There are innumerable soft tissue lesions in both lungs, with some extending into the adjacent pleura. The largest is located in the right middle zone, has ill-defined central areas of hyperdensity. It extends into the right lateral thoracic wall, with permeative bone destruction in the right 3rd and 4th ribs. On the left, there is a large loculated pleural effusion causing compression of the interposed left lower lobe. Two bulky adrenal lesions probably represent further metastases. Bilateral hydronephrosis. Within the limits of a noncontrast study, the imaged portions of the liver, gallbladder and spleen are unremarkable. No evidence of bony metastasis.