Evaluate renal masses, RCC versus angiomyolipoma ABDOMEN:LIVER, BILIARY TRACT: Hepatic segment 7/6 arterially enhancing focus, measuring 7 x 7 mm, image 40 series 10, appears to retain contrast to some degree on subsequent more delayed imaging, increased T2 signal seen, characteristics suggestive of a hemangioma. Mild biliary duct dilatation, particularly intrahepatic, left greater than right.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral renal masses, all of which appear to contain macroscopic fat, consistent with angiomyolipomas, representative measurements as follows:Largest mass visualized extending exophytically from right kidney, measuring 7.2 x 6.8 cm (image 37 series 901), associated mass effect on adjacent right kidney and liver seen.Another mass extending exophytically from the right kidney more inferiorly measures 4.2 x 3.9 cm, image 58 series 901.Additional right-sided angiomyolipoma measuring 4.7 x 3.7 cm, image 68 series 901.Small right lower pole angiomyolipoma measuring 1.4 x 1.3 cm, image 70 series 901.Largest mass on left side measures 5.3 x 4.2 cm, extending exophytically from lower pole, image 61 series 901.Additional left angiomyolipoma seen extending from upper pole, measuring 5.3 x 3.3 cm, image 29 series 901.Another left-sided angiomyolipoma seen at mid level of left kidney, measuring 3.9 x 3.4 cm, image 59 series 901.Additional enhancing renal lesions seen without internal macroscopic fat, largest ones as follows: Another 3 x 2.5 cm lesion seen in right kidney, image 28 series 10, mass effect on right adrenal gland.2 x 1.7 cm right renal lesion, image 28 series 10.Left-sided renal lesion measuring 1.9 x 1.7 cm, image 48 series 9.Given the corresponding T2 hypointense signal demonstrated by these lesions, lipid poor AMLs are favored (as opposed to clear cell renal cell carcinomas, which would demonstrate avid postcontrast enhancement, too, but with T2 hyperintense signal). Additional smaller angiomyolipomas and renal lesions are also seen that are too small to characterize. Masses are without significant change in size when compared to earlier imaging.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Incompletely imaged breast prostheses.OTHER: No significant abnormality noted.
1. Bilateral lipidrich and lipidpoor angiomyolipomas.2. Stable subcentimeter arterially enhancing right hepatic lesion, imaging features suggest a hemangioma.