Genitourinary imaging Flashcards
Solid renal mass
RCC: Clear cell, papillary, chromophobe, medullary
Oncocytoma: older men, central scar, spoke-wheel vascularity, Birt-Hogg-Dube association
Angiomyolipoma: associated with TS. Show gross fat and lack calcification
TCC: <10% arise in renal pelvis
Lymphoma: soliraty or multiple masses of diffuse enlargement
staging:
t1: <7cm
t2: >7cm
t3a: renal vein, t3b: infradiaphragmatic IVC, t3c: supradiaphragmatic
t4: through gerota fascia or ipsilateral adrenal
Miltiple bilateral renal masses
Lymphoma: most commonly multiple masses, can be solitary mass or diffuse infiltration
Infection: pyelonephritis or pseudotumoral Tb
RCC in VHL or dialysis
AML in TS. >4cm risk of haemorrhage
Metastases
Oncocytomas and chromophobe RCCs in Birt-Hogg-Dube
Cystic renal mass
Cystic RCC or Wilm's Renal cyst Multilocular cystic nephroma (young boys and middle aged women, prolapses into renal pelvis) Hydronephrosis: mimic MCDK: can be focal Abscess
Bosniak
1: simple 0%
2: fine septations/calcifications or hyperdense <3cm 0%
2f: minimally thick smooth walls or nodular calcification, hyperdense >3cm 5%
3: enhancing walls 55%
4: enhancing soft tissue components 100% cancer
Retroperitoneal mass
Liposarcoma
Lymphadenopathy (lymphoma): lifts aorta
Retroperitonal fibrosis: medialyses ureters
Haemorrhage or abscess
Cortical nephrocalcinosis
“GOAT Piss”
Glomerulonephritis
Oxalosis
Acute cortical necrosis most commonly and alport syndrome
Transplant rejection
PJP/Tb with parenchymal calcification are mimics
Medullary nephrocalcinosis
HAMHOP
Hypercalcuria RT Acidosis Medullary sponge kidney Hyperparathyroidism Oxalosis Papillary necrosis
Striated nephrogram
Pyelonephritis Renal vein thrombosis Ureteric obstruction Renal contusion Hypotension
papillary necrosis
DINOSAUR (U=C) diabetes infection: pyelonephritis, Tb nsaids obtruction sickle cell acetamenophen cirrhosis renal vein thrombosis
staghorn calculus
struvite= AMP, seen in the context of recurrent infection
Xanthogranulomatous pyelonephritis ureteric obstruction and pyonephrosis Calcified neoplasm (mimic)
Renal cortical defect
reflux nephropathy chronic pyelonephritis infarct vasculitis partial nephrectomy
Renal pelvic mass
TCC (40% synchronous bladder TCC) Medullary carcinoma Other RCC Multilocular cystic nephroma Haematoma
Medial ureteric deviation
retroperitoneal fibrosis psoas hypertrophy pelvic lipomatosis postoperative retrocaval ureter
Ureteral filling defects
TCC radiolucent calculi: uric acid/xanthine/indinavir Haematoma Air Fungus ball pyeloureteritis cystica
Renal migration anomaly
Pelvic kidney
Crossed fused renal ectopia - abnormal vascularity but normal ureteric insertion
Horseshoe kidney
Duplication - upper moiety inserts inferomedially (weigert-Meyer) and is prone to obstruction
Bladder filling defect
Haematoma
TCC/SCC
Fungus ball
Radiolucent calculus - urate/xanthine/indinavir
Bilateral renal cysts
ADPCKD VHL Dialysis and ESRF Lithium TS
Perinephric fluid collection
haematoma
urinoma
pyelonephritis with perinephric collection
Pear shaped bladder
pelvic lymphadenopathy pelvic lipomatosis iliac artery aneurysm psoas hypertrophy pelvic haematoma
Prostate enlargement
BPH
prostatitis
prostate adenocarcinoma
Bladder rupture
Extraperitoneal
Intraperitoneal
Bladder wall calcification
TCC schistosomiasis Cystitis Tb Urachal carcinoma
Adrenal mass
Adenoma <2cm <10HU >40% relative or 60% absolute washout
Myelolipoma
Adrenocortical carcinoma: large, heterogeneous, 30% calcify
Phaeochromocytoma: chromaffin cells, MIBG avid
Met
Haemorrhage
Fatty retroperitoneal mass
Liposarcoma
AML
adrenal myelolipoma
RCC
Dilated ureter
obstruction
reflux
megaureter
prune belly
