Evaluate previously seen renal lesions. LIVER: The liver is normal in morphology and mildly coarse in echotexture. No focal lesion. It measures 15 cm in craniocaudal length. Normal hepatopedal portal venous blood flow at 29 cm/s.BILIARY TRACT: Cholelithiasis within a normally distended gallbladder without wall thickening, pericholecystic fluid or focal tenderness.No biliary ductal dilatation with the common duct measuring 3 mm.PANCREAS: Suboptimal evaluation of the pancreatic head and body is unremarkable. The remainder is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 12.4 cm in length without a focal lesion.RIGHT KIDNEY: Mild cortical thinning and echogenicity. The right kidney measures 11.6 cm. In the interpolar region there is an isoechoic round mass measuring 4.1 x 3.5 x 4.4 cm demonstrating internal vascularity. An adjacent 3.3 x 2.6 x 4.8 cm hypoechoic lesion with enhanced through transmission, a probable cyst.OTHER: The left kidney measures 12.3 cm in length with mild cortical thinning and echogenicity. Note is made of a 2.9 x 1.6 x 2.9 cm simple appearing cyst.
4.4 cm right interpolar round isoechoic mass with internal vascularity is suspicious for a renal neoplasm. Bilateral simple appearing cysts are also noted.