58-year-old male with known renal mass and IVC thrombus presents for evaluation of liver vasculature patency. LIMITED ABDOMENLIVER: The liver measures 16.5 cm. There is coarse increased echogenicity of the liver parenchyma. No parenchymal mass. No ductal dilation.BILIARY TRACT: The gallbladder wall measures 0.3 cm. No stones. No pericholecystic fluid. The common bile duct measures 2.6 mm.PANCREAS: Evaluation limited by overlying bowel gas.SPLEEN: The spleen measures 9.9 cm. No significant abnormalities noted. RIGHT KIDNEY: Right kidney measures 14.4 cm. As seen on CT there is infiltrative tumor involving the right renal parenchyma.LEFT KIDNEY: Left kidney measures 14.0 cm. As seen on CT, there is tumor extending into the left renal vein.OTHER: There is free fluid in the abdomen.
1. Occlusion of the inferior vena cava with tumor thrombus which extends to involve the right and left renal veins, right hepatic vein and extends to the right cardiac atrium.2. Infiltrating mass of the right kidney as seen on prior CT.3. Coarse echogenic liver consistent with chronic liver disease/parenchymal dysfunction.4. Echogenic kidneys consistent with chronic medical renal disease/parenchymal dysfunction.5. Free fluid in the abdomen.