50-year-old female with history of von Hippel-Lindau and surgery in 2014 for renal cell carcinoma and cysts. Evaluate kidneys and pancreas for lesions. ABDOMEN: Limited examination given motion artifact (per technologist note, patient is claustrophobic).LIVER, BILIARY TRACT: Scattered T2 hyperintense nonenhancing foci consistent with cysts. Hepatic steatosis. No intra or extrahepatic biliary ductal dilatation.SPLEEN: Scattered T2 hyperintense foci consistent with splenic cysts. Additional scattered nonspecific T2 hypointense subcentimeter splenic foci noted. Splenule noted.PANCREAS: Cystic lesions within the pancreas have increased in size; reference pancreatic body/head lesion measures 2.2 x 2.2 cm (series 5, image 18), previously measuring 1.9 x 1.8 cm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Postoperative changes of right partial nephrectomy. There are 3 T2 heterogeneous cystic and enhancing lesions in the left lower pole. Reference measurements are as follows: 3.0 x 2.5 cm (series 15, image 14), 2.9 x 2.7 cm (series 15, image 16); the third lesion is exophytic, demonstrates peripheral enhancement and measures 2.6 x 1.7 cm (series 15, image 47).There are multiple bilateral T2 hyperintense nonenhancing lesions compatible with cysts; some of these have increased in size and are complex in appearance. For example right upper pole Bosniak 2 lesion measures 5.6 x 4.4 cm (series 5, image 14), previously measuring 5.3 x 4.2 cm.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.Within limitations of motion artifact, there are 3 left lower pole renal lesions demonstrating enhancement. These are highly suspicious for renal cell carcinoma, particularly the larger 2 detailed above.2.Partial right nephrectomy. Multiple bilateral cysts.3.Hepatic, splenic, and pancreatic cyst formation.4.Hepatic steatosis.