Case of the Month: April, 2011 Page 3

Answer: D: Cystic renal mass:The collecting system is visualized with contrast and is not dilated. The labs and symptoms do not suggest infection. Infarction and lymphoma typically give a striated hypodensities like appearance and not lobulated and cystic.

An ultrasound was also ordered for further characterization. Note the large cyst in the superior pole of the right kidney and relative normal appearance of the left kidney.

(Click here for larger image.)


(Click here for larger image.)


Given the relative normal functioning of the abnormal kidney no immediate surgical intervention was planned and the patient was followed up with a CT scan in 6 weeks. See the images below.

(Click here for larger image.)


CT scan with contrast demonstrated enlarging cysts in the right kidney compared to prior study. A radical right nephrectomy was then performed. See the gross and microscopic pathologic images.



(Click here for larger image.)


(Click here for larger image.)


Questions: Given the clinical and radiologic information obtained to this point and the following differential for a cystic renal mass, what do you think is the final pathologic diagnosis?
A: mesoblastic nephroma
B: Wilm’s Tumor
C: multicystic dysplastic kidney
D: autosomal dominant polycystic kidney disease
E: autosomal recessive polycystic kidney disease
F: cystic renal cell carcinoma
G: medullary cystic disease
H: multilocular cystic nephroma

< Previous PageView our Case of the Month ArchivesNext Page >


Android app on Google Play