Bilobed left retroperitoneal soft tissue mass, measuring 8.1 x 7.3 cm in greatest transaxial dimensions, and 13.5 cm in craniocaudal dimension, it is possible this may represent two adjacent soft tissue masses.
Left pelvic sidewall soft tissue mass, measuring 5.6 x 6.2 x 6.5 cm (TR x AP x CC).
Slight fullness of the left renal pelvis, the left ureter is displaced laterally by the left retroperitoneal mass, with mild left hydroureter, and likely compression of the left distal ureter by the left pelvic sidewall mass.
No urinary tract calculi.
Normal appearance of the unenhanced right kidney and urinary bladder.
Mild splenomegaly, AP spleen length 14.9 cm.
Normal appearances of the imaged unenhanced liver, gallbladder, adrenals and pancreas.
Normal appearances of the unenhanced large and small bowel.
No abdominal or pelvic free fluid.
The imaged lung bases are clear.
Normal imaged skeleton.
Opinion:
Left retroperitoneal soft tissue mass, and left pelvic sidewall soft tissue mass, these likely represent enlarged nodes; together with the mild splenomegaly concern raised for an underlying haematological abnormality; the differential would include nodal metastases from a left-sided testicular tumour, particularly given the family history. Is there a palpable left testicular mass?
The left pelvic sidewall mass is likely compressing the left distal ureter with very mild left hydronephrosis. No urinary tract calculi.