Female; 51 years old. Reason: history metastatic renal cancer. presumed RT induced esophageal ulcer, with esophageal stent, assess for cancer progression History: upper back pain CHEST:LUNGS AND PLEURA: Interval decreased left pleural effusion.MEDIASTINUM AND HILA: Reference left para-aortic lymph node measures 1.3 x 1 cm, not significantly changed since prior study when it measured 1.2 x 0 .9 cm (series 10/26). CHEST WALL: Surgical changes above the xiphoid process.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. Mild diffuse hepatic steatosis. There are postsurgical changes in the caudate. Stable hypoenhancing lesion in the right hepatic lobe measures 1 cm, previously 1 cm (series 10/135). There is mild intrahepatic biliary ductal dilatation, unchanged. The hepatic and portal veins are patent.SPLEEN: The spleen is absent.PANCREAS: The pancreatic body and tail are severely atrophic, unchanged and possibly due to radiation. Pancreatic duct is mildly prominent but not dilated, unchanged.ADRENAL GLANDS: Right adrenal gland is unremarkable. Left adrenal gland has been resected.KIDNEYS, URETERS: Status post left nephrectomy. Stable 7-mm enhancing nodule near the left nephrectomy bed (series 10/42), which may be a small splenule. Right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: Stable postsurgical changes near the gastroesophageal junction. Stable enlarged gastrohepatic lymph node (series 10/43).BOWEL, MESENTERY: Stable diffuse circumferential wall thickening of the distal esophagus and GE junction. No significant interval change in focal gastric wall thickening about the GE junction measuring 2.5 x 2.1 cm, previously 2.5 x 2.4 cm (series 10/38). BONES, SOFT TISSUES: Postsurgical changes in the intra-abdominal wall and chest wall, chest wall Port-A-Cath that causes artifact on some of the sequences.OTHER: No upper abdominal fluid collections.
1.Stable diffuse distal esophageal and GE wall thickening with stable enlarged left para-aortic and gastrohepatic lymph nodes.2.Stable right hepatic lobe lesion, remains suspicious for a metastatic focus.3.No new sites of disease.