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Small Renal Cell Carcinomas: Correlation of Size with Tumor Stage, Nuclear Grade, and Histologic Subtype

Raymond M. Hsu1,2, David Y. Chan3 and Stanley S. Siegelman1

1 Russell H. Morgan Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, and Department of Radiology, Johns Hopkins University, 601 N Caroline St., Rm. 4214, Baltimore, MD 21287-0801.
2 Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr., H1307, Stanford, CA 94304-5105.
3 James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, MD.



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  		Fig. 1A. —54-year-old man with incidentally detected 2-cm enhancing left renal mass (arrow 1). Unenhanced CT scan shows lesion with attenuation of 46 H and normal adjacent renal parenchyma (arrow 2), which measured 42 H.

 


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  		Fig. 1B. —54-year-old man with incidentally detected 2-cm enhancing left renal mass (arrow 1). Early contrast-enhanced CT scan shows that lesion appears exophytic but well circumscribed. Attenuation of lesion is 67 H (enhancement = 21 H). Normal adjacent renal parenchyma (arrow 2) was 127 H.

 


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  		Fig. 1C. —54-year-old man with incidentally detected 2-cm enhancing left renal mass (arrow 1). Delayed contrast-enhanced CT scan shows lesion with attenuation of 95 H (enhancement = 49 H). After patient underwent partial nephrectomy, pathologic examination revealed papillary renal cell carcinoma, nuclear grade 2, and tumor penetration of renal capsule (T3).

 


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  		Fig. 2A. —67-year-old man with incidentally detected 3-cm enhancing exophytic left renal mass (arrow). Unenhanced CT scan shows lesion with attenuation of 49 H.

 


View larger version (185K):

[in a new window]
  		Fig. 2B. —67-year-old man with incidentally detected 3-cm enhancing exophytic left renal mass (arrow). Early contrast-enhanced CT scan shows lesion with attenuation of 90 H (enhancement = 41 H).

 


View larger version (169K):

[in a new window]
  		Fig. 2C. —67-year-old man with incidentally detected 3-cm enhancing exophytic left renal mass (arrow). Delayed contrast-enhanced CT scan shows lesion with attenuation of 94 H (enhancement = 45 H). After patient underwent partial nephrectomy, pathologic examination revealed papillary renal cell carcinoma, nuclear grade 3, and penetration of renal capsule (T3).

 


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  		Fig. 3A. —56-year-old woman with incidentally detected 3-cm enhancing well-circumscribed left renal mass (arrow 1). Unenhanced CT scan shows lesion with attenuation of 43 H and normal adjacent renal parenchyma (arrow 2), which measured 40 H.

 


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  		Fig. 3B. —56-year-old woman with incidentally detected 3-cm enhancing well-circumscribed left renal mass (arrow 1). Early contrast-enhanced CT scan shows lesion with attenuation of 73 H (enhancement = 32 H).

 


View larger version (131K):

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  		Fig. 3C. —56-year-old woman with incidentally detected 3-cm enhancing well-circumscribed left renal mass (arrow 1). Delayed contrast-enhanced CT scan shows lesion with attenuation of 78 H (enhancement = 37 H). After patient underwent partial nephrectomy, pathologic examination revealed papillary renal cell carcinoma, nuclear grade 2, with penetration of renal capsule (T3).

 

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