Perinephric Cyst: Report of Case Associated with Ureteropelvic Occlusion and Congenital Hydronephrosis

Pautler, Elmer E.; Garvey, Fred K.

doi:10.1016/s0022-5347(17)67993-x

Cited by 15 publications

(4 citation statements)

References 2 publications

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“…At some point during the development of the hydronephrosis, the integrity of the lining wall is compromised, causing the rupture/leakage of urine into the subcapsular space that, in turn, forms a fluid-filled cavity (perinephric pseudocyst) between the renal capsule and the remnant kidney. 9,10,13 In the mouse of this study, the hydronephrosis had apparently progressed to a severe stage, as suggested by the thin rims of cortical tissue intermittently lining the renal capsule. We believe that, following the rupture/leakage into the subcapsular space, much of the injured renal parenchyma collapsed near the hilus, while small portions remained attached to the capsule.…”

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“…The large amount of remnant renal parenchyma remaining at the hilus is not consistent with severe hydronephrosis, but it is most compatible with perinephric pseudocyst formation secondary to hydronephrosis. 10, 14, 15 Hydronephrosis with secondary perinephric pseudocyst formation has been described in humans and cats. 9, 13 The suggested pathogenesis involves some degree of urinary obstruction leading to hydronephrosis (Fig.…”

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Unilateral Perinephric Pseudocyst Secondary to Hydronephrosis in a C57BL/6J Mouse

Meyerholz¹,

Hostetter²

2005

Vet Pathol

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Abstract. A 9-month-old C57BL/6J mouse had progressive abdominal distension over a 1-week period, and a distended left renal capsule was discovered at postmortem examination. Incision of the capsule showed a tan, cloudy fluid that separated the renal capsule and the remnant left kidney. Microscopically, the capsule was significantly separated from the renal parenchyma by clear space and necrotic cellular debris. The majority of the lining of the renal capsule was composed of fibrous connective tissue and lacked an epithelial lining, consistent with a subcapsular perinephric pseudocyst. In addition, attached to intermittent portions of the renal capsule were thin rims of compressed cortical tissue lined by transitional epithelium. The finding of remnant cortical tissue lined by transitional epithelium is consistent with severe hydronephrosis and indicates that the hydronephrosis preceded the formation of the perinephric pseudocyst. To our knowledge, this is the first case report to characterize a perinephric pseudocyst secondary to severe hydronephrosis in a mouse.Key words: C57BL/6J mice; hydronephrosis; perinephric pseudocyst; perirenal pseudocyst.Perinephric pseudocysts are locally extensive accumulations of fluid in a fibrous sac surrounding one or both kidneys. 8 The fluid accumulation may be extracapsular, but it is often subcapsular between the fibrous renal capsule and renal parenchyma. 1 Whereas a cyst is defined as a fluid filled cavity lined by epithelium, the term pseudocyst is more appropriate for this lesion, as it lacks an epithelial lining. 9 A review of the literature indicates multiple synonyms for this lesion, including capsulogenic renal cyst, capsular cyst, pararenal cyst, pararenal pseudocyst, capsular hydronephrosis, perirenal cyst, perirenal pseudocyst, and pseudohydronephrosis. 6,8,9 Perinephric pseudocysts are uncommon lesions in cats and are rare in dogs, ferrets, pigs, and humans. 4,7,[11][12][13] This manuscript characterizes a unilateral perinephric pseudocyst secondary to hydronephrosis in a C57BL/6J mouse.A 9-month-old female C57BL/6J mouse, part of a control group of an impending research study, showed progressive abdominal distension over 1 week's time. The mouse was euthanatized with carbon dioxide, and an incision of the abdomen showed a distended left kidney. The entire body was placed in 10% neutral-buffered formalin and submitted to Iowa State University's Surgical Pathology Service for histopathologic diagnosis. On examination, the renal capsule was greatly distended (3.4 ϫ 2.5 ϫ 2.2 cm) ( Fig. 1) and encased a tan, turbid fluid. Cytospin preparations were nondiagnostic due to formalin fixation. Near the hilus of the capsule was an aggregate of tissue compatible with the remnant kidney, and the adjacent proximal ureter had small, pale serosal nodules (ϳ1 mm).The tissues were processed routinely and stained with hematoxylin and eosin (HE) for microscopic evaluation. The remnant left kidney was slightly shrunken (8 ϫ 5 ϫ 4 mm), and the capsule was elevated above the parenchym...

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Unilateral Perinephric Pseudocyst Secondary to Hydronephrosis in a C57BL/6J Mouse

Meyerholz¹,

Hostetter²

2005

Vet Pathol

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“…Clinically they present as flank masses usually in association with urine ascites. The localized perirenal urinomas [5][6][7], on the other hand, are walled-off collections of urine in a portion of the perirenal space usually lateral to the affected kidney. They are probably due to chronic low pressure extravasations around which the fatty contents of the perirenal space have formed a thick, confining, fibrous capsule [1].…”

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confidence: 99%

“…Neonatal urinomas occur in association with congenital obstructive uropathies such as posterior urethral valves, [2,4], pelviureteric obstruction [5,7] or vesicoureteric obstruction [8]. As such, they may present as abdominal masses in the newborn or in conjunction with urine ascites.…”

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Neonatal urinomas: Imaging considerations

1984

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Neonatal urinomas can be defined as encapsulated extravasations of urine occurring secondary to congenital obstructive uropathies. Since 1978, four patients with proven urinomas have been studied at the Medical University of South Carolina, three of which had posterior urethral valves and the fourth, a segmental ureteral atresia. They were classified into three major types; subcapsular, diffuse perirenal and localized perirenal. The radiologic and imaging appearances are demonstrated. We found the most efficacious approach for identification of neonatal urinomas to be renal ultrasound, voiding cystourethrography and the Tc-99m DPTA renal scintigraphy.

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