Reason: hx of kidney cancer, evaluate for metastatic disease History: see above ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence cholecystitis.There are multiple bilateral nonenhancing cysts throughout the liver. Some of these cysts appear slightly larger on the prior exam which may be due to differences in technique.SPLEEN: No significant abnormality noted.PANCREAS: Lobule of fat insinuates within the pancreatic tailADRENAL GLANDS: There is both a 7 mm (7/29) and 9 mm (7/32) nodule in the right adrenal gland which loses signal on out of phase imaging, consistent with adenomas.KIDNEYS, URETERS: Postsurgical changes of left partial nephrectomy with scarring and a multi septated nonenhancing cystic lesion in the left midpole, similar to the prior CT.Interval right-sided partial nephrectomy with resection of 2 lesions seen on the prior CT. The right kidney is now oriented more anteriorly and is located more posteriorly with a decreased amount of posterior pararenal fat.There is an ill-defined region of low T2 signal along the medial aspect of the right nephrectomy bed without focal enhancement to suggest recurrence. There is however linear enhancement surrounding regions of fat in the posterior pararenal spaces bilaterally which likely represents areas of fat necrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate degenerative changes visualized spine without suspicious lesions evident.OTHER: Small right pleural effusion.
1.Status post right partial nephrectomy. Status post left partial nephrectomy. No evidence of recurrent or metastatic disease.2.Small right pleural effusion.