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RRC DDx 2 > GU > Flashcards

GU Flashcards

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
Q

Extratesticular solid mass

A

Neoplasm
- benign (majority): adenomatoid tumor of epidydimis, mesenchymal (lipoma, leiomyoma, fibroma)
- malignant = sarcomas / mets (rare)
Hernia
Polyorchidism
Granulomatous (fungal / myocobacterial / sarcoid)

26
Q

Epidydimal cystic lesions

A

Cyst
Spermatocele
Cystadenoma (rare – in VHL)

27
Q

Extra-epidydimal and extra-testicular cystic lesions

A

Hydrocele (simple, pyocele, hematocele)
Tunica albuginea cyst
Spermatic cord cyst / patent tunica vaginalis
Varicocele

28
Q

Solid uterine myometrial mass

A

Fibroid
Uterine sarcoma (leiomyosarcoma, MMMT, ESS)
Adenomyoma

29
Q

Solid mass in endometrial cavity / endometrial thickening

A

Neoplasm
- benign = polyp, submucosal fibroid, endometrial hyperplasia
- malignant = endometrial cancer, gestational trophoblastic disease (partial/complete/invasive mole, chorioca)
Blood products / RPOC
Tamoxifen / HRT

30
Q

Blood expanding endometrial / cervical canal

A 
Primary
- imperforate hymen
- vaginal septum
- congenital stenosis
- uterine abnormalities with obstructed horn(s)
Secondary
- post insult (usually iatrogenic) adhesions / scar
- tumour
31
Q

Congenital uterine abnormalities

A

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
Q

Hydrosalpinx

A 
Endometriosis (MCC of hematosalpinx)
PID (also pyosalpinx)
Prior surgery
Tubal pregnancy
Malignancy
33
Q

Dilated pelvic veins

A

Normal variant
Pelvic congestion syndrome
Venous obstruction
AVM / AVF

34
Q

Cystic ovarian mass

A 
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
Q

Solid ovarian mass

A 
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
Q

Cysts of the vagina / uterus

A

Urethral diverticulum
Cysts
- Gartner duct (anterolateral vaginal wall)
- Bartholin gland (posterior labia majora)
- Skene duct (external urethral meatus)
- Nabothian (cervix)
Collection

37
Q

Solid adrenal mass

A 
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
Q

Cystic adrenal mass

A 
Endothelial cyst (lymphangioma, sometimes hemangioma)
Pseudocyst
Cystic change of solid mass (pheo, ACC)
39
Q

Solid retroperitoneal mass

A

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
Q

Cystic retroperitoneal mass

A 
Cystic adenopathy
Collection 
Lymphangioma
Cystic appearance of solid mass
- cystic teratoma
- peripheral nerve sheath tumour
- paraganglioma
- treated malignancy
41
Q

Fatty retroperitoneal mass

A

Liposarcoma
Teratoma
AML
Myelolipoma

42
Q

Cystic adenopathy

A 
Infectious
- mycobacterial / fungal
- Whipple’s
Celiac
Necrotic malignant
43
Q

Filling defect IVC

A 
Bland thrombus
Tumour thrombus
- primary (leiomysarcoma)
- secondary (RCC, ACC, HCC)
Admixture artifact

RRC DDx 2 (8 decks)

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