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56 Cards in this Set
- Front
- Back
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Renal mass lesions
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* Tumor– solid, cystic
* Infection– lobar nephronia, abscess, XGP * Congenital – dupl collecting system * Pseudotumors – fetal lobul, dromedary hump, clmn of Bertin * Trauma - hematoma |
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Solid renal neoplasm
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RCC
oncocytoma adenoma AML TCC mets (lung, colon, melanoma, RCC) lymphoma Wilms mesoblastic nephroma nephroblastomatosis MFH |
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Cystic renal masses
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Top choices-
cystic RCC, multilocular cystic nephroma, abscess, focal XGP ---------------------------- - tumor – RCC, mult cystic nephroma, Wilms, mets - true cysts – cortical c, medullary cystic disease, ADPKD, VHL, TS, ESRF, hemorrhagic or infected cyst - other – hydronephrosis/dupl system, renal art aneurysm, abscess |
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Hyperechoic renal mass
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AML
RCC milk of calcium cyst nephritis (XGP, emphysem pyelo, focal nephritis, Candida) hematoma infarction mimics (sinus fat, dupl collecting system) |
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Renal sinus mass
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TCC
RCC lymphoma papilloma ren artery aneurysm, sinus hemorrhage complicated parapelvic cyst |
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Wedge-shaped renal lesion
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renal mets
infarction lobar nephritis |
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Infiltrative changes of kidney
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TCC
mets, lymphoma infarction pyelonephritis XGP |
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Diffusely hyperechoic kidneys
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* AIDS nephropathy
* Glomerulonephritis * Goodpasture's * SLE * DM |
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Renal calcifications
DDx |
tumors – cysts, RCC
infection – TB metastatic Ca++ – med n-calcinosis, cortical n-calcinosis collecting system – calculi |
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Fat in kidney
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AML
lipoma replacement lipomatosis |
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Filling defect in collecting system
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* Tumor – TCC, papilloma, leukoplakia, malakoplakia
* Mobile – bld clot, sloughed papilla, stone, fungus * Other – vascular impression, bowel gas |
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Papillary necrosis
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POSTCARD
pyelonephritis obstruction sickle cell TB cirrhosis analgesics RVT DM |
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Delayed (persistent) nephrogram
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Generally:
Symmetr bilateral =medical dz Asymm/unilateral =surgical PRERENAL – RAS, hypotension RENAL– acute GN, ATN, acute cort necrosis (preg, sepsis), tubular precip (uric acid, hemolysis, myeloma), acute interstitial nephritis (antibiotics), papillary necrosis, RVT POSTRENAL– obstruction (stone, stricture) |
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Striated nephrogram
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acute pyelonephritis
renal contusion RVT ureteral obstruction medullary sponge kidney |
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Large kidney with spindled calices
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lymphoma, leukemia
pyelonephritis acute RA occlusion acute RVT acute obstruction |
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Normal size kidney with spindled calices
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multiple cysts (parapelvic or peripelvic)
renal sinus lipomatosis |
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Kidney demonstrates hypodense rim on CT
DDx |
acute cortical necrosis
perinephric lymphoma |
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Subcapsular rim sign in the kidney
DDx |
infarct
ATN RVT |
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Extracalyceal contrast
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striations – medullary sponge, early papill necrosis, backflow in obstruction, interstitial edema
focal collections – late papill necrosis, calyceal diverticulum, cyst rupture, abscess |
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Dilated calyces/collecting system
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obstruction
papillary necrosis congenital megacalyces calyceal diverticulum reflux |
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Bilaterally enlarged kidneys
DDx |
ADPKD
lymphoma glomerulonephritis HIV amyloid bilateral RVT |
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Bilaterally small kidneys
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chronic inflammation
bilateral RAS chronic reflux ESRD |
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Unilateral renal atrophy (smooth)
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chronic ischemia (RAS, RVT)
postobstructive atrophy renal hypoplasia chronic subcapsular hematoma radiation |
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Unilateral renal atrophy (irregular)
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reflux nephropathy
analgesic nephropathy DM |
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Renal TB features
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parenchymal calcs
putty kidney pap necrosis tuberculoma scarring infundibular stenosis, amputated calyx corkscrew ureter purse-string stenosis pelvis pipestem ureter calculi small thick-walled bladder urethral fistulas (watering can perineum) |
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Hypercalcemia
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parathyroid adenoma or hyperplasia, Addison disease, milk alkali, sarcoid, carcinomatosis, HPT, myeloma, immobilization, vitD, thiazides
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Cortical nephrocalcinosis
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chronic glomerulonephritis
cortical necrosis (preg, shock, toxins) AIDS nephropathy Alport’s oxalosis chronic transplant rejection |
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Medullary nephrocalcinosis
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HPT
RTA medullary sponge kidney papillary necrosis Lasix therapy in kids |
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Renal vein thrombosis
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*Tumor - RCC, Wilm’s, lymphoma, TCC, adrenal, gonadal, pancreatic CA
* Renal dz– membr glomer...itis, SLE, amyloid * Other – hypercoag state, ext of ovarian vein or IVC thrombosis, trauma, surgery, transplant complication, dehydration in kids |
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Dilated ureter
criteria - >8mm, visible entire length, no peristalsis |
obstruction – 1ary megaureter (functional), stricture, stone, BOO, urethral stricture
reflux diuresis |
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Ureteral stricture
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* Tumor – TCC, mets, LAD
* Inflamm – TB (corkscrew), Schisto, Crohn’s, PID * Congenital – ectopic ureterocele, 1ary megaureter, congenital stenosis * Metab/drugs – amyloid, morphine, methysergide (retroper fibrosis) * Trauma – iatrogenic, RTX * Vascular – aneurysm, ovar vein syn, lymphocele, Xing vessel |
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Multiple ureteral filling defects
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* wall – ureteritis cystica (usu upper), vascular impressions, papillomas, melanoma mets, submucosal bleed, fibroepithelial polyp (single)
* luminal (acute angles) – stones, clot, sl papillae, fungus ball, air, TCC |
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Ureteral diverticula
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congenital, pseudodiverticulosis, TB (also strictures)
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Deviated ureters
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lateral – bulky RP adenopathy, primary RP tumors, RP fluid collection, aneurysm, malrotated kidney, ovarian or uterine mass; medial – posterior bladder diverticulum (#1 cause of distal medial deviation), fibroids, RP fibrosis, postoperative, enlarged prostate, retrocaval ureter (only on R side)
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Bladder wall thickening
criteria - >5mm, trabeculations |
*Tumor – TCC, lymphoma
*Inflamm – RTX, cytoxan, infection, IBD, appy, tic-itis *BOO – BPH, PUV, ectopic ureterocele, urethral stricture *Neurogenic |
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Bladder filling defect
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* Tumor – TCC, SCC, mets, leiomyoma, endometriosis, polyps
* Infection – PID, Schisto, fungus ball, leukoplakia, malacoplakia, cystitis cystica, cystitis glandularis luminal – stones, blood clot, BPH, foreign body, ureterocele * Adjacent inflammation e.g. appy or tics * rare – amyloid |
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Bladder neoplasm
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TCC, SCC
adenoCA, leiomyoma, pheo, mets (melanoma, prostate) lymphoma urachal adenoCA (dome) |
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risk factors for TCC of bladder
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smoking
cytoxan radiation interstitial nephritis aniline dyes phenacetin |
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risk factors for SCC of bladder
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Schistosomiasis
calculi chronic infection leukoplakia |
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risk factors for adenoCA of bladder
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bladder exstrophy
urachal remnant cystitis glandularis |
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Bladder wall calcification
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SCRITT –
Schistosomiasis Cytoxan Radiation Interstitial cystitis TB TCC |
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Air in bladder
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* instrumentation, catheter
* fistula (diverticulitis, Crohn’s, colon CA) * emphysematous cystitis (DM) |
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Teardrop bladder
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normal variant
iliopsoas hypertrophy hematoma/ abscess lymphoma pelvic lipomatosis RP fibrosis IVC obstruction |
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Bladder fistulas
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diverticulitis
Crohn’s CA surgery radiation |
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Bladder diverticula
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congenital (Hutch, urachal)
acquired (BOO) |
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Bladder rupture
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trauma
radiation tumor cystitis neurogenic bladder |
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“Female prostate”
central filling defect at base of bladder |
urethral diverticulum
urethral tumor periurethritis pubic bone lesion |
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Urethral stricture
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GC
trauma iatrogenic |
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Adrenal mass DDx
-what kinds of tumors? -what if it has fat in it? -what if it's bilateral |
*Tumor - adenoma, mets (esp small cell), pheo, lymphoma, neuroblast, carcinoma, hemangioma
*Fatty – adenoma, myelolipoma, lipoma *Other – bleed, TB, Wolman’s dz *Bilateral – bleed, mets, lymphoma, bilat pheo (MEN2, VHL, NF), TB, histo, hyperplasia |
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Adrenal calcifications
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* tumor – neuroblastoma, pheo, carcinoma, myelolipoma, hemangioma
* infection – TB, histo, meningococcemia * trauma – bleed * congenital – Wolman’s, Addison’s * cyst |
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Adrenal pseudotumors
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gastric fundus
varices tortuous splenic artery pancreatic tail medial splenic lobulation |
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Large retroperitoneal mass
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* hematoma or abscess
* LAD from lymphoma or mets * liposarcoma * leiomyosarcoma * MFH * neurogenic tumor * germ cell tumor |
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Retroperitoneal hematoma
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anticoagulation
trauma or iatrogenic ruptured AAA RCC AML |
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Retroperitoneal air
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trauma (perforation)
ERCP emphysematous pyelonephritis |
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Retroperitoneal abscess
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pancreatitis
renal inflammatory disease osteomyelitis |
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Retroperitoneal fibrosis
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* idiopathic
* methysergide * radiation, surgery * lymphoma, mets * retroperitoneal fluid * inflammation from other organs |
