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RRC DDx 2 > GU > Flashcards

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1
Q

Well defined solid renal mass

A 
Neoplasm
- RCC
- oncocytoma
- (lipid poor) AML
- mets / lymphoma
Infection
- abscess / lobar nephronia
- focal xanthogranulomatous pyelonephritis
- TB
Sarcoid
IgG4
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2
Q

Ill-defined renal mass(es) / striated nephrogram

A 
Neoplasm
- urothelial Ca
- mets / lymphoma
Pyelonephritis
Contusion
Urine in / out
- glomerulonephritis / vasculitis / sarcoid
- urinary outflow obstruction
Blood in / out
- infarct / arterial ischemia
- renal vein thrombosis
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3
Q

Cystic renal mass

A

Neoplasm (Cystic RCC, multilocular cystic nephroma)
Cyst (simple / complex / hemorrhagic)
Collection (abscess, hematoma, echinococcal cyst)
Caliceal diverticulum

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4
Q

Perinephric soft tissue

A

Neoplasm (lymphoma, Walderstrom’s macroglobulinemia)
Fibrotic / granulomatous (retroperitoneal fibrosis, Erdheim-Chester)
Extramedullary hematopoiesis
Hematoma

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5
Q

Perinephric fluid

A 
Urinoma
Abscess
Seroma
Lymphocele
Hematoma
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6
Q

Diffuse renal enlargement / echogenic kidneys

A 
Lymphoma (most commonly Burkitt’s)
Infectious
- pyelonephritis
- HIV nephropathy
Autoimmune
- acute glomerulonephritis
- GPA / SLE / PAN / HSP
Outflow obstruction (ureteric, renal vein)
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7
Q

Unilateral small smooth kidney

A

Postobstructive atrophy (some residual collecting system dilation)
Longstanding renal vascular disease (nondilated collecting system)
Congenital unilateral hypoplastic kidney (nondilated collecting system, enlarged contralateral kidney)

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8
Q

Causes of papillary necrosis (NSOID)

A 
NSAIDs / acetaminophen / analgesic abuse
Sickle cell
Obstruction (hydronephrosis or renal vein thrombus)
Infection (pyelo, TB)
Diabetes / dehydration
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9
Q

Medullary nephrocalcinosis

A 
H: hyperparathyroidism
A: (renal tubular) acidosis
M: medullary sponge kidney
H: hypercalcemia/hypercalciuria
O: oxalosis
P: papillary necrosis
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10
Q

Cortical nephrocalcinosis

A

C: cortical necrosis
O: oxalosis
A: Alport syndrome
G: (chronic) glomerulonephritis

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11
Q

High resistance waveform in transplant kidney

A 
Rejection
ATN
Post-surgical edema
Renal vein thrombosis
Hydronephrosis
Extrinsic compression (e.g. hematoma)
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12
Q

Intraluminal filling defect - collecting system

A

Stone / blood / gas
TCC
Fungal ball
Sloughed papillae from papillary necrosis

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13
Q

Gas in collecting system

A

Emphysematous pyelitis
Recent instrumentation
Fistula to bowel

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14
Q

Deformed calyces

A

Papillary necrosis
Medullary sponge kidney (renal tubular ectasia)
TB
TCC

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15
Q

Absence of reflux into ureters post-conduit in conduitogram

A

Underdistention of the conduit
Anti-reflux surgical technique
Stenosis at the ureteroenteric anastomosis
Recurrence of tumour at the anastomosis

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16
Q

Calcification at the UVJ

A

Stone
Ureterocele with stone formed inside
Phlebolith

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17
Q

Intraluminal bladder mass

A 
Malignancy (TCC/SCC, mets)
Hematoma
Infection (TB / schisto)
Malakoplakia
Inflammatory pseudotumor
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18
Q

Intramural bladder mass

A

Pheochromocytoma
Rhabdomyosarcoma
Leiomyoma; other mesenchymal tumors
Endometriosis

19
Q

Bladder wall calcification

A

Schisto
TB
Cyclophosphamide or radiation cystitis

20
Q

Urachal mass

A

AdenoCa
Infected / Inflamed urachal remnant
Bladder tumours (more likely intramural)

21
Q

T2 dark areas in PZ of prostate

A

Cancer
Hemorrhage
Prostatitis
Post-treatment

22
Q

Cystic prostatic mass

A 
Abscess
Cystic degen of BPH nodule
Cysts
- utricle (central)
- mullerian duct (central)
- ejaculatory duct (off midline)
23
Q

Urethral stricture

A 
Anterior
- traumatic
- iatrogenic
- infectious (gonococcus)
Posterior
- pelvic fractures
- prostatic surgery
24
Q

Solid testicular mass

A 
Primary malignant (germ cell tumours: seminomatous, nonseminomatous [embryonal, yolk sac, immature teratoma, chorio])
Primary benign (sex cord / stromal = Sertoli, Leydig, Granulosa, fibromathecoma)
Mets / lymphoma
Orchitis
Hematoma / contusion
Ischemia (+/- reperfusion)
Sarcoid
Adrenal rests
Epidermoid cyst
25
Extratesticular solid mass
Neoplasm - benign (majority): adenomatoid tumor of epidydimis, mesenchymal (lipoma, leiomyoma, fibroma) - malignant = sarcomas / mets (rare) Hernia Polyorchidism Granulomatous (fungal / myocobacterial / sarcoid)
26
Epidydimal cystic lesions
Cyst Spermatocele Cystadenoma (rare – in VHL)
27
Extra-epidydimal and extra-testicular cystic lesions
Hydrocele (simple, pyocele, hematocele) Tunica albuginea cyst Spermatic cord cyst / patent tunica vaginalis Varicocele
28
Solid uterine myometrial mass
Fibroid Uterine sarcoma (leiomyosarcoma, MMMT, ESS) Adenomyoma
29
Solid mass in endometrial cavity / endometrial thickening
Neoplasm - benign = polyp, submucosal fibroid, endometrial hyperplasia - malignant = endometrial cancer, gestational trophoblastic disease (partial/complete/invasive mole, chorioca) Blood products / RPOC Tamoxifen / HRT
30
Blood expanding endometrial / cervical canal
``` Primary - imperforate hymen - vaginal septum - congenital stenosis - uterine abnormalities with obstructed horn(s) Secondary - post insult (usually iatrogenic) adhesions / scar - tumour ```
31
Congenital uterine abnormalities
Top of fundus is not cleaved - arcuate - septate - unicornuate +/- rudimentary horn (may communicate, may have cavity) Top of fundus is cleaved - bicornuate (uterine cavities communicate): unicollis, bicollis - didelphys T-shaped = diethylstilbestrol (DES) exposure in utero
32
Hydrosalpinx
``` Endometriosis (MCC of hematosalpinx) PID (also pyosalpinx) Prior surgery Tubal pregnancy Malignancy ```
33
Dilated pelvic veins
Normal variant Pelvic congestion syndrome Venous obstruction AVM / AVF
34
Cystic ovarian mass
``` Neoplasm - epithelial (serous / mucinous cystadenoma or cystadenocarcinoma) - metastatic (Krukenberg) - dermoid Physiologic structure - simple cyst / follicle - corpus luteal cyst Physiologic structure gone bad - hemorrhagic cyst / endometrioma - theca-lutein cysts / ovarian hyperstimulation syndrome - polycystic ovarian syndrome Ectopic pregnancy TOA (dilated tube helps, not seen in ovarian malignancy usually) Infarcted necrotic ovary ```
35
Solid ovarian mass
``` Primary neoplasm - sex cord / stromal (Sertoli / Leydig / fibroma-thecoma spectrum) - Brenner tumour -dysgerminoma Metastases / lymphoma Infarcted ovary Ectopic pregnancy Mimic = Pedunculated exophytic uterine fibroid ```
36
Cysts of the vagina / uterus
Urethral diverticulum Cysts - Gartner duct (anterolateral vaginal wall) - Bartholin gland (posterior labia majora) - Skene duct (external urethral meatus) - Nabothian (cervix) Collection
37
Solid adrenal mass
``` Neoplasm - primary benign - adenoma (functional vs nonfunctional / lipid rich vs lipid poor) - myelolipoma - primary malignant - adrenal cortical carcinoma - pheochromocytoma - mets (lung, breast, thyroid, colon, melanoma) - lymphoma - collision tumour (can be any two neoplasms above) Hemorrhage Hyperplasia (if bilateral / nodular) ```
38
Cystic adrenal mass
``` Endothelial cyst (lymphangioma, sometimes hemangioma) Pseudocyst Cystic change of solid mass (pheo, ACC) ```
39
Solid retroperitoneal mass
Neoplasm - benign primary - nerve sheath tumor, other mesenchymal tumors - desmoid - malignant primary - sarcoma (1 = lipo, 2 = leiomyo, 3 = pleomorphic undifferentiated) - paraganglioma - mets / lymphoma - mass from nearby organ Adenopathy Fibrosis (primary – IgG4, secondary – drugs, radiation, malignancy, etc.) Cystic mimics (hematoma, endometrioma, complex cystic lesion)
40
Cystic retroperitoneal mass
``` Cystic adenopathy Collection Lymphangioma Cystic appearance of solid mass - cystic teratoma - peripheral nerve sheath tumour - paraganglioma - treated malignancy ```
41
Fatty retroperitoneal mass
Liposarcoma Teratoma AML Myelolipoma
42
Cystic adenopathy
``` Infectious - mycobacterial / fungal - Whipple’s Celiac Necrotic malignant ```
43
Filling defect IVC
``` Bland thrombus Tumour thrombus - primary (leiomysarcoma) - secondary (RCC, ACC, HCC) Admixture artifact ```

RRC DDx 2 (8 decks)

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