72-year-old male with complex left renal lesion seen on outside hospital MRI examination. Needs dedicated renal imaging to evaluate for RCC. ABDOMEN:LUNG BASES: No significant abnormality noted. There is coronary artery calcification.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted. There is a splenule at the splenic hilum.PANCREAS: No significant abnormality notedADRENAL GLANDS: There is mild eccentric thickening of the left adrenal that measures 1 cm in greatest dimension.KIDNEYS, URETERS: The right kidney is normal. No hydronephrosis. There are two left renal cysts, including a mid pole region cortical cyst and a more inferior exophytic cyst. The cortical cyst measures approximately 1.5 x 1.8 cm and demonstrates no significant contrast enhancement on immediate and delayed sequences. The exophytic cyst measures 2.7 x 3.3 cm with attenuation value of 2 Hounsfield units prior to contrast, and 4 - 6 Hounsfield units after contrast and approximately 2 Hounsfield units on delay. The renal cortical cyst is uniloculated and compatible with a benign simple cyst. The wall of the larger exophytic cyst appears eccentrically thickened at axial image 56/172 of the axial postcontrast series 9. This Bosniak II category cyst should be followed in 4 to 6 months. Alternatively, comparison can be made with the patient's outside MRI examination, if available.RETROPERITONEUM, LYMPH NODES: There is an enlarged aortocaval periportal lymph node at axial image 43/172 which measures 2 x 2.7 cm. Several additional enlarged lymph nodes are seen in the celiac region.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: There are degenerative changes in the lumbosacral spine and pelvis.OTHER: No significant abnormality noted
Two left renal cysts, but no significant enhancement with contrast administration. The larger exophytic left mid pole cyst has a eccentrically thickened wall and should be followed. Comparison with outside MRI examination may be helpful, if available. No solid renal mass was found. Enlarged periportal & celiac lymph nodes. See above.