HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bhatt, S. Articles by Dogra, V. Search for Related Content PubMed PubMed Citation Articles by Bhatt, S. Articles by Dogra, V. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Renal Pseudotumors

¹ Department of Radiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave., Box 648, Rochester, NY 14642.
² Department of Pathology, Case Western Reserve University, Cleveland, OH.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —46-year-old man with hypertrophied columns (septa) of Bertin. (Reprinted with permission from Paspulati RM, Bhatt S. Sonography in benign and malignant renal masses. Ultrasound Clinics 2006; 1:25-41 [2]) Longitudinal gray-scale sonogram of left kidney shows large hypertrophied columns of Bertin (arrows) located in middle third of kidney. It is continuous with normal renal cortex, and smooth renal surface overlies this pseudotumor.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —46-year-old man with hypertrophied columns (septa) of Bertin. (Reprinted with permission from Paspulati RM, Bhatt S. Sonography in benign and malignant renal masses. Ultrasound Clinics 2006; 1:25-41 [2]) Follow-up MRI was performed to rule out renal tumor. T1-weighted fat saturated (B) and gadolinium-enhanced (C) images of kidneys confirm presence of hypertrophied columns of Bertin (arrows), which shows similar signal intensity and identical homogeneous enhancement as that of normal renal cortex.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —46-year-old man with hypertrophied columns (septa) of Bertin. (Reprinted with permission from Paspulati RM, Bhatt S. Sonography in benign and malignant renal masses. Ultrasound Clinics 2006; 1:25-41 [2]) Follow-up MRI was performed to rule out renal tumor. T1-weighted fat saturated (B) and gadolinium-enhanced (C) images of kidneys confirm presence of hypertrophied columns of Bertin (arrows), which shows similar signal intensity and identical homogeneous enhancement as that of normal renal cortex.

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —25-year-old man with dromedary hump. Longitudinal gray-scale sonogram of left kidney shows presence of focal bulge (arrow) on lateral border of left kidney that has similar echotexture as adjacent renal cortex. Adjacent spleen (SP) is visualized, which is causing impression on kidney. (Reprinted with permission from Paspulati RM, Bhatt S. Sonography in benign and malignant renal masses. Ultrasound Clinics 2006; 1:25-41 [2])

View larger version (151K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —32-year-old man with persistent fetal lobulation. Longitudinal gray-scale sonogram of right kidney shows sharp indentation (arrow) overlying space between pyramids. Resultant focal bulge on renal surface mimics renal tumor and should be carefully scanned to confirm presence of normal renal tissue within it.

View larger version (149K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —53-year-old woman with splenorenal fusion. Axial T1-weighted (A) and coronal T2-weighted (B) MRI images of kidneys show well-defined mass (arrow) in lower pole of left kidney, which is hypointense on T1-weighted and has intermediate signal on T2-weighted images. Multiple renal cysts are also present bilaterally.

View larger version (154K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —53-year-old woman with splenorenal fusion. Axial T1-weighted (A) and coronal T2-weighted (B) MRI images of kidneys show well-defined mass (arrow) in lower pole of left kidney, which is hypointense on T1-weighted and has intermediate signal on T2-weighted images. Multiple renal cysts are also present bilaterally.

View larger version (145K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —53-year-old woman with splenorenal fusion. Axial (C) and coronal (D) gadolinium-enhanced images of kidneys show intense enhancement of mass (arrow), simulating renal cell carcinoma.

View larger version (157K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4D —53-year-old woman with splenorenal fusion. Axial (C) and coronal (D) gadolinium-enhanced images of kidneys show intense enhancement of mass (arrow), simulating renal cell carcinoma.

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4E —53-year-old woman with splenorenal fusion. Gross specimen of left kidney after nephrectomy reveals mass consists of hemorrhagic-appearing splenic tissue (SP) in renal capsule but sharply demarcated from adjacent renal parenchyma (K), confirming splenorenal fusion. (Reprinted with permission from Tynski Z, MacLennan GT. Renal pseudotumors. J Urol 2005; 173:600 [1].

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —35-year-old woman with focal pyelonephritis. Contrast-enhanced CT scan of kidneys shows focal hypoattenuating lesion (arrowheads) in right kidney with decreased contrast enhancement. Absence of distinct wall around lesion and clinical information suggestive of infection are helpful in distinguishing this lesion from renal tumor.

View larger version (116K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —36-year-old man with left renal abscess. Longitudinal gray-scale sonogram of left kidney shows well-defined hypoechoic mass (arrow) near mid region of kidney.

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —36-year-old man with left renal abscess. Corresponding contrast-enhanced CT scan of kidneys shows low-attenuation mass (arrow) in mid region of left kidney simulating renal cell carcinoma.

View larger version (100K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6C —36-year-old man with left renal abscess. Gross specimen of kidney shows presence of pus and debris in lesion, consistent with abscess (arrowheads).

View larger version (105K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —47-year-old woman with xanthogranulomatous pyelonephritis (XGP). Contrast-enhanced CT scans of kidneys show enlarged right kidney with focal area of hypodensity (white arrow, A). Also seen is presence of calculus (arrowhead, B) and part of stent (black arrow, A) in right renal pelvis.

View larger version (110K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —47-year-old woman with xanthogranulomatous pyelonephritis (XGP). Contrast-enhanced CT scans of kidneys show enlarged right kidney with focal area of hypodensity (white arrow, A). Also seen is presence of calculus (arrowhead, B) and part of stent (black arrow, A) in right renal pelvis.

View larger version (76K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7C —47-year-old woman with xanthogranulomatous pyelonephritis (XGP). Surgical specimen of kidney (K in C) shows focal XGP (C) and necrotic debris (D). Debris was originally in cavity seen in C.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7D —47-year-old woman with xanthogranulomatous pyelonephritis (XGP). Surgical specimen of kidney (K in C) shows focal XGP (C) and necrotic debris (D). Debris was originally in cavity seen in C.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7E —47-year-old woman with xanthogranulomatous pyelonephritis (XGP). Microscopic slide shows abundant lipid-laden macrophages (arrowheads), xanthoma cells, with multiple acute and chronic inflammatory cells. (H and E, x40) (Reprinted with permission from Tynski Z, MacLennan GT. Renal pseudotumors. J Urol 2005; 173:600 [1])

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —35-year-old man with renal arteriovenous malformation. Nephrographic phase of contrast-enhanced CT scan of kidneys in this patient with no history of trauma or biopsy shows enhancing lesion in renal pelvis (arrowheads).

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —35-year-old man with renal arteriovenous malformation. Subsequent gray-scale (B) and color Doppler (C) sonograms reveal anechoic structures (arrows, B) in renal pelvis (excluding possibility of solid mass), which fill with color, showing mosaic color-flow pattern with high-velocity, low-impedance pulsatile flow, which is consistent with vascular malformation rather than solid neoplasm.

View larger version (90K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8C —35-year-old man with renal arteriovenous malformation. Subsequent gray-scale (B) and color Doppler (C) sonograms reveal anechoic structures (arrows, B) in renal pelvis (excluding possibility of solid mass), which fill with color, showing mosaic color-flow pattern with high-velocity, low-impedance pulsatile flow, which is consistent with vascular malformation rather than solid neoplasm.

View larger version (140K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9A —35-year-old woman with subepithelial renal pelvic hematomas. Unenhanced CT scan of kidneys shows heterogeneous mass (arrow) in left renal hilum.

View larger version (144K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9B —35-year-old woman with subepithelial renal pelvic hematomas. Corresponding scan during corticomedullary phase of kidneys shows no enhancement of this heterogeneous mass (arrow).

View larger version (142K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9C —35-year-old woman with subepithelial renal pelvic hematomas. Excretory phase scan shows mass effect on collecting system due to left renal hilar mass (arrow).

View larger version (137K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9D —35-year-old woman with subepithelial renal pelvic hematomas. Cut section of surgically removed kidney shows multiple organizing hematomas (arrow) and thromboemboli (arrowhead) in hilar adipose tissue. Pathologic examination showed mass to be subepithelial renal pelvic hematomas secondary to vasculitis.

View larger version (132K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10A —82-year-old woman with renal extramedullary hematopoiesis. Axial (A) and coronal (B) unenhanced CT scans of right kidney show multiple perirenal masses (arrowheads) with severe splenomegaly (SP).

View larger version (119K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10B —82-year-old woman with renal extramedullary hematopoiesis. Axial (A) and coronal (B) unenhanced CT scans of right kidney show multiple perirenal masses (arrowheads) with severe splenomegaly (SP).

View larger version (90K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10C —82-year-old woman with renal extramedullary hematopoiesis. Axial CT scan of pelvis at bone window setting shows coarsening of bone matrix and thinning of cortices, which are suggestive of extramedullary hematopoiesis.

View larger version (155K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10D —82-year-old woman with renal extramedullary hematopoiesis. Microscopy is characterized by presence of megakaryocytes (red arrow) (confirmation by positive immunostaining for factor VIIIra) and granulocyte precursors (blue arrow) (confirmation by positive Leder staining). Presence of these blood cell precursors suggests hematopoietic process in these masses. These microscopic features are confirmatory for extramedullary hematopoiesis. (H and E, x40)

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati