Thoracic nodal metastases in renal cancer
Left nephrectomy performed 9 months ago for renal cell carcinoma (clear-cell type).
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On pre-aortic lesion between the left mainstem bronchus and the left lower pulmonary vein, another pre-esophageal lesion above the diaphragm. Probably some more small lesions above the left PA. They show intense enhancement, which is typical for the highly-vascularized metastases of clear-cell RCC. There is also a small pulmonary metastasis in the 1st segment of the left lung.
These nodal metastases have probably spread via the thoracic duct. They are classified as distant metastases (M1).