Computed tomography (CT) of the thorax, abdomen and pelvis was performed. Oral administration of positive contrast was administered. Unenhanced CT and enhanced CT, in portal and excretory phase were acquired.
CT revealed perinephric disease in the left kidney, with maximum thickness of 18mm, demonstrating soft tissue density in unenhanced CT and slight enhancement after contrast administration. This finding was associated with mild irregularity of renal contour and heterogeneity of renal parenchyma. This mass surrounded two renal simple cysts. Vascular invasion was not identified.
Multiple pathologically enlarged lymph nodes were identified in the following topographies: infracarinal; right axillary; retro-caval; peri-celiac; internal iliac and left inguinal. Other smaller lymph nodes, without pathological volumetric criteria, were identified.
A large right hydropneumothorax was also revealed.