47-year-old female history of ESRD on HD, now status post kidney transplant 2005 presenting with left-sided abdominal pain and hematuria. Noncontrast renal stone protocol requested. ABDOMEN: Exam is not sensitive for detecting lesions in the solid organs of the upper to lack of oral or IV contrast dedicated nature the protocol.LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The native right kidney is atrophic. The native left kidney has high density material in the collecting system consistent with blood. There is a 4.5-cm diameter lesion off the posterior aspect of the left kidney with the average density of 12 Hounsfield units likely representing a cyst. On the posterior aspect of the cyst is a small exophytic 1.1-cm lesion seen on axial series 4 image 52 and coronal image 47 where in average density of 28 Hounsfield units. There is also rim-like thick calcification along the posterior wall of the dominant lesion bordering on the smaller lesion. No other definite lesions are seen in the kidney. Given hematuria and a small exophytic lesion consider contrast enhanced CT or MRI to rule out renal malignancy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes consistent with gastric surgery. Dilated to the nature of the surgery.BONES, SOFT TISSUES: Focal large area of calcification or ossification in the subcutaneous fat of the right back series 4 image 55 possibly post traumatic.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Left adnexal mass with fat fluid level and multifocal calcifications on the soft tissue plug and in the rim in the pattern consistent with ovarian teratoma dermoid.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes clips anterior abdominal pelvic wallSurgical pins both hips.
Left adnexal mass consistent with dermoid / teratoma. Blood in collecting system of native left kidney with large lower pole cyst and small exophytic mass. This could be evaluated better with IV contrast enhanced scan. Postsurgical changes stomach and hips.