CT
Non-contrast imaging of the chest, followed by contrast-enhanced imaging of the abdomen following the identification of a renal mass.
Complex thoracic vascular anatomy is difficult to assess on non-contrast scan but includes dextrocardia, bilateral SVCs, dilated hemiazygos and azygos veins/ azygos continuation of IVC. No obvious anomalous pulmonary venous drainage and hepatic veins drain normally into the right atrium.
Bilobed lungs bilaterally but no bronchiectasis.
Transverse position of the liver, polysplenia and truncated pancreas. Right renal lesion identified on non-contrast is concerning for RCC on subsequent contrast imaging.
Non-rotation of the bowel with small bowel all on the right, large bowel all on the left.