60-year-old man with history of HCV cirrhosis, evaluate for liver and left kidney lesions. ABDOMEN:LIVER, BILIARY TRACT: The liver is slightly nodular in contour with widened fissures. Within segment 5/6 (9/21) there is a 28 x 26 mm T2 hyperintense, T1 hypointense lesion with heterogeneous arterial enhancement (11/135) and washout of early enhancing portions (11/411). This lesion also demonstrates diffusion restriction. No additional suspicious enhancing lesions are identified.The gallbladder is normal. There is no intra or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: In the superior pole of the left kidney (9/18) there is a 16 x 16 mm mildly T2 hyperintense lesion with mild arterial enhancement (11/128) and diffusion restriction. This lesion also washes out on delayed phase of contrast. There is no loss of signal on opposed phase imaging (7/75).Immediately posterior to this lesion there is a subcentimeter cyst. No additional suspicious renal lesions are seen. There is no hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Segment 5/6 hepatic lesion, portions of which enhance on arterial phase imaging and washout. This lesion is favored to be a "nodule within nodule" appearance of hepatocellular carcinoma.2.Enhancing left upper pole renal lesion without macroscopic fat. While nonspecific, this could represent a malignant tumor such as renal cell carcinoma or benign tumor such as oncocytoma.