69-year-old female with hematuria and renal cell carcinoma. ABDOMEN:LIVER, BILIARY TRACT: There is an approximately 1.5 cm T2 hyperintense lesion in the left hepatic lobe (series 8/15), which contains a few fine internal septations and demonstrated contrast washout on the prior contrast enhanced CT examination, most likely representing a hemangioma, although remains incompletely characterized on this examination without contrast. An additional punctate T2 hyperintensity in the right hepatic lobe is too small to characterize, but most likely represents a cyst or hemangioma (series 8/32). Nonspecific focus of restricted diffusion in the right hepatic lobe (image 83/198) is seen only on one B-value and there is no correlate on other sequences, which is of uncertain significance.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Again seen is a large heterogeneous predominately T2 isointense mass arising from the interpolar region of the left kidney, which demonstrates areas of increased signal as well as internal cystic change suggesting necrosis. The mass is not significantly changed in size from the prior examination. The hepatic veins appear grossly patent. However, evaluation of the mass and vasculature is limited given the lack of intravenous contrast. Reference measurements below.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a small umbilical hernia which contains small bowel as well as fat, and laxity of the right posterior abdominal wall which contains the liver.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 10/7/2016 07:00:00)LEFT RENAL MASS: 8.5 x 6.9 cm (Image 32, Series 5); 8.7 x 7.1 cm on prior (8/12/2016) (Image 67, Series 3).
1.Heterogeneous centrally necrotic mass in the left kidney without definite renal vein invasion, although evaluation of both the mass and renal vasculature is limited without contrast.2.Hyperintense lesions in the liver, which are incompletely characterized without contrast, but are most likely benign.