65-year-old male with history of kidney cancer. Evaluate for metastatic disease. Evaluate lesions in the liver. ABDOMEN:Left subpleural nodule measuring approximately 4 mm is not appreciated on this MRI examination.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: The pancreatic duct size is upper limits of normal without an obvious lesion. There is a fatty cleft within the pancreatic body.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: RIGHT KIDNEY: There is a 1.5 x 1.1 cm T1 hyperintense, T2 hypointense focus at the right nephrectomy site which does not demonstrate contrast enhancement or diffusion restriction. This lesion has decreased in size compared to the previous examination where it measured 2.3 x 2.5 cm. This is most likely post operative in etiology. There are 2 additional subcentimeter foci within the right kidney which demonstrates T1 hypointensity and T2 hyperintensity without corresponding diffusion restriction or enhancement, was compatible with cysts.LEFT KIDNEY: There is a 3.6 x 4.2 cm (series 10, image 21), T1 isointense and T2 hypointense focus, which demonstrates diffusion restriction. While there is suspected minimal enhancement, given appearance of this lesion and diffusion restriction, this is a suspicious mass. This mass was not well visualized on the prior noncontrast CT examination but is stable in size compared to the 8/20/2014 contrast enhanced CT examination.There are additional subcentimeter T2 hyperintense foci with corresponding T1 hypointensity; there is no diffusion restriction or contrast enhancement. These are compatible with simple cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Suspicious left renal lesion measuring up to 4.2 cm as detailed. Differential considerations include papillary versus chromophobe renal cell carcinoma.2.Subcentimeter bilateral renal cysts.3.Interval decrease in size of the right nephrectomy bed postoperative collection, likely hematoma.