Retroperitoneum Flashcards
What confines the anterior pararenal space?
Anterior renal fascia (Gerota’s)
Posterior renal fascia (Zuckerkandl)
Lateroconal Fascia
What is contained within the anterior renal fascia?
Ascending and Descending colon
Duodenum and Pancreas (Pancreaticoduodenal Component)
Continuous across the midline
What binds the posterior pararenal space?
Posterior renal fascia (anteriorly)
Transversalis Fascia (posteriorly)
- medially the psoas muscle limits
- laterally open toward the flank
- inferiorly open to the pelvis
» the posterior pararenal space contains fat
Name differentials for cystic non-neoplastic processes in the retroperitoneum
Haematoma
Urinoma
Lymphocele
Seroma
Abscess
Pancreatic pseudocyst
Pancreatic or peripancreatic necrosis
Describe the appearance of a retroperitoneal haematoma on CT and MRI?
Variable appearance
What is a urinoma?
What is a lymphocele?
Collection of lymph, contains no epithelial lining, can occur post-lymphadenectomy.
On CT homogenous, low attenuation. Fat can be seen.
List differentials for solid non neoplastic processes?
Retroperitoneal fibrosis
IG4 Related Sclerosing Disease
Pseudotumoral
Lipomatosis
Histiocytosis
Extramedullary Haematopoesis
Amyloidosis
Describe retroperitoneal fibrosis?
It is more often than not idiopathic ~ 70% of cases
Secondary causes include
- Drug-induced
- Inflammatory Aortic Aneurysm
- Traumatic (haematoma, urinoma, radiation, surgery)
- Infectious
- Granulomatous disorders
- Histiocytosis (Erdheim- Chester)
- Occupational
Neoplastic
- endometriosis
- amyloidsis
What does retroperitoneal fibrosis look like on imaging?
Differentials for Ig4 sclerosing disease in RP?
What is extramedullary haematopoesis and what are the imaging features?
What are the differentials for retroperitoneal tumours?
- Primary retroperitoneal Tumours
- Originating from retroperitoneal organs
- Metastasis
Describe the four primary retroperitoneal tumors
- Mesodermal
- Germ cell
- Neurogenic
- Lymphoid
Describe the different mesodermal retroperitoneal tumours.
important features of a desmoid tumour?
describe the different subtypes of liposarcoma and their imaging features?
What is the most common primary IVC tumour?
Describe a lymphangioma?
Differentials for neurogenic retroperitoneal mass?
Describe a schwannoma?
- small schwannomas are round and homogenous
- large schwannomas are heterogeneous, encapsulated and extend along nerves.
Describe the features of a neurofibroma?
What is a plexiform neurofibroma?
Neurogenic RP mass differential
Describe paraganglioma?
Neurogenic RP mass differential
describe germ cell tumor?
Describe a teratoma? (included within differentials of germ cell tumour)
Describe some diagnostic clues for retroperitoneal masses.
Describe the pattern of spread for lesions that spread between structures.
What retroperitoneal masses will contain fat?
What RP masses contain myxoid strroma?
What RP masses might you see tumour necrosis?
important things to keep in mind about RP masses
