Male 21 years old with von Hippel Lindau disease and previously seen of pancreatic cysts. Evaluate for growth of cysts and new pancreatic, renal and adrenal lesions. ABDOMEN:LIVER, BILIARY TRACT: No focal liver lesion, biliary ductal dilation, or ascites.SPLEEN: No significant abnormality noted.PANCREAS: There are scattered subcentimeter pancreatic cysts which, when accounting for differences in technique, were present on the previous exam. The index cyst in the uncinate process measures 4 mm (series 3, image 22), previously 3 mm, unchanged when accounting for differences in technique.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is a 1.2 cm partially exophytic right upper pole renal lesion that is T2 hyperintense and heterogeneously enhancing suspicious for renal cell carcinoma, particularly clear cell subtype (902, image 43). Corresponding restricted diffusion also seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a large amount of ingested material within the stomach, may be related to timing of exam but nonspecific.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.New 1.2 cm right upper pole renal lesion is suspicious for renal cell carcinoma, particularly clear cell subtype (based on imaging appearance as well as increased incidence of subtype among patients with VHL disease) .2.Stable subcentimeter pancreatic cysts.3.Please note that this exam was not performed as a dedicated pancreas protocol. If the patient returns the additional sequences may be obtained at no cost and an addendum will be added to the report.Findings discussed with Dr. Jane Churpek by phone at 13:40 on 11/22/2016.