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Contemporary update on imaging of cystic renal masses with histopathological correlation and emphasis on patient management.
Narayanasamy, S; Krishna, S; Prasad Shanbhogue, A K; Flood, T A; Sadoughi, N; Sathiadoss, P; Schieda, N.
Afiliação
  • Narayanasamy S; Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
  • Krishna S; Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
  • Prasad Shanbhogue AK; Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY 10016, USA.
  • Flood TA; Department of Anatomic Pathology, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
  • Sadoughi N; Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
  • Sathiadoss P; Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
  • Schieda N; Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada. Electronic address: nschieda@toh.on.ca.
Clin Radiol ; 74(2): 83-94, 2019 02.
Article em En | MEDLINE | ID: mdl-30314810
ABSTRACT
This article presents an updated review of cystic renal mass imaging. Most cystic renal masses encountered incidentally are benign and can be diagnosed confidently on imaging and require no follow-up. Hyperattenuating masses discovered at unenhanced or single-phase enhanced computed tomography (CT) measuring between 20-70 HU are indeterminate and can be further investigated first by using ultrasound and, then with multi-phase CT or magnetic resonance imaging (MRI); as the majority represent haemorrhagic/proteinaceous cysts (HPCs). Dual-energy CT may improve differentiation between HPCs and masses by suppressing unwanted pseudo-enhancement observed with conventional CT. HPCs can be diagnosed confidently when measuring >70 HU at unenhanced CT or showing markedly increased signal on T1-weighted imaging. Although the Bosniak criteria remains the reference standard for diagnosis and classification of cystic renal masses, histopathological classification and current management has evolved multilocular cystic renal cell carcinoma (RCC) has been reclassified as a cystic renal neoplasm of low malignant potential, few Bosniak 2F cystic masses progress radiologically during follow-up; RCC with predominantly cystic components are less aggressive than solid RCC; and Bosniak III cystic masses behave non-aggressively. These advances have led to an increase in non-radical management or surveillance of cystic renal masses including Bosniak 3 lesions. Tubulocystic RCC is a newly described entity with distinct imaging characteristics, resembling a pancreatic serous microcystadenoma. Other benign cystic masses including mixed epithelial stromal tumours (MEST) are now considered in the spectrum of cystic nephroma and angiomyolipoma (AML) with epithelial cysts (AMLEC) resemble a fat-poor AML with cystic components.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Carcinoma de Células Renais / Tomografia Computadorizada por Raios X / Angiomiolipoma / Doenças Renais Císticas / Neoplasias Renais Tipo de estudo: Diagnostic_studies Limite: Humans Idioma: En Revista: Clin Radiol Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Carcinoma de Células Renais / Tomografia Computadorizada por Raios X / Angiomiolipoma / Doenças Renais Císticas / Neoplasias Renais Tipo de estudo: Diagnostic_studies Limite: Humans Idioma: En Revista: Clin Radiol Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Canadá