CT of the thorax and abdomen –
Thorax: A large infiltrative non-uniformly enhancing soft tissue mass of 5 x 5 cm is seen at the cardiac base entrapping the aortic root, descending and ascending aorta including the brachycephalic trunc. There is a significant mass effect on the surrounding cardiac and vascular anatomy including the lumen of the left ventricle. Only scant pericardial effusion is noted. One of the cranial mediastinal lymph nodes reveals severe enlargement with loss of the regular short-to-long-axis ratio and non-uniform contrast enhancement. Several pleural plugs and ditzels are noted throughout the lungs. There is no evidence of metastatic spread to the pulmonary interstitium.
Abdomen:
Both kidneys present signs of hypercalcemic nephropathy with accumulation of non-obstructive calculi within the renal pelvis as well as multifocal expansile cortical cysts up to 7.5 mm diameter. The nephrogram is symmetric between the right and left kidney. The renal pyelogram is delayed respectively. Multiple large, non-obstructive urinary bladder calculi and signs of chronic cystitis with urinary bladder wall thickening are noted.