83-year-old male with prostate cancer. Staging. CHEST:LUNGS AND PLEURA: Upper lobe predominant centrilobular emphysema. Scattered micronodules, many of which are calcified. No suspicious nodules, masses, or pleural effusion. Central bronchial wall thickening.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Coronary artery calcifications.CHEST WALL: Left chest ICD with leads in expected locations. Sternal wires.Degenerative changes of the spine.ABDOMEN: LIVER, BILIARY TRACT: Three peripherally-calcified lesions in the hepatic dome (series 3, image 87) are atypical in appearance for malignancy and possibly represent complex cysts. For reference, a rim calcified lesion measures 2.2 x 1.8 cm.Two other nonspecific hypoattenuating lesions are seen in the right hepatic lobe (series 3, images 96 and 114). The largest measures 2.4 x 2.8 cm.Two small, well marginated hypoattenuating lesions in the hepatic dome (series 3, image 89) likely represent benign cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple hypoattenuating lesions bilaterally are compatible with simple cysts.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications of the descending aorta with elongated ectasia. At the level of the celiac artery, the aorta is approximate 3.3 cm in caliber. At the level of the renal arteries, the aorta measures 4 cm in caliber with more focal aneurysm also seen at the origin of the left renal artery. Just proximal to its bifurcation, the aorta measures 3.3 cm.Ectasia of the left common iliac artery, measuring 1.5 cm in caliber (series 80216, coronal image 50).BOWEL, MESENTERY: Two ventral abdominal wall hernias containing nonobstructed transverse colon as well as a segment of small bowel. No evidence of bowel wall thickening or fluid in the hernia sac.BONES, SOFT TISSUES: Degenerative changes of the spine.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: Bladder wall thickening, which may in part be due to incomplete distention.LYMPH NODES: No pelvic lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Left hip prosthesis. Degenerative changes of the spine.
1. Multiple liver lesions as detailed above. Several lesions near the hepatic dome appear to be a combination of simple and complex cysts. Two less well defined lesions in the right hepatic lobe are nonspecific and given the lack of IV contrast they are not well characterized. The largest lesion may be amenable to ultrasound-guided biopsy.2. Ectatic aorta as above.3. Nonspecific bladder wall thickening.