|[[Renal]] [[ultrasound]] in renal oncocytoma [[patients]] may show:
*It is the best initial diagnostic study used in cases suspected with [[Wilms tumor]].
* Solid [[mass]] ( help to distinguish solid from [[cystic]] mass)
*[[Ultrasonography]] can help identify the mass as a kidney mass.
* [[Central]] [[scarring]]
*It can distinguish [[tumor]] mass from other causes of renal swelling like [[hydronephrosis]].<ref name="pmid61529362">{{cite journal |vauthors=Hartman DS, Sanders RC |title=Wilms' tumor versus neuroblastoma: usefulness of ultrasound in differentiation |journal=J Ultrasound Med |volume=1 |issue=3 |pages=117–22 |date=April 1982 |pmid=6152936 |doi= |url=}}</ref>
* [[Calcification]]
*[[Doppler ultrasonography]] can help to detect invasion of [[renal vein]] and [[Inferior vena cava|IVC]] by the tumor.<ref name="pmid30036602">{{cite journal |vauthors=De Campo JF |title=Ultrasound of Wilms' tumor |journal=Pediatr Radiol |volume=16 |issue=1 |pages=21–4 |date=1986 |pmid=3003660 |doi= |url=}}</ref>
* [[Central]] [[necrosis]]
|
* '''note:''' None of these characteristics are indicating for a specific [[renal]] [[lesion]].
*Findings on [[CT scan]] which can be suggestive of [[Wilms tumor]] include:<ref name="pmid4080660">{{cite journal |vauthors=Cahan LD |title=Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease |journal=Pediatr Neurosci |volume=12 |issue=1 |pages=58–62 |date=1985 |pmid=4080660 |doi= |url=}}</ref>
|[[Abdominal]] [[Computed tomography|CT scan]] may be helpful in the [[diagnosis]] of renal oncocytoma. Findings on [[Computed tomography|CT scan]] suggestive of renal oncocytoma include:
**Heterogeneous soft-tissue density masses
* [[Solid]] [[renal]] [[lesion]]
**These masses have frequent areas of [[calcification]] (~10%) and fat-density regions
* [[Central]] [[scar]] (stellate [[scar]])
**[[Lymph node]] metastasis
* Hypervascularity
*[[CT scan]] of the renal mass can further reveal:
* Hypodenseity ( most of the time)
**Invasion of surrounding organs
* [[Homogenous]] enhancements
**[[Thrombus]] in or occlusion of the [[renal vein]] and/or the [[inferior vena cava]]
**Abdominal lymph nodes and contralateral involvement
Ultrasound (US) may be helpful when CT scan results are equivocal. It is noteworthy to mention that not all renal cell carcinomas are detectable on ultrasound.
Both CT and MRI may be used to detect neoplastic masses that may define renal cell carcinoma or metastasis of the primary cancer. CT scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with renal cell carcinoma.
CT scan may be diagnostic of malignant rhabdoid tumor. Findings on CT scan suggestive of malignant rhabdoid tumor include a large, heterogenous, centrally located mass, which is lobulated with individual lobules separated by intervening areas of decreased attenuation, relating to either previous hemorrhage or necrosis. Enhancement is similarly heterogeneous. Calcification is relatively common, observed in 20-50% of cases and is typically linear and tends to outline tumor lobules.
Malignant rhabdoid tumor is characterized by the round blue tumor cells of high cellularity composed of atypical cells with eccentric nuclei, small nucleoli, and abundant amounts of eosinophilic cytoplasm with frequent mitotic figures.
Ultrasound may be helpful in the diagnosis of polycystic kidney disease. Findings on an ultrasound diagnostic of polycystic kidney disease include:[5][6]
At least three unilateral or bilateral cysts in patients 15 - 39 years old
Atleast two cysts in each kidney in patients 40 - 59 years old
Atleast four cysts in each kidney in patients 60 years of age or older
Renal CT scan may be helpful in the diagnosis of polycystic kidney disease. Findings on CT scan diagnostic of ADPKD include:
On microscopic histopathological analysis, interstitial fibrosis, tubular atrophy, thickening and lamellation of tubular basement membranes, microcysts and negative immunofluorescence for complement and immunoglobulin are characteristic findings of ADPKD.[7][8][9][10]
On microscopic pathology, Pheochromocytoma typically demonstrates a nesting (Zellballen) pattern on microscopy. This pattern is composed of well-defined clusters of tumor cells containing eosinophilic cytoplasm separated by fibrovascular stroma.
Chest, abdomen, and pelvis CT scan may be helpful in the diagnosis of Burkitt's lymphoma but it is not done routinely.[15]
On microscopic histopathological analysis, characteristic findings of Burkitt's lymphoma include:[16]
Medium-sized (~1.5-2x the size of a RBC) with uniform size ("monotonous") -- key feature (i.e. tumor nuclei size similar to that of histiocytes or endothelial cells)
Edematous intussuscipien forms an external ring around the centrally located intussusceptum
Target sign is usually seen in right lower quadrant
Layers of intussusception forms pseudo-kidney appearance on the transverse view
CT scan may be helpful in the diagnosis of intussusception. CT scan maybe used when other image modalities like x-ray and ultrasound have not given positive results but suspicion of intussusception is high.
Intussusception occurs if there is an imbalance between the longitudinal and radial smooth muscle forces of intestine that maintain its normal structure. This imbalance leads to a segment of intestine to invaginate into another segment and cause entero-enteral intussusception. Etiology of intussusception is either idiopathic or pathologic (lead point).
In the case of renal colic (one sided loin pain usually accompanied by a trace of blood in the urine) the initial investigation is usually an intravenous urogram. This has the advantage of showing whether there is any obstruction of flow of urine causing hydronephrosis as well as demonstrating the function of the other kidney. Many stones are not visible on plain x ray or IVU but 99% of stones are visible on CT and therefore CT is becoming a common choice of initial investigation.
The kidney undergoes extensive dilation with atrophy and thinning of the renal cortex.
MCDK is usually diagnosed by ultrasound examination before birth.
Mass of non-communicating cysts of variable size.
Unlike severe hydronephrosis, in which the largest cystic structure (the renal pelvis) lies in a central location and is surrounded by dilated calices, in multicystic dysplastic kidney the cyst distribution shows no recognizable pattern.
Dysplastic, echogenic parenchyma may be visible between the cysts, but no normal renal parenchyma is seen.
On microscopic histopathological analysis the presence of round blue cells separated by thin fibrous septa are characteristic findings of neuroblastoma.
↑ 1.01.11.2Jolly RD, Stellwagen E, Babul J, Vodkaĭlo LV, Titov VL, Moldomusaev DM, Maianskiĭ AN (November 1975). "Mannosidosis of Angus Cattle: a prototype control program for some genetic diseases". Adv Vet Sci Comp Med. 19 (23): 1–21. PMID1978.
↑ 2.02.1Hartman DS, Sanders RC (April 1982). "Wilms' tumor versus neuroblastoma: usefulness of ultrasound in differentiation". J Ultrasound Med. 1 (3): 117–22. PMID6152936.
↑ 3.03.1De Campo JF (1986). "Ultrasound of Wilms' tumor". Pediatr Radiol. 16 (1): 21–4. PMID3003660.
↑ 4.04.1Cahan LD (1985). "Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease". Pediatr Neurosci. 12 (1): 58–62. PMID4080660.
↑Stavrou C, Koptides M, Tombazos C, Psara E, Patsias C, Zouvani I, Kyriacou K, Hildebrandt F, Christofides T, Pierides A, Deltas CC (October 2002). "Autosomal-dominant medullary cystic kidney disease type 1: clinical and molecular findings in six large Cypriot families". Kidney Int. 62 (4): 1385–94. doi:10.1111/j.1523-1755.2002.kid581.x. PMID12234310.
