Reason: 66 year old female with VHL and history of renal cysts; evaluate for size and growth ABDOMEN:LIVER, BILIARY TRACT: The hepatic parenchyma demonstrates geographic areas of decreased signal intensity on out of phase images compatible with hepatic steatosis. A 7 mm simple cyst is present within segment 7 of the liver. No additional focal hepatic lesions are identified. There is no biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is normal in appearance. No masses or cystic lesions are identified.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is a 5 mm round lesion arising from the cortex of the midpole of the left kidney (series 1002, image 227) which demonstrates isointense signal on T1, decreased signal on T2, and mild enhancement. This lesion may represent a small papillary renal cell carcinoma. Multiple simple cysts are present in both kidneys. The largest in the right kidney is in the lower pole (series 801, image 13) and measures 4.9 x 5.4 cm. Additional subcentimeter simple cysts are present within the right kidney. The largest simple cyst in the left kidney is in the upper pole (series 801, image 7) and measures approximately 1.0 x 1.4 cm. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the lumbar spine including degenerative endplate changes and disc bulges at L2-L3, L3-L4, and L5-S1.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.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.Subcentimeter lesion within the left kidney with features suggestive of papillary renal cell carcinoma.2.Multiple simple renal cysts the largest of which is in the right kidney measuring up to 5.4 cm.3.Hepatic steatosis.Findings discussed with NIELSEN, SARAH at 4:30 PM on 11/17/2015.