Reason: rule out recurrence or metastasis History: hx of urothelial carcinoma, status post left nephrectomy. Evaluation of the solid organs and vasculature is somewhat limited by lack of intravenous contrast.ABDOMEN:LUNG BASES: Subsegmental basilar opacities, likely scarring or atelectasis. Trace right and small amount of left pleural fluid.LIVER, BILIARY TRACT: No focal hepatic lesions within the limits of a noncontrast examination. Cholelithiasis. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: There is a cystic structure within the pancreatic uncinate process with most likely reflects a sidebranch IPMN with reference measurements below.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post left nephrectomy without evidence of recurrent mass in the surgical bed. Right kidney is mildly atrophic without gross masses within the limits of a noncontrast examination.RETROPERITONEUM, LYMPH NODES: Mildly prominent left periaortic lymph nodes with reference measurement below which are nonspecific but do not appear significantly changed in size compared to pre and postoperative CT examinations. Atherosclerotic disease of the abdominal aorta and its branches.BOWEL, MESENTERY: Left lower quadrant ostomy.BONES, SOFT TISSUES: Mild nonspecific body wall edema.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Susceptibility artifact related surgical clips in the left hemipelvis. The bladder appears grossly unremarkable.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Left hip arthroplasty device creates artifact which obscures surrounding structures.OTHER: There is redemonstration of a fluid signal structure in left external iliac region slightly decreased in size compared to recent CT with reference measurements below and which most likely represents a lymphocele.INDEX LESION MEASUREMENTS (Current exam date/time: 9/19/2016 12:53:00)LEFT PARA-AORTIC LYMPH NODE: 1.5 x 0.9 cm (Image 24, Series 4); 1.6 x 0.9 cm on prior (3/14/2016) (Image 36, Series 201).LEFT INGUINAL CYSTIC LESION: 1.8 x 1.3 cm (Image 17, Series 11).CYSTIC PANCREATIC UNCINATE PROCESS LESION: 0.9 x 0.7 cm (Image 24, Series 14).
1.Examination of the solid organs limited by lack of intravenous contrast.2.Surgical changes of left nephrectomy without specific evidence of local recurrence.3.Nonspecific mildly prominent left periaortic lymph nodes are not significantly changed in size. Continued attention to these on subsequent follow-up examinations is recommended.4.Decrease in size of left external iliac lymphocele.5.Incidental note of a probable pancreatic side branch IPMN which can be followed on subsequent examinations.6.Cholelithiasis. 