Figure 1

A 55-year-old man with autopsy-confirmed collecting duct carcinoma and pulmonary, liver, and lymph node metastases. A. Computed tomography scan shows an enlarged right kidney and an ill-defined mass (arrows). B. Early phase computed tomography reveals slow and heterogeneous enhancement of the lesion. C. Delayed phase computed tomography reveals slow and heterogeneous enhancement of the lesion. D. Computed tomography scan through the upper lung shows multiple cavitary lesions (arrows). E. Autopsy specimen reveals hemorrhagic nodules with central cavities (arrows) in both lungs. F. Enhanced computed tomography shows a low-attenuation area (arrow) with minimal enhancement in S4 of the liver. G. Autopsy specimen demonstrates a mass in S4 (arrow) with hemorrhagic and necrotic changes. H. Enhanced computed tomography shows a marginally enhanced nodule in the para-aortic area. I. Gross examination reveals a lymph node with central necrosis (arrow).