Known left para-aortic retroperitoneal nodal mass measuring 13.6 cm in craniocaudal length with a bilobed appearance and central areas of necrosis. Further 7.2 cm left common/external iliac nodal mass also shows low attenuation. The left kidney shows impaired enhancement compared to the right and there is mild hydronephrosis and hydroureter suggesting ureteric obstruction at the level of the left pelvic mass.
Normal appearances of the remaining upper abdominal organs.
No lymphadenopathy above the diaphragm. Small amount of anterior mediastinal soft tissue compatible with thymus. The lungs and pleural spaces are clear. Bone windows review is unremarkable.
Comment: Known left para-aortic and left pelvic nodal masses causing left distal ureteric obstruction and hydronephrosis with impaired enhancement of the left kidney.