No 2.4 cm Nodule on Left Kidney Identified
The MRI report explicitly states "No focal lesions in the left kidney," meaning there is no 2.4 cm nodule present in the left kidney. 1
What the MRI Actually Shows
Right Kidney Findings
The imaging identified two distinct lesions in the right kidney only:
- 10 mm T1 hyperintense lesion in the superior pole: T1 bright, T2 dark, no enhancement → classified as Bosniak 2 hemorrhagic/proteinaceous cyst 1
- 8 mm fat-containing lesion in the lower pole lateral cortex: shows signal loss on opposed-phase imaging → consistent with angiomyolipoma 1
Left Kidney Status
- Completely normal with no hydronephrosis and no focal lesions of any size 1
Management of the Identified Right Kidney Lesions
For the 10 mm Bosniak 2 Hemorrhagic Cyst
No follow-up imaging is required. 1, 2
- Bosniak 2 cysts (including hemorrhagic/proteinaceous cysts ≤30 mm) are classified as benign findings highly likely (ONCO-RADS category 2) 1
- The American College of Radiology guidelines state that Bosniak I and II cysts require no further follow-up 2
For the 8 mm Angiomyolipoma
No follow-up imaging is required. 1
- Angiomyolipomas are classified as benign findings highly likely (ONCO-RADS category 2) 1
- The presence of macroscopic fat (demonstrated by signal loss on opposed-phase imaging) indicates a benign angiomyolipoma with virtual certainty 1
- Small angiomyolipomas <1 cm pose minimal risk and do not require surveillance 1
Clinical Pitfall to Avoid
Do not confuse the 10 mm measurement (1.0 cm) with 2.4 cm. The report describes millimeter-sized lesions, not centimeter-sized masses. There is no 2.4 cm lesion anywhere in either kidney on this MRI. 1