We report the imaging findings of metanephric adenoma. US examination showed a protruding hypoechoic mass at the right kidney. CT revealed a well defined isodense mass with calcifications. On angiography, neither neovascularization nor tumor staining was revealed at all. The T1-weighted MR images showed a hypointense mass that was slightly hyperintense on T2-weighted MR images. Histologically, the tumor was metanephric adenoma.

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An autopsy case of massive renal hemorrhage in a 49 year old male who had undergone maintenance hemodialysis for 8 years, is reported. No bleeding tendency had been noticed, and blood pressure had been reduced to within the normal range. Histological investigation with semiserial sections revealed that hemorrhage had occurred in four arteries, corresponding to the interlobar, arcuate, and interlobular levels, which existed in the same ruptured cyst wall. Acute dissection had occurred in two of the four arteries, leading to rupture of the cyst; this led to destruction of the remaining arteries. Both kidneys, which were markedly shrunken and had numerous cysts in the cortex and medulla, fell into the category of acquired cystic renal disease of long term hemodialysis. It was suspected that renal vascular change during hemodialysis, mechanical factors compressing the protruding artery in the cyst with scanty renal interstitium, and relatively radical hemodynamic changes during dialysis had contributed to the hemorrhage. Acta Pathol Jpn 39: 342∼348, 1989.

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