68-year-old male with urothelial cancer. Concern for metastatic disease. ABDOMEN:LIVER, BILIARY TRACT: No hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: Atrophic pancreatic parenchyma.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right-sided renal cysts most prominently in the lower pole, and no complex features are identified.New mild right-sided hydronephrosis with prominent wall thickening and corresponding T2 hyperintense signal intensity of the proximal ureter (axial series 4 image 44).RETROPERITONEUM, LYMPH NODES: Incidental note is made of a duplicated IVC (series 8 image 45). No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Enlarged prostate compressing the base of the urinary bladder.BLADDER: Persistent asymmetric thickening and enhancement of the left lateral bladder wall. Mildly trabeculated urinary bladder, and increased T1 hyperintense signal could represent blood products (series 1401 image 63).LYMPH NODES: No suspicious pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable small sclerotic focus of the right sacrum (axial series 16 image 27) compared to the 4/20/2016 CT abdomen and pelvis exam.OTHER: No significant abnormality noted.
1. Persistent asymmetric left lateral wall thickening and enhancement of the urinary bladder. No suspicious pelvic or retroperitoneal lymphadenopathy seen.2. New mild right-sided hydronephrosis, appears to extend to level of proximal ureter where there is wall thickening and edema, uncertain whether related to inflammatory or infectious etiology given length of involvement (as opposed to neoplastic site); correlation with patient's clinical history and urinalysis recommended.