Genitour system
Kidneys: left renal cystic lesion, exophytic from the lower pole, 2.3*2.1cm transverse, 25cm craniocaudal. The cystic lesion is predominantly water signal intensity and nonenhancing. At the superior aspect of the lesion, adjacent to the wall, there is an enhancing nodule, measuring 4*2mm, unchanged since November 30, 2012. Patent left renal vein. Solitary left renal artery. Unremarkable right kidney.
Adrenals: unremarkable.
Impression:
Left renal cystic lesion, 2.5cm, Bosniak IV, suspicious for cystic renal cell carcinoma. Urology referral recommended.
Note: The lesion is predominantly cystic and small enhancing nodule at its superior aspect (4*2mm) is stable since November 30, 2012. However, based on the presence of enhancing soft tissue component adjacent to wall, it is categorized as Bosniak IV.
CT(30-11-2012)
Kidney and adrenals: the 1.8cm well-circumscribed fluid density arising from the lower pole of the left kidney is nonenhancing. An apparent peripheral nodular soft tissue component is most likely volume averaging from the adjacent renal parenchyma, best seen on the coronal reformats.
Impression:
The 1.8cm well-circumscribed fluid dense structure arising from the lower pole of the left renal cortex is nonenhancing favoring a benign cyst. An apparent peripheral solid nodular component most likely represents volume averaging from the adjacent cortical parenchyma as described above. Nonetheless, a three-month followup ultrasound is recommended.
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