19. RReennaall LLyymmpphhaannggiioommaattoossiiss
((BBiigg bbrrootthheerr ooff ppeerriippeellvviicc ccyyssttss))
Gorantla R, Yalapati A, Dev B, Joseph S. Case report: Perinephric lymphangiomatosis. Indian J Radiol Imaging
2010;20:224-
Ultrasound of renal sinus
Echogenic area (ie central echo complex)
fat
variable, esp with age
Anechoic/hypoechoic areas
vessels, collecting system
Should be able to distinguish subtle hydronephrosis (water density) from vessels
pitfall blood in collecting system.
2 cases of simple parapelvic (renal parenchymal renal sinus cysts)
Bilateral
Unilateral
Sometimes cannot be certain on US or CT and need delayed CT (or MRI)
Figures – 3 separate cases.
Two easily diagnosed cases of RAA
Bottom case illustrates a large RAA that may be misdiagnosed as a cystic mass if contrast was not administered.
2 cases of renal avm. Top is subtle on ct
Bottom is more prominent and could be varix
Top row – tcc filling defect
Middle row – tcc then tb
Lower row – tcc then tb
Early TCC
Two different cases of TCC, from emedicine article
TCC
Case of SCC with stone on noncontrast
Top left – rcc; top right collecting duct rcc
Bottom tcc
Top case benign leiomyoma in 28 yo women with hematuria
Bottom case malignant leiomyosarcoma in 68 yo woman with flank pain