Learning objectives
The purpose of our educational exhibit is to help radiologists :
Recognize common and rare presentation of bilateral renal lesions.
Seek association with extra-renal features.
Narrow the differential diagnosis to reduce time to final diagnosis.
Background
Bilateral renal lesions are common findings.
The radiologists should be able to recognize some typical common and rare patterns.
We selected cases with bilateral renal lesions issued from large tertiary referral centers demonstrating an educational interest.
For each case we provideclinical setting,
radiological description and tips.
We propose a classification of these case as follows :
Tumoral:
Nephroblastoma
Leukemia
Lymphoma
Chromophobe RCC
Oncocytomatosis
Hereditary papillary
Renal Cell Carcinoma (RCC)
Clear RCC
Transitional cell carcinoma
Metastases
Angiomyolipoma (Bourneville Tuberous Sclerosis)
Adult Polycystic Kidney Disease
Toxic /...
Findings and procedure details
BILATERAL RENAL LESIONS : TUMORAL
1.
Nephroblastoma :
Male infant (6 y.o.) -Exploration of abdominal pain and parental palpation of an abdominal mass.
US shows bilateral renal masses,
slightly more echogenic than renal parenchyma.
MRI confirms bilateral renal tumors,
with the typical characteristics of nephroblastoma (hyperT2,
hypoT1,
heterogeneous enhancement).
Final diagnosis is bilateral nephroblastomas without metastasis,
probably part of a undefined syndrome (still currently being analyzed).
Tips :
Neuroblastoma (or Wilms tumor) is the most common pediatric renal mass,
typically occurring in early childhood (1-11...
Conclusion
Bilateral renal lesions are common findings and radiologists should know specific associations to narrow the differential diagnosis.
References
Pediatric Renal Masses,
Lowe L and al.,
Radiographics 2000
Renal Lymphoma : CT patterns with Emphasis on Helical CT,
Bruce A and al.,
Radiographics 2000
MRI Features of Renal Oncocytoma and Chromophobe Renal Cell Carcinoma,
Rosenkrantz A and al.,
AJR 2010
Differentiation of Subtypes of Renal Cell Carcinoma on Helical CT Scans,
Jeong KK and al.,
AJR 2002
Pyelonephritis : radiologic-pathologic review,
Craig W and al.,
Radiographics 2008
Urothelial Cancer of the Renal Pelvicaliceal System : Unusual Imaging Manifestations,
Prando A and al.,
Radiographics 2010...