CT and US Findings of Multilocular Cystic Renal Cell Carcinoma

Kim, Jong Chul; Kim, Kie Hwan; Lee, Jun Woo

doi:10.3348/kjr.2000.1.2.104

Cited by 25 publications

(12 citation statements)

References 11 publications

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“…5). Ein zusätzliches Kriterium für Malignität sind Raumforderungen oder Knoten in der Wand, die meist eine deutliche Kontrastmittelaufnahme aufweisen [14,58].…”

Section: Zvstisches Nierenzellkarzinomunclassified

Zystische Nierenläsionen

Kreft

Schild²

2003

Rofo Fortschr Geb Rontgenstr N

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Cystic renal lesions are most often simple or complicated cysts, which can be seen solitary or as part of cystic renal disease. The minority of these lesions are benign or malignant cystic tumors. The classification of cystic renal masses by Bosniak (category l - IV) based on specific ultrasound and CT features is very useful for the characterization of the lesion and for the therapeutic decision. The main objective of this classification is to differentiate nonsurgical (category II) from surgical cystic masses (category III/IV). Ultrasound is the first modality of choice in the diagnostic work-up of cystic renal masses, because an accurate and economically reasonable diagnosis of the frequent simple cyst can be made by maintaining rigid ultrasound criteria of the Bosniak classification. If a complicated cyst or a cystic tumor is suspected a three phasic contrast-enhanced CT of the kidneys should be performed. MRI is superior to CT in the characterization of complex cystic masses.

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“…5). Ein zusätzliches Kriterium für Malignität sind Raumforderungen oder Knoten in der Wand, die meist eine deutliche Kontrastmittelaufnahme aufweisen [14,58].…”

Section: Zvstisches Nierenzellkarzinomunclassified

Zystische Nierenläsionen

Kreft

Schild²

2003

Rofo Fortschr Geb Rontgenstr N

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“…To our knowledge, just two MCRCC cases have been reported to be accompanied by hemorrhage, but only in the partial portion of the cystic component. 40 Although the CT attenuation of the cyst wall or septum was hyperattenuating in all four multilocular cystic-type eAML, no reports of hyperattenuation of the wall or septum on CT images of MCRCC have been made.…”

Section: Discussionmentioning

confidence: 78%

“…Although massive hemorrhage was seen in the cystic components of all four multilocular cystic‐type eAML, there are few reports of MCRCC accompanied by massive hemorrhage in the cystic component on CT and/or MRI findings. To our knowledge, just two MCRCC cases have been reported to be accompanied by hemorrhage, but only in the partial portion of the cystic component . Although the CT attenuation of the cyst wall or septum was hyperattenuating in all four multilocular cystic‐type eAML, no reports of hyperattenuation of the wall or septum on CT images of MCRCC have been made.…”

Section: Discussionmentioning

confidence: 94%

“…One of our eight cases showed a spontaneous perirenal hematoma around the renal tumor. It is well known that classic AML often causes spontaneous perirenal hematoma, followed by RCC . Other renal tumors that cause spontaneous perirenal hematoma include metastatic tumors of malignant melanoma, renal abscesses, ruptured renal cysts and pheochromocytomas .…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that classic AML often causes spontaneous perirenal hematoma, followed by RCC. 40 Other renal tumors that cause spontaneous perirenal hematoma include metastatic tumors of malignant melanoma, renal abscesses, ruptured renal cysts Imaging of epithelioid angiomyolipoma and pheochromocytomas. 41,42 eAML should be included in the differential diagnosis of tumors with spontaneous perirenal hematoma.…”

Section: Discussionmentioning

confidence: 99%

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Epithelioid angiomyolipoma of the kidney: Radiological imaging

et al. 2013

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Objectives: To review the imaging findings of renal epithelioid angiomyolipomas. Methods: Eight patients treated at two institutions were pathologically diagnosed as having epithelioid angiomyolipoma. All of them underwent computed tomography, and four underwent magnetic resonance imaging. The tumor size, existence of fat, heterogeneity, computed tomography attenuation, degree of enhancement, enhancement pattern and magnetic resonance imaging signal intensity were evaluated. Results: Intratumoral fat was not detected in any of the cases. On unenhanced computed tomography, the intratumoral attenuation was hyperattenuating in six of the seven patients who were examined using this modality. On T2-weighted images, the signal intensity of the solid component, cyst wall or septum was low in three of the four cases. Four of the eight cases were heterogeneous solid-type accompanied by hemorrhage, necrosis or hyalinization. One homogeneous solid-type lesion was large in size and was pathologically accompanied by neither hemorrhage nor necrosis. All three multilocular cystic types were pathologically accompanied by massive hemorrhage in the cystic component. One was accompanied by spontaneous perirenal hematoma. Conclusions:The radiological appearance of most epithelioid angiomyolipomas has a tendency to be hyperattenuating on unenhanced computed tomography images, with low intensities on T2-weighted images. They can be heterogeneously solid, homogeneously solid or a multilocular cystic lesion with massive hemorrhage.

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Apparent wall thickening of cystic renal lesions on MRI

Gulani

Adusumilli

Hussain

et al. 2008

Magnetic Resonance Imaging

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Purpose: To show that cystic renal lesions that would otherwise meet criteria for simple cysts can demonstrate perceptible walls or increased wall thickness on MRI, sometimes causing these lesions to be "upgraded." It was hypothesized that thickening of cyst walls on MRI can be artifactual, due to data truncation, applied filtering, and low signal-to-noise ratio (SNR).Materials and Methods: k-Space data for a 4-cm cyst were created in a 40-cm field of view (FOV) (512 ϫ 512 matrix). Additional data sets were created using the central 512 ϫ 256 and 512 ϫ 128 points. Noise was simulated so that the cyst SNR was approximately 7, 14, and 20, respectively. Actual wall thickness was set at 0.25 mm, and cyst:wall signal at 1:4. An inverse two-dimensional (2D) fast Fourier transform (FFT) yielded simulated images. A Fermi filter was applied to reduce ringing. Images/projections were examined for wall thickening. Seven patients with initially thick-walled cysts on fat-saturated spoiled gradient-echo (FS-SPGR) images were scanned with increasing resolution (256 ϫ 128 and 256 ϫ 256; four patients were also scanned with 512 ϫ 512). Average wall thickness at each resolution was compared using a two-tailed paired Student's t-test. Results:Simulations showed apparent wall thickening at low resolution, improving with higher resolutions. Low SNR and application of the Fermi filter made it difficult to identify ringing as the cause of this thickening. The simulation results were confirmed on seven patients, whose cyst walls proved to be artifactually thickened (P Ͻ 0.01). Conclusion:Thickening of cyst walls on MRI can be artifactual. Upon encountering thick-walled cystic renal lesions, high-resolution images can be acquired to exclude apparent thickening.

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CT and US Findings of Multilocular Cystic Renal Cell Carcinoma

Cited by 25 publications

References 11 publications

Zystische Nierenläsionen

Zystische Nierenläsionen

Epithelioid angiomyolipoma of the kidney: Radiological imaging

Apparent wall thickening of cystic renal lesions on MRI

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