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Figure 1. A 59-year-old man with hypertension presented with a three-month history of fatigue and progressive shortness of breath. Physical examination revealed mild jaundice, tachypnea, tachycardia, bibasilar rales, and mild hepatomegaly. Laboratory studies disclosed microcytic anemia and elevated concentrations of total bilirubin and alkaline phosphatase. Urinalysis revealed no evidence of hematuria or proteinuria. Transthoracic echocardiography performed to investigate heart failure demonstrated mild, concentric left ventricular hypertrophy and mild, diffuse left ventricular dysfunction. A standard subcostal view revealed a multilobar cystic mass (arrows in Panel A) in the inferior vena cava (IVC) that appeared to originate from the right kidney. . . . [Full Text of this Article] |