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56 Cards in this Set

  • Front
  • Back
Renal mass lesions
* Tumor– solid, cystic
* Infection– lobar nephronia, abscess, XGP
* Congenital – dupl collecting system
* Pseudotumors – fetal lobul, dromedary hump, clmn of Bertin
* Trauma - hematoma
Solid renal neoplasm
RCC
oncocytoma
adenoma
AML
TCC
mets (lung, colon, melanoma, RCC)
lymphoma
Wilms
mesoblastic nephroma
nephroblastomatosis
MFH
Cystic renal masses
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
Hyperechoic renal mass
AML
RCC
milk of calcium cyst
nephritis (XGP, emphysem pyelo, focal nephritis, Candida)
hematoma
infarction
mimics (sinus fat, dupl collecting system)
Renal sinus mass
TCC
RCC
lymphoma
papilloma
ren artery aneurysm, sinus hemorrhage
complicated parapelvic cyst
Wedge-shaped renal lesion
renal mets
infarction
lobar nephritis
Infiltrative changes of kidney
TCC
mets, lymphoma
infarction
pyelonephritis
XGP
Diffusely hyperechoic kidneys
* AIDS nephropathy
* Glomerulonephritis
* Goodpasture's
* SLE
* DM
Renal calcifications

DDx
tumors – cysts, RCC
infection – TB
metastatic Ca++ – med n-calcinosis, cortical n-calcinosis
collecting system – calculi
Fat in kidney
AML
lipoma
replacement lipomatosis
Filling defect in collecting system
* Tumor – TCC, papilloma, leukoplakia, malakoplakia
* Mobile – bld clot, sloughed papilla, stone, fungus
* Other – vascular impression, bowel gas
Papillary necrosis
POSTCARD
pyelonephritis
obstruction
sickle cell
TB
cirrhosis
analgesics
RVT
DM
Delayed (persistent) nephrogram
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)
Striated nephrogram
acute pyelonephritis
renal contusion
RVT
ureteral obstruction
medullary sponge kidney
Large kidney with spindled calices
lymphoma, leukemia
pyelonephritis
acute RA occlusion
acute RVT
acute obstruction
Normal size kidney with spindled calices
multiple cysts (parapelvic or peripelvic)
renal sinus lipomatosis
Kidney demonstrates hypodense rim on CT

DDx
acute cortical necrosis
perinephric lymphoma
Subcapsular rim sign in the kidney

DDx
infarct
ATN
RVT
Extracalyceal contrast
striations – medullary sponge, early papill necrosis, backflow in obstruction, interstitial edema

focal collections – late papill necrosis, calyceal diverticulum, cyst rupture, abscess
Dilated calyces/collecting system
obstruction
papillary necrosis
congenital megacalyces
calyceal diverticulum
reflux
Bilaterally enlarged kidneys

DDx
ADPKD
lymphoma
glomerulonephritis
HIV
amyloid
bilateral RVT
Bilaterally small kidneys
chronic inflammation
bilateral RAS
chronic reflux
ESRD
Unilateral renal atrophy (smooth)
chronic ischemia (RAS, RVT)
postobstructive atrophy
renal hypoplasia
chronic subcapsular hematoma
radiation
Unilateral renal atrophy (irregular)
reflux nephropathy
analgesic nephropathy
DM
Renal TB features
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)
Hypercalcemia
parathyroid adenoma or hyperplasia, Addison disease, milk alkali, sarcoid, carcinomatosis, HPT, myeloma, immobilization, vitD, thiazides
Cortical nephrocalcinosis
chronic glomerulonephritis
cortical necrosis (preg, shock, toxins)
AIDS nephropathy
Alport’s
oxalosis
chronic transplant rejection
Medullary nephrocalcinosis
HPT
RTA
medullary sponge kidney
papillary necrosis
Lasix therapy in kids
Renal vein thrombosis
*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
Dilated ureter

criteria - >8mm, visible entire length, no peristalsis
obstruction – 1ary megaureter (functional), stricture, stone, BOO, urethral stricture
reflux
diuresis
Ureteral stricture
* 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
Multiple ureteral filling defects
* 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
Ureteral diverticula
congenital, pseudodiverticulosis, TB (also strictures)
Deviated ureters
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)
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
Bladder filling defect
* 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
Bladder neoplasm
TCC, SCC
adenoCA, leiomyoma, pheo,
mets (melanoma, prostate)
lymphoma
urachal adenoCA (dome)
risk factors for TCC of bladder
smoking
cytoxan
radiation
interstitial nephritis
aniline dyes
phenacetin
risk factors for SCC of bladder
Schistosomiasis
calculi
chronic infection
leukoplakia
risk factors for adenoCA of bladder
bladder exstrophy
urachal remnant
cystitis glandularis
Bladder wall calcification
SCRITT –
Schistosomiasis
Cytoxan
Radiation
Interstitial cystitis
TB
TCC
Air in bladder
* instrumentation, catheter
* fistula (diverticulitis, Crohn’s, colon CA)
* emphysematous cystitis (DM)
Teardrop bladder
normal variant
iliopsoas hypertrophy
hematoma/ abscess
lymphoma
pelvic lipomatosis
RP fibrosis
IVC obstruction
Bladder fistulas
diverticulitis
Crohn’s
CA
surgery
radiation
Bladder diverticula
congenital (Hutch, urachal)

acquired (BOO)
Bladder rupture
trauma
radiation
tumor
cystitis
neurogenic bladder
“Female prostate”
central filling defect at base of bladder
urethral diverticulum
urethral tumor
periurethritis
pubic bone lesion
Urethral stricture
GC
trauma
iatrogenic
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
Adrenal calcifications
* tumor – neuroblastoma, pheo, carcinoma, myelolipoma, hemangioma
* infection – TB, histo, meningococcemia
* trauma – bleed
* congenital – Wolman’s, Addison’s
* cyst
Adrenal pseudotumors
gastric fundus
varices
tortuous splenic artery
pancreatic tail
medial splenic lobulation
Large retroperitoneal mass
* hematoma or abscess
* LAD from lymphoma or mets
* liposarcoma
* leiomyosarcoma
* MFH
* neurogenic tumor
* germ cell tumor
Retroperitoneal hematoma
anticoagulation
trauma or iatrogenic
ruptured AAA
RCC
AML
Retroperitoneal air
trauma (perforation)
ERCP
emphysematous pyelonephritis
Retroperitoneal abscess
pancreatitis
renal inflammatory disease
osteomyelitis
Retroperitoneal fibrosis
* idiopathic
* methysergide
* radiation, surgery
* lymphoma, mets
* retroperitoneal fluid
* inflammation from other organs