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Uroradiology > retroperitoneum > Flashcards

retroperitoneum Flashcards

1
Q

What are the causes of spontaneous retroperitoneal hemorrhage in the following spaces?
Anterior pararenal
Perirenal
Posterior pararenal

A

Ant - hemorrhagic pancreatitis
Peri - AAA, RCC, AML, polyarteritis nodosa
Post - anticoagulation

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2
Q

What is the most common nontraumatic cause of RPH?

A

Ruptured aortic aneurysm

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3
Q

What are the adrenal tumors that can bleed

A 
Primary/metastatic tumors
myelolipoma
pheochromocytoma
cyst
abscess
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4
Q

What are the two most common renal tumors that bleed

A

AML, usually >4cm

RCC

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5
Q

What is a urinoma?

A

Mass formed by encapsulated extravasated urine

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6
Q

What is a page kidney

A

Mass effect on the renal parenchyma activates the RAS system resulting in significant hypertension

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7
Q

What are the two outcomes with urine leakage intot he retroperitoneum

A

Retroperitoneal fibrosis

Urinoma

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8
Q

What are the most common causes of retroperitoneal abscess in the

anterior pararenal space
perinephric
posterior pararenal

A

Ant - pancreatitis
Peri - UTI
Post - osteomyelitis

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9
Q

What is a lymphocele?

A

discrete collections of chylous fluid found after inadequate ligation of disrupted lymphatic vessels

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10
Q

On CT, how does one differentiate between abscess and lymphocele

A

Lymphocele will be negative houndsfield due to the fat content

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11
Q

How does fluid in the prevesicle extraperitoneal space present?

A

Molar tooth shaped

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12
Q

Most common cause of chyluria? Other causes?

A

Filariasis

retroperitoneal malignancy, trauma, surgery, TB, LAM

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13
Q

What are the radiographic findings of chyluria?

A

Lymphangiography - increase in number, size, and tortuosity of retroperitoneal vessels with retrograde flow of contrast into the renal lymphatics

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14
Q

What is ormands disease?

A

Idiopathic retroperitoneal fibrosis encasing both ureters

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15
Q

What are the causes of retroperitoneal fibrosis?

A

Meds - methysergide, ergotamine, methyldopa
Retroperitoneal fluid
Inflammatory disease
Surgery/Radiation
Desomplastic response to malignancy
Lymphoma, sarcoma
Breast, stomach, colon, prostate, kidney, lung

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16
Q

What are features of retroperitoneal fibrosis that suggest malignancy?

A

Lobulated contour, ill defined borders, displacement of great vessels away from spine

17
Q

Enhancement of the retroperitoneal plaque suggests what?

A

Malignancy

18
Q

What distinguishes malignant RPF on MRI?

A

bright on T2

19
Q

What are the size criteria for enlarged LN in the

retrocrural
retroperitoneum
pelvis

A

> 6mm
10mm
13mm

20
Q

Which LN chain do the following drain to

pelvic organs
testes and ovaries
retroperitoneal

A

internal/external iliac chains to the common iliac chains

ipsilateral retroperitoneal nodes in region of great vessels

regional nodes along aorta and IVC

21
Q

What are the differences in lymph node appearance in NHL and HL

A

NHL - significantly enlarged nodes or conglomerate masses

HL - discrete enlargement of individual nodes

22
Q

Left paraaortic mass inferior to left renal vein raises suspicion of what

A

Metastatic testicular cancer

23
Q

Name 3 common benign and malignant retroperitoneal tumors

A

Benign - lipoma, nerve sheath tumor, lymphangioma

Malignant - liposarcoma, leiomyosarcoma, MFH

24
Q

Most common malignant tumor in retroperitoneum?

A

lymphoma

25
Q

How does a neurilemoma look in CT? neurofibroma?

A

well defined oval mass with low density and areas of cystic degeneration and calcification

well defined ovoid masses with attn 20-25 with homogenous enhancement

26
Q

Multiple symmetric low density masses along the courses of the peripheral nerves is classic for what disease

A

neurofibromatosis 1

27
Q

Most common malignant retroperitoneal tumor? usual age group? if over 50?

A

Liposarcoma > leiomyosarcoma > MFH

30-50yo

MFH if over 50

28
Q

Calcification is suggestive of what two malignant tumors? central necrosis? elongated appearance and spinal erosion?

A

MFH and mature teratoma

leiomyosarcoma

neural sheath tumors

29
Q

Difference between lipoma and liposarcoma?

A

Liposarcoma has soft tissue component

30
Q

Most common type of retroperitoneal liposarcoma?

A

Myxoid - large amounts of connective tissue and little lipid

can mimic abscess or muscle

Uroradiology (11 decks)

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