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  • Renal Cysts: Surbhi Gupta, Ms4 Radiology 6/2/17

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    This document summarizes a case study of a 41-year-old male presenting with right upper quadrant pain. Imaging revealed hypoechoic renal masses, which were classified as Bosniak class II cysts based on their features on CT scan. Renal cysts are common in older adults and usually asymptomatic. They are typically diagnosed with ultrasound or CT and often do not require treatment. This patient's cysts were not intervened on and he was treated conservatively for his irritable bowel syndrome instead.

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    Renal Cysts

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    This document summarizes a case study of a 41-year-old male presenting with right upper quadrant pain. Imaging revealed hypoechoic renal masses, which were classified as Bosniak class II cysts based on their features on CT scan. Renal cysts are common in older adults and usually asymptomatic. They are typically diagnosed with ultrasound or CT and often do not require treatment. This patient's cysts were not intervened on and he was treated conservatively for his irritable bowel syndrome instead.

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    10 просмотров10 страниц

    Renal Cysts: Surbhi Gupta, Ms4 Radiology 6/2/17

    Загружено:

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    This document summarizes a case study of a 41-year-old male presenting with right upper quadrant pain. Imaging revealed hypoechoic renal masses, which were classified as Bosniak class II cysts based on their features on CT scan. Renal cysts are common in older adults and usually asymptomatic. They are typically diagnosed with ultrasound or CT and often do not require treatment. This patient's cysts were not intervened on and he was treated conservatively for his irritable bowel syndrome instead.

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    © All Rights Reserved
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    из 10

    RENAL CYSTS

    SURBHI GUPTA, MS4


    RADIOLOGY
    6/2/17
    BACKGROUND

    • TAF, 41 year old male


    • History of IBS, now presenting as an outpatient with RUQ pain, diarrhea, weight loss
    INITIAL DDX AND WORKUP
    • Differential diagnosis
    • Gallstones
    • IBS flare
    • IBD
    • Pancreatitis
    • Hepatitis
    • Peptic ulcer disease
    • Workup
    • Vitals: stable, normal
    • Physical exam: normal
    • Labs: within normal CBC, CMP, viral panel
    • RUQ u/s: hypoechoic right renal upper pole mass
    • CT
    • 2-5 images
    PARAMETERS AND NEW DDX

    • Lesion parameters
    • Largest two lesions reaching 25mm
    • Average Hounsfield units 30-45
    • No enhancement
    • New Differential Diagnosis
    • Renal cysts
    • Neoplasm
    BOSNIAK CLASSIFICATION

    Features Work-up Malignancy


    1 Thin-walled, round None 0%

    2 Few septae, fine calcifications, <3cm, non-enhancing None 0%

    2F More septae, thick calcifications, >3cm, non-enhancing Follow with u/s or CT 5%

    3 Thick and irregular septae, can be enhancing (+10-20 Nephrectomy or 55%


    HU) radiofrequency ablation
    4 Solid with cystic or necrotic elements Nephrectomy 100%
    RENAL CYSTS OVERVIEW
    • Found in 50% of people over the age of 50
    • Unclear pathogenesis
    • Complications
    • Infection
    • Ischemia
    • Hemorrhage
    • Pain
    • Management
    • Dx: ultrasound with Doppler, CT
    • Tx: if symptomatic, ultrasound guided sclerotherapy vs laparoscopic cystectomy
    FINAL DIAGNOSIS
    • Bosniak class II cysts
    • No intervention or follow up recommended
    • Treatment with gut hypnotherapy and acupuncture for IBS
    REFERENCES
    • Cecil G. Wood III, LeRoy J. Stromberg III, Carla B. Harmath, Jeanne M. Horowitz, Chun Feng, Nancy A.
    Hammond, David D. Casalino, Lori A. Goodhartz, Frank H. Miller, and Paul Nikolaidis. CT and MR Imaging
    for Evaluation of Cystic Renal Lesions and Diseases. RadioGraphics 2015 35:1, 125-141.
    • Muglia, Valdair F., and Antonio Carlos Westphalen. “Bosniak Classification for Complex Renal Cysts:
    History and Critical Analysis.” Radiologia Brasileira 47.6 (2014): 368–373. PMC. Web. 1 June 2017.
    • http://www.radiologyassistant.nl/en/p44d1045b472df/kidney-cystic-masses.html

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