Renal cyst - Bosniak class IV
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Work up for right flank pain.
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A 130×110×115 mm cystic lesion with several eccentric enhancing solid components is present at the lower pole of the right kidney (Bosniak class IV). There are no signs of local invasion, surrounding fat stranding, vascular extension, or regional enlarged lymph nodes.
A few small calcified foci are seen at liver parenchyma, most consistent with healed granuloma.
A few adjacent small calcified foci are observed at the lower pole of the spleen.
In imaged portions of the lower thorax, several subpleural nodules are seen at lung bases.
The large majority of Bosniak IV masses are malignant and need surgical resection.