67-year-old male patient status post OLT for PSC. Biopsy in 2012 suggested extrahepatic biliary obstruction. ABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes from choledochojejunostomy with patent anastomosis. No intrahepatic or extrahepatic biliary ductal dilatation. Hepatic vasculature is patent.No suspicious hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: Prominent pancreatic duct measures up to 4 mm in maximal diameter.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Numerous T2 hyperintense lesions without enhancement in the bilateral kidneys compatible with renal cysts. Probable subcentimeter hemorrhagic cyst in the left kidney.There is a 1.3 x 1.3 cm lesion (series 103 image 29) in the midpole of the left kidney that is isointense on T2 and appears to have some enhancement on subtraction images. This lesion is not well seen on prior CT.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right upper quadrant ileostomy with peristomal hernia. No evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.No intrahepatic or extrahepatic biliary ductal dilatation and patent choledochojejunostomy anastomosis.2.Lesion in the midpole of the left kidney with enhancement is suspicious for renal cell carcinoma, such as papillary subtype.