Sandbox: DDx Kidney mass: Difference between revisions

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* 3-4 yo patients
* Asymptomatic abdominal mass
* May have abdominal pain, fever, nausea/vomiting, hematuria, and hypertension
* Beckwith-Wiedemann syndrome and WAGR syndrome


* Unilateral, smooth, firm, nontender, flank mass
* Fever, chills, night sweats, and abdominal pain
* Does not cross the midline
* Hematuria, pallor, and weight loss




* Elevated serum creatinine and BUN
* Costovertebral tenderness
* Reduced glomerular filtration rate
* Abnormal liver function tests
* Erythrocytosis, hypercalcemia, and acquired Von Willebrand disease




* Elevated WBC count
* Elevated ESR and CRP


* Large heterogeneous solid mass on U/S
* Well defined hypoechoic area within the corticomedullary parenchyma on U/S
* Displace adjacent structures
* Well defined mass of low attenuation with a thick, irregular wall or pseudocapsule on CT
* Lung and lymph nodes metastasis
* Renal vein thrombosis
 
 
* Triphasic pattern consisting of tubules, solid sheets of small round cells, and stroma
* Small round blue cells, nuclear pleomorphism, and irregular nuclear membrane
* Clustered tubular structures Tubular with central clear spaces surrounded by a rim of intensely eosinophilic cytoplasm.
 
* WT1 and WT2 genes on chromosome 11
* WTX gene on chromosome X
 
 


* Not applicable


Angiosarcoma






==Nonmalignant causes==
==Nonmalignant causes==
anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying tumor renal cell carcinoma rhabdoid tumor translocation carcinoma (children) Wilms tumor of children
anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying

Latest revision as of 20:52, 9 November 2015

  • Fever, chills, night sweats, and abdominal pain
  • Hematuria, pallor, and weight loss


  • Costovertebral tenderness


  • Elevated WBC count
  • Elevated ESR and CRP
  • Well defined hypoechoic area within the corticomedullary parenchyma on U/S
  • Well defined mass of low attenuation with a thick, irregular wall or pseudocapsule on CT
  • Not applicable

Angiosarcoma


Nonmalignant causes

anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying

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