Cytologically Yours: CoW: 20131209
The patient is an 64 year old white male who presented with left sided back pain. Imaging showed a left perinephric retroperitoneal hematoma and a left renal lower pole cystic lesion with hemorrhage. Additional imaging showed numerous pulmonary lesions. An endobronchial ultrasound guided fine needle aspiration was scheduled.
Past Medical History
- Congestive heart failure
- Ventricular tachycardia
- Ischemic heart disease
Past Surgical History
- Coronary stent placement
- Implant of AICD
The concern is a primary renal malignancy with metastatic disease to lungs. An endobronchial ultrasound guided FNA is scheduled. An onsite rapid diagnosis by cytology was scheduled.
- CT Abdomen shows a large perinephric hematoma and large low anterior structure in left lower pole suspicious for a hemorrhagic renal cell carcinoma.
- CT Chest shows multiple small lung lesions measuring up to 13x12 mm in greatest dimension.
- Kidney specific antigen