73-year-old male with prostate cancer, status post radiation therapy. Now with biochemical recurrence. Please evaluate for metastatic disease. CHEST:LUNGS AND PLEURA: Punctate calcified granulomata are present at the lung bases.MEDIASTINUM AND HILA: There are coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: There are centimeter sized hepatic parenchymal hypodensities at axial images 68 and 73/212 which may represent simple cysts.SPLEEN: The native spleen appears absent and partially regenerated including a 5-cm left infra-diaphragmatic remnant and axial image 67/212. This contains a solitary 6-mm diameter calcification. Anterior to the tail of the spleen and axial image 77/212 is a 4.2 x 4.7 cm mass which may represents regenerated spleen.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There are bilateral renal lesions including a hypodense left upper pole lesion which measures approximately 4 cm in diameter with attenuation of less than 3 Hounsfield units compatible with a benign simple cyst. An exophytic right mid pole lesion measures 5 cm in diameter at axial image 92/212 and has attenuation of approximately 15 Hounsfield units. This may be an atypical cyst, but a solid renal mass cannot be excluded. Ultrasound or MRI examination may be helpful for further evaluation, if comparison studies are not available.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Atrophic prostate and seminal vesicles compatible with history of radiation therapy.BLADDER: Diffuse bladder wall thickening compatible with history of pelvic radiotherapy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes in the pelvis and spine.OTHER: No significant abnormality noted
Probable regenerated spleen in the left upper quadrant. Left renal cyst. Right renal mass versus atypical cyst, recommend ultrasound or MRI, if CT comparison studies are not available. Hepatic hypodensities are probably cysts.