Chapter 7-Renal Mass Flashcards
–a progressive hereditary disorder that leads to renal failure; affects 1:1000.
Clinical Symptoms-30s-40’s w/ decreasing renal function and hypertension; may present with abnormalities of the heart valves, colonic diverticula, and cerebral aneuris; symptoms include flank pain and hematuria (cysts are prone to hemorrhage and infection)
Sonographically- multiple cysts of varying sizes noted bilaterally. As the disease progresses, the kidneys become enlarged and present with nephromegaly. Patients younger than 30 should have two renal cysts (uni or bilat), patients 30-59 should have two cysts and patients older than 60 should have 4.
Autosomal Dominant Polycystic Kidney Disease
located in the renal sinus and are lymphatic in origin; they do not communicate with the collecting system although may mimic hydronephrosis.
Clinically- asymptomatic Sonographic -cystic area in the sinus of kidney.
Parapelvic cyst
progressive disorder that results in chronic renal failure from a noncystic renal disorder characterized by development of multiple cysts
Clinical Symptoms-patients with long-term dialysis. It is usually asymptomatic but patients with secondary complications may have hemorrhage and the development of renal cell carcinoma (RCC) (may include hematuria, flank pain, and fever)
Sonographically-when three or more cysts are identified in each kidney. Kidneys are usually decreased in size but may be enlarged as well.
Acquired Cystic Kidney Disease
a cyst that doesn’t meet the criteria of a simple cyst; may exist within the cortex, medulla, or pelvis-
Characteristics-perceptible wall which may include calcification, irregularity, or thickening; internal echoes that may include septations and enhancement.
Characteristics of complex cyst
What is the claw sign?
Concavity in the renal cortex in which the parenchyma seems to be cupping the cyst or mass
The claw sign is most commonly found with what type of simple cyst?
Cortical
Parapelvic cysts are from _____ origin
Lymphatic origin
True or false
Parapelvic cysts communicate with the renal collecting system.
False
They do not communicate with renal collecting system
Are patients with parapelvic cysts usually
Symptomatic or asymptomatic
Asymptomatic
If there is multiple parapelvic cysts what could it be mistaken with?
Hydronephrosis
When a cyst does not meet the criteria of a simple cysts, what is it then called?
Complex cyst
Where can a complex cyst exist?
Cortex medulla or pelvis
What are the common findings of a complex cyst
3 things
Perceptible wall
Internal echoes
Variable enhancement
Name a few types of complex cysts
Hemorrhagic Infected cyst Multilocular or septated cyst Calcified cysts Cyst malignancy
What would the symptoms of a patient with a hemorrhagic cyst be?
Flank pain and hematuria
If the patient has an infected cyst, what would their symptoms be?
Flank pain
Fever
Hematuria
white blood count
KEY WORD IS WHITE BLOOD COUNT-dead giveaway that the patient has infection
Sonographic findings of an infected cyst?
Debri (low level echoes)
Debri may have a layer effect that changes LLD.
Thickened wall
A cyst that contains septations or locultions are?
Multilocular cysts
Where do the septations come from?
Resolved hemorrhage or infection
Thin septations usually are fine although aspiration should be used to rule out ______.
Malignancy
If the septation is thick and shows papillary projections, ____ should be suspected.
Malignancy
Calcifications can occur if the cyst had previously been _______ or ______
Infected or hemorrhaged
Thick calcifications can be worrisome of ________
Malignancy
Milk in calcium frequently occurs in patients with______ ???
Calyceal diverticulum
Urine stasis in the diverticulum leads to the formation of….
Milk of calcium
What are some types of cyst malignancy
Cystic nephroma or cystic renal cell carcinoma
