Learning objectives
To review the most common and other less frequent lesions containing macroscopic fat in the perirrenal space.
To describe the different imaging techniques that will better identify and characterise those lesions.
Background
The perirenal space is a retroperitoneal space anteriorly delimited by the anterior renal or Gerota´s fascia and posteriorly by the posterior renal or Zuckerandl´s fascia (Fig.1).
The perirrenal space is the largest of three divisions of the retroperitoneum,
and is additionally divided into multiple compartments that contain the kidneys,
renal vessels and proximal collecting systems,
adrenal glands,
lymphatic and blood vessels and an adequate amount of fat.
The complexity of this space and the numerous structures we find in it,
make it susceptible to a...
Findings and procedure details
Herein we report a variety of fat containing lesions appearing in the perirenal space:
1. Renal angyomyolipoma and complicated angyomyolipoma with Wünderlich Syndrome:
Angyomyolipoma is the most frequent benign mesenchymal tumour of the kidney.
It is composed of fat,
smooth muscle and abnormal blood vessels.
It can be a sporadic lesion or occur as a part of tuberous sclerosis.
The vast majority will be sporadic and happen more frequently in middle-aged women.
On US angyomyolipomas appear as hyper-echogenic,
well-defined lesions in the renal cortex with...
Conclusion
A wide range of proliferative conditions can affect the perirenal space,
individually or as a part of a systemic process.
Therefore,
the understanding of the normal anatomical,
clinical and imaging features of this space is of vital importance in order to recognise and characterise the variations in normality and the various conditions,
both benign and malignant,
as well as those findings that are considered secondary to medical treatments that may occur in the complex and large perirenal space.
Radiologists play an important role in establishing...
References
1. Akram M.
Shaaban,
Maryam Rezyani,
Marc Tubay,
Khaled M.
Elsayes,
Paula J.
Woodward and Christine O.
Menias; Fat-containing Retroperitoneal Lesions: Imaging Characteristics,
Localization,
and Differential Diagnosis; Radiographics; volume 36,
Number 3; May 2016
2. Venkateswar R.
Surabhi,
Chritine Menias,
Srinivasa R.
Prasad,
Ankitkumar H.
Patel,
Arpit Nagar and Neal C.
Dalrymple; Neoplastic and Non-Neoplastic Proliferative Disorders of the Perirenal Space: Cross-sectional Imaging Findings; Radiographics; volume 28,
Number 4,
July 2008
3. Jose M.
Pereira,
Claude B.
Sirlin,
Pedro S.
Pinto,
Giovanna and Casola; CT...