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CT Renal RCC

Technique: Helical CT of the kidneys was performed with and without contrast, acquiring coronal and sagittal reformations. Findings: There is a 3.8 x 3.4 x 3.9 cm right interpolar, laterally exophytic, solid renal mass that demonstrates heterogeneous enhancement. There is a focus of coarse calcification at the interface of the mass and the normal appearing renal cortex, measuring 1.3 cm. There is a nonenhancing hypodense filling defect in the right renal vein that measures up to 1.4 cm in length. Multiple simple renal cysts are seen bilaterally, the largest of which is seen in the left inferior pole, measuring 2.4 cm. There is a tiny punctate nephrolith in the left inferior pole measuring 1 mm. Hyperdense layering material is seen in the hydropic gallbladder with peripherally calcified stones. There is no gallbladder wall thickening or pericholecystic inflammation/fluid. The liver is incompletely evaluated. The spleen is unremarkable. The pancreas demonstrates fatty infiltration. The visualized bowel is unremarkable. Atherosclerotic calcifications are seen throughout the aorta and its branches. Degenerative changes are seen in the visualized spine without acute osseous abnormality. Impression: 1. Enhancing, exophytic right interpolar renal mass, worrisome for renal cell carcinoma with possible right renal vein invasion versus thrombosis. 2. Cholelithiasis with hyperdense sludge without evidence of cholecystitis.