71-year-old male with history of CKD 4 on bisphosphates with low platelets and lung mass on CT. Evaluate lymph node size. Known right renal complex cysts. Status post right midpole partial nephrectomy in 9/07. This examination is limited by the absence of intravenous contrast.ABDOMEN:LUNG BASES: Extensive coronary artery calcifications. Transvenous pacemaker leads are present in the right ventricular apex. Old right posterior lateral rib fracture at image 35 of series 3.LIVER, BILIARY TRACT: Cholelithiasis. Punctate calcification in the right hepatic lobe is probably due to old granulomatous disease.SPLEEN: Splenomegaly with overall length of 16 cm. PANCREAS: Atrophic pancreas. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Exophytic 2 cm diameter cyst at right upper pole has attenuation of 23 HU, so contrast enhanced evaluation with CT or MRI would be helpful to better characterize the lesion. This lesion has increased in size since 2007, from 1.5 then to 2 cm now. Deformity of the right kidney lower pole is probably post-operative. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.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: There are numerous enlarged pelvic lymph nodes which are predominately replaced with fat, unchanged from 2008.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes involve the spine and pelvis.OTHER: Superficial anterior left thigh collateral vessels are enlarged. Probably due to iliac vein occlusion on the left.
Slowly enlarging right upper pole lesion is now 2 cm in diameter. Enlarged benign fat-replaced pelvic lymph nodes are stable since 2008. No other significant interval change. 