Advertisement

Problematic renal masses in ultrasonography and computed tomography

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The diagnosis of renal masses is based upon the contribution of ultrasonography (US) and computed tomography (CT), which enable the recognition of these lesions with high diagnostic difficulties exist in the ever, a number of diagnostic difficulties exist in the definition of the nature of the mass, both for cystic and solid lesions, and to a lesser extent in the identification of the mass. “Complicated” cystic masses, such as calcified cysts, hemorrhagic cysts, inflammatory cysts, abscesses, and cystic tumors may be difficult to diagnose with US and sometimes with CT. CT is helpful in most of these cases because it enables the evaluation of the calcifications and the density of the fluid content. CT is also helpful in cases of cystic tumors because it shows the enhancement of septae within the masses. Problems with solid masses are the identification of small renal tumors and the definition of the benign or malignant nature of the mass. Although both techniques enable the recognition of most tumors, even if small in diameter, they are still limited in defining the pathological structure of the tumor.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bosniak M.A.
        The current radiological approach to renal cysts.
        Radiology. 1986; 158: 1-10
        • Charboneau J.W.
        • Hatterly R.R.
        • Ernst E.C.
        • James E.M.
        • Williamson B.
        • Hartman J.W.
        Spectrum of sonographic findings in 125 renal masses other than benign simple cysts.
        Am J Roentgenol. 1983; 140: 89-94
        • Dalla-Palma L.
        • Pozzi-Mucelli R.S.
        • Magnaldi S.
        • Ricci C.
        Apporto diagnostico delle differenti tecniche di immagini delle masse renali.
        Radiol Med. 1989; 77: 115-127
        • Magnaldi S.
        • Pozzi-Mucelli R.S.
        • Ricci C.
        Ecografia e Tomografia Computerizzata nella diagnosi delle lesioni complesse addominali.
        Radiol Med. 1988; 76: 68-74
        • Ziviello M.
        Interpretazione delle componenti strutiurali della lesione.
        in: Atti XI Convegno di Diagnostica con Ultrasuoni, Modena, Monduzzi1984
        • Dalla-Palma L.
        • Pozzi-Mucelli R.S.
        • Pozzi-Mucelli F.
        Ruolo della Tomografia Computerizzata nella diagnostica renale.
        in: DallaPalma L. ed 2. Progressi in Radiologia, Radiourologia 1986. 2. Lint, Trieste1986: 59-89
        • Daniels W.W.
        • Hartman G.W.
        • Witten D.M.
        • Farrow G.M.
        • Kelalis P.P.
        Calcified renal masses: a review of 10 years experience at the Mayo Clinic.
        Radiology. 1972; 103: 503-508
        • Weyman P.J.
        • McClennan B.L.
        • Lee J.K.T.
        • Stanley R.J.
        CT of calcified renal masses.
        Am J Roentgenol. 1982; 138: 1095-1099
        • Kim W.S.
        • Goldman S.M.
        • Gatewood O.M.B.
        • Marshall F.F.
        • Siegelman S.S.
        Computed tomography in calcified renal masses.
        J Comput Assist Tomogr. 1981; 5: 855-860
        • Love L.
        • Yeddlicka J.
        Computed tomography of internally calcified renal cysts.
        Am J Roentgenol. 1985; 145: 1225-1227
        • Coelho J.C.V.
        • Siegel B.
        • Ryva J.C.
        • Machi J.
        • Renigars S.A.
        B-mode sonography of blood clots.
        J Clin Ultrasound. 1982; 10: 323-327
        • Dunnick N.R.
        • Korobkin M.
        • Silverman P.M.
        • Foster Jr., W.L.
        Computed Tomography of high density renal cysts.
        J Comput Assist Tomogr. 1984; 8: 458-461
        • Pearlstein A.E.
        Hyperdense renal cysts.
        J Comput Assist Tomogr. 1985; 7: 1029-1031
        • Zirinsky K.N.
        • Auh Y.H.
        • Rubenstein W.A.
        • Williams J.J.
        • Pasmentier M.W.
        • Kazam E.
        CT of the hyperdense renal cyst: sonographic correlation.
        Am J Roentgenol. 1984; 143: 151-156
        • Bergstrom M.
        • Erikson K.
        • Levander B.
        • Svendsen P.
        • Larsson S.
        Variation with time of the attenuation values of intracranial hematomas.
        J Comput Assist Tomogr. 1977; 1: 57-63
        • Norman D.
        • Price D.
        • Boyd D.
        • Fishman R.
        • Newton T.H.
        Quantitative aspects of computed tomography of the blood and the cerebral fluid.
        Radiology. 1985; 157: 741-744
        • Wolverson M.K.
        • Grepps L.S.
        • Sundarama M.
        • Heiberg E.
        • Vas W.G.
        • Shields J.B.
        Hyperdensity of recent hemorrhage at body computed tomography: incidence and morphologic variation.
        Radiology. 1983; 148: 779-784
        • Englestad B.L.
        • McClennan B.L.
        • Levitt R.G.
        • Stanley R.J.
        • Sagel S.S.
        The role of pre-contrast images in computed tomography.
        Radiology. 1980; 136: 153-155
        • Sussman S.
        • Cochran S.T.
        • Pagani J.J.
        • McArale C.
        • Wong W.
        • Austin R.
        • Curry N.
        • Kelly K.M.
        Hyperdense renal masses: a CT manifestation of hemorrhagic renal cyst.
        Radiology. 1984; 150: 207-211
        • Fishman M.
        • Pollack H.M.
        • Arger P.H.
        • Bauner M.P.
        High protein content: another cause of CT hyperdense benign renal cyst.
        J Comput Assist Tomogr. 1985; 7: 1029-1031
        • Dalla-Palma L.
        • Bazzocchi M.
        • Pozzi-Mucelli R.S.
        • Stacul F.
        Ecografia renale 1985.
        in: Dalla-Palma L. ed 2. Progressi in Radiologia, Radiourologia 1986. 1. Lint, Trieste1985: 19-35
        • Dalla-Palma L.
        • Pozzi-Mucelli R.S.
        • Pozzi-Mucelli F.
        • Magnaldi S.
        Diagnostica per immagini delle infezioni renali acute.
        Acta Urol Ital. 1988; 4: 277-284
        • Fiegler W.
        Ultrasound in acute renal inflammatory lesion.
        Eur J Radiol. 1983; 3: 354-357
        • Weill F.
        • Rohmer P.
        • Zeltner F.
        Renal sonography in 1982. Success and limitations: a general review.
        Eur J Radiol. 1983; : 141-151
        • Pollack H.M.
        • Banner M.P.
        • Arger P.H.
        • Goldberg B.B.
        • Mulhern C.B.
        Comparison of computed tomography and ultrasound in the diagnosis of renal masses.
        in: Rosenfield A.T. Clinics in diagnostic ultrasound 2. ed 2. Genitourinary Ultrasonography. 2. Churchill Livingtone, New York, Edinburg, London1979: 25-72
        • Godeck C.J.
        • Tsai S.H.
        • Smith S.J.
        • Cass A.S.
        Diagnostic strategy in evaluation of renal abscess.
        Urology. 1981; 18: 535-541
        • Mendez G.
        • Isikoff M.B.
        • Mortillo G.
        The role of computed tomography in the diagnosis of renal and perirenal abscess.
        J Urol. 1979; 122: 582-586
        • Triller J.
        • Scheidegger J.
        • Terrier F.
        Computer tomographic bei akuter pyelonephritis.
        Fortschr Roentgenstr. 1983; 139: 38-44
        • Dalla-Palma L.
        • Pozzi-Mucelli R.S.
        • Bazzocchi M.
        • Pozzi-Mucelli F.
        Le infezioni renali acute.
        in: Dalla-Palma L. ed 2. Progressi in Radiologia, Radiourologia 1985. 1. Lint, Trieste1985: 63-79
        • Hartman D.S.
        • Davis Jr., C.J.
        • Johns T.
        • Goldman S.M.
        Cystic renal cell carcinoma.
        Urology. 1986; 28: 145-153
        • Alanen A.
        • Nurmi M.
        • Ekfors T.
        Multilocular renal lesions—a diagnostic challenge.
        Clin Radiol. 1987; 38: 475-477
        • Banner M.P.
        • Pollack H.M.
        • Chatten J.
        • Witzleben C.
        Multilocular renal cysts: radiologic-pathologic correlation.
        Am J Roentgenol. 1981; 136: 239-247
        • Bard R.H.
        • Lord B.
        • Fromowitz F.
        Papillary adenocarcinoma of kidney. Radiographic and biologic characteristics.
        Urology. 1982; 19: 16-20
        • Di Donna A.
        Cisti e carcinomi renali settati. Aspetti ecografici e problemi diagnostici.
        US Med. 1986; 7: 205-216
        • Feldberg M.A.M.
        • Van Waes P.F.G.M.
        Multilocular cystic renal cell carcinoma.
        Am J Roentgenol. 1982; 138: 953-955
        • Madewell J.E.
        • Goldman S.M.
        • Davis Jr., C.J.
        • Hartman D.S.
        • Faigin D.S.
        • Lichtenstein J.E.
        Multilocular cystic nephroma: a radiographic-pathologic correlation of 58 patients.
        Radiology. 1983; 146: 309-321
        • Parienty R.A.
        • Pradel J.
        • Parienty I.
        Renal cancers: CT characteristics.
        Radiology. 1985; 157: 741-744
        • Press G.A.
        • McClennan B.L.
        • Melson G.L.
        • Weiman P.J.
        • Mauro M.A.
        • Lee J.K.T.
        Papillay renal cell carcinoma: CT and sonographic evaluation.
        Am J Roentgenol. 1984; 143: 1005-1009
        • Veneziano S.
        • Busato F.
        • Pavlica P.
        • Querzè R.
        • Teglia F.
        • Ferri C.
        • Corrado G.
        • Mannini D.
        • Bertoni F.
        Nefrocarcinoma papillifero: aspetti radiografici ed ecografici.
        Radiol Med. 1988; 76: 584-589
        • Pozzi-Mucelli F.
        • Di Donna A.
        • Pozzi-Mucelli R.S.
        • Magnaldi S.
        Apporto dell'ecografia e della tomografia computerizzata nei tumori renali cistici.
        in: ed 2. Atti XXXIII Congresso Nazionale S.I.R.M.N.4. Monduzzi, Roma1988: 2049-2053
        • Plainfossé M.C.
        • Delecoeullerie G.
        • Vital J.L.
        • Paty E.
        • Merran S.
        165 renal carcinomas: accuracy of imaging for diagnosis and spread cost efficiency.
        Eur J Radiol. 1983; 3: 132-137
        • Viglietta G.
        • Pavlica P.
        • Busato F.
        • Veneziano S.
        L'ecografia ha modificato l'incidenza del carcinoma renale?.
        Radiol Med. 1988; 75: 193-194
      1. Weill F.S. Bihr E. Rohmer P. Zeltuer F. Renal sonography. Springer-Verlag, Berlin, Heidelberg1981
        • Curry N.S.
        • Schabel S.I.
        • Betsill W.L.
        Small renal neoplasms: diagnostic imaging, pathological features, and clinical course.
        Radiology. 1986; 158: 113-117
        • Daughtry J.D.
        • Rodan B.A.
        Incidental sonographic detection or renal cell carcinoma.
        South Med J. 1984; 77: 292-293
        • Kass D.A.
        • Hricak H.
        • Davidson A.J.
        Renal malignancies with normal excretory urograms.
        Am J Roentgenol. 1983; 141: 731-734
        • Konnak J.W.
        • Grossman H.B.
        Renal cell carcinoma as an incidental finding.
        J Urol. 1985; 134: 1094-1096
        • Raval B.
        • Lamki N.
        Computed tomography in detection of occult hypernephroma.
        J Comput Assist Tomogr. 1983; 7: 199-207
        • Amendola M.A.
        • Bree R.L.
        • Pollack H.M.
        • Francis I.R.
        • Glazer G.M.
        • Jafri S.Z.H.
        • Tomaszewski J.E.
        Small renal cell carcinomas: resolving a diagnostic dilemma.
        Radiology. 1988; 166: 637-641
        • Bosniak M.A.
        Scoperta e diagnosi dei tumori renali piccoli.
        in: Dalla-Palma L. ed 2. Progressi in Radiologia, Radiourologia 1986. 2. Lint, Trieste,1986: 247-252
        • Dalla-Palma L.
        • Pozzi-Mucelli R.S.
        • Magnaldi S.
        • Pozzi-Mucelli F.
        Diagnostica per immagini dei tumori renali di piccole dimensioni.
        Radiol Med. 1988; 76: 590-596
        • Smith S.J.
        • Bosniak M.A.
        • Megibow A.J.
        • Hulnick D.H.
        • Horii S.C.
        • Raghvendra B.N.
        Renal cell carcinoma: earlier discovery and increased detection.
        Radiology. 1989; 170: 699-703
        • Choyke P.L.
        • White E.M.
        • Zeman R.K.
        • Jaffe M.H.
        • Clark L.R.
        Renal metastases: clinicopathologic and radiologic correlation.
        Radiology. 1987; 162: 359-363
        • Mucci B.
        • Lewi H.J.I.
        • Flennin S.
        The radiology of sarcomas and sarcomatoid carcinomas of the kidney.
        Clin Radiol. 1987; 38: 249-254
        • Nishitani H.
        • Onitsuka H.
        • Kawahira K.
        Computed tomography of renal metastases.
        J Comput Assist Tomogr. 1984; 8: 727-730
        • Bennington G.
        • Beckwith J.
        Tumors of the kidney, renal pelvis and ureter.
        in: ed 2. Atlas of tumor pathology. Armed Forces Institute of Pathology, Bethesda1975
      2. Elkin M. Radiology of the urinary system. Little, Brown and Company, Boston1980: 300-301
      3. Ney C. Friedenberg R.M. Radiologic atlas of the genitourinary system. Lippincott JB Company, Philadelphia, Toronto1981
        • Bazzocchi M.
        • Pozzi-Mucelli R.S.
        • Zanella F.
        • Ricci C.
        Diagnostica 1985 delle neoplasie renali.
        in: Dalla-Palma L. ed 2. Progressi in Radiologia, Radiourologica 1985. 1. Lint, Trieste1985: 81-95
        • Coleman B.G.
        • Arger P.H.
        • Mulhern C.B.
        • Pollack H.M.
        • Banner M.B.
        • Arenson R.L.
        Gray scale sonographic spectrum of hypernephromas.
        Radiology. 1980; 137: 757-765
        • Bosniak M.A.
        Angiomyolipoma (hamartoma) of the kidney: a preoperative diagnosis is possible in virtually every case.
        Urol Radiol. 1981; 3: 135-142
        • Hartman D.S.
        • Goldman S.M.
        • Friedman A.C.
        • Davis Jr., C.J.
        • Madewell J.E.
        • Sherman J.L.
        Angiomyolipoma: ultrasonic-pathologic correlation.
        Radiology. 1981; 139: 451-458
        • Lee T.G.
        • Henderson S.C.
        • Freeny P.C.
        • Raskin M.M.
        • Benson E.P.
        • Peerse H.D.
        Ultrasound findings of renal angiomyolipoma.
        J Clin Ultrasound. 1978; 6: 150-155
        • Stasi G.
        • Barozzi L.
        • Orrei M.G.
        • Piraccini A.
        • Tommasini D.
        • Carcello A.
        Diagnostica per immagini dell'angiomiolipoma renale.
        Radiol Med. 1986; 72: 733-738
        • Erwin B.C.
        • Carol B.A.
        • Walter J.F.
        • Sommer F.G.
        Renal infarction appearing as an echogenic mass.
        Am J Roentgenol. 1982; 138: 759-761
        • Saxton H.M.
        Pseudoneoplasie renali.
        in: Dalla-Palma L. ed 2. Progressi in Radiologia, Radiourologia 1985. 1. Lint, Trieste1985: 95-109
        • Pozzi-Mucelli F.
        • Magnaldi S.
        • Zennaro F.
        • Pozzi-Mucelli R.S.
        Diagnostica per immagini dei tumori renali di piccole dimensioni.
        in: ed 2. Atti del XXXIII Congresso Nazionale S.I.R.M.N.1. Monduzzi, Roma1988: 541-545
        • McClennan B.L.
        • Lee J.K.T.
        Kidneys.
        in: Lee J.K.T. Sagel S.S. Stanley R.J.S. Computed Body Tomography. Raven Press, New York1983
        • Cohan R.H.
        • Dunnick N.R.
        • Degesys G.E.
        • Korobkin M.
        Computed tomography of renal oncocytoma.
        J Comput Assist Tomogr. 1984; 8: 284-287
        • Levine E.
        • Huntrakoon M.
        Computed tomography of renal oncocytoma.
        Am J Roentgenol. 1983; 141: 741-746
        • Neisus D.
        • Braedel H.U.
        • Schindler E.
        • Hoene E.
        • Alloussi S.
        Computed tomographic and angiographic findings in renal oncocytoma.
        Br J Radiol. 1988; 61: 1019-1025
        • Quinn M.J.
        • Hartman D.S.
        • Friedman A.C.
        • Sherman J.L.
        • Lantin E.M.
        • Pyatt R.S.
        • Ho C.R.
        • Csere R.
        • Fromowitz F.B.
        Renal oncocytoma: new observation.
        Radiology. 1984; 153: 49-53
        • Kandell L.B.
        • McCollaugh D.L.
        • Harrison L.H.
        • Ahl Jr., E.
        • Munitz A.
        • Woodruff R.D.
        Primary renal lymphoma, Does it exist?.
        Cancer. 1987; 60: 386-391
        • Farrow G.M.
        • Harrison E.G.
        • Utz D.
        • Reinine W.H.
        Sarcomas and sarcomatoid and mixed malignant tumours in the kidney in adults.
        Cancer. 1968; 22: 545-563
        • Leder L.D.
        • Ricther H.J.
        • Stambolis C.
        Pathology of renal and adrenal neoplasms.
        in: Lohr R. Renal and adrenal tumours. Springer-Verlag Ed, Berlin, Heidelberg, New York1979 (Berlin, Heidelberg)
        • Shirkhoda A.
        • Lewis E.
        Renal sarcoma and sarcomatoid renal cell carcinoma: CT and angiographic features.
        Radiology. 1987; 162: 535-537
        • Granmayeh M.
        • Wallace S.
        • Barret A.F.
        • Fisher R.
        • Heslep J.H.
        Sarcoma of the kidney: angiographic features.
        Am J Roentgenol. 1977; 129: 107-112