evidence of residual or recurrent disease on this noncontrast examination. Prominent inguinal lymph nodes are nonspecific but may be reactive in etiology.2.Scattered areas of signal abnormality in the right iliac fossa transplanted kidney are incompletely characterized on this noncontrast examination. Differential considerations include scarring and infarct. Pyelonephritis cannot be excluded and clinical correlation is indicated. 3.Small perinephric hematoma along the superior aspect of the right iliac fossa transplant kidney which appears similar to slightly decreased in size when compared to previous examinations.