• 제목/요약/키워드: Renal Mass

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Morphological classification of Renal Disease Using $^{99m}Tc-DMSA$ Scintigram ($^{99m}Tc-DMSA$ 신티그램을 이용한 신질환 형태 분류)

  • Moon, Tae-Yong
    • The Korean Journal of Nuclear Medicine
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    • 제25권2호
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    • pp.237-244
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    • 1991
  • $^{99m}Tc-DMSA$ renal scan has been evaluated not only the renal functional cell mass but also some anatomical structures at a loss of the renal parenchymal function. The author classified a renal morphology of the posterior image of $^{99m}Tc-DMSA$ renal scan as the groups of symmetric and asymmetric morphology, the groups of the large, normal and small sized kidneys, the groups of the central photon defects (PD) which could be noted in a dilated pelvocalyceal system due to obstructive uropathy and the cortical photon defects (CD) due to focal parenchymal lesions or scars after a loss of function and the last groups of the single and multiple CD for a suggestion of the clinical usefulness. Regarding to measurement of normal renal size, the longest size of the kidneys were evaluated with 5 cm of a lead scale on the posterior renal image, and those were decided to the limits beteen 104.1 and 119.4 mm as comparison with the renal size of intravenous pyelogram (IVP) in 59 cases who were underwent $^{99m}Tc-DMSA$ and IVP concommitantly. Among 85 cases of PD in $^{99m}Tc-DMSA$ renal scan, the 61 (71.8%) were cases of a dilated pelvocalyceal system related with obstructive uropathy, meanwhile the 28 (27.0%) of 162 cases with CD were cases of obstructive and infectious uropathy. The probability of a presence of some uropathy in cases of CD were 99.3%, meanwhile that of the presence of CD in cases of some uropathy were 37.9%. Besides, there were some specific anatomical findings such as polycystic kidneys with symmetric enlarged kidneys with multiple CD and the kidneys of chronic renal failure and/or hypertension with symmetric small size in $^{99m}Tc-DMSA$ renal stan.

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Endobronchial Metastasis from Renal Cell Carcinoma -A case report- (신장세포암의 기관지내 전이 - 1예 보고 -)

  • Kim, Si-Wook;Shin, Yoon-Mi
    • Journal of Chest Surgery
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    • 제41권3호
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    • pp.386-389
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    • 2008
  • Lung parenchyma is a common organ for metastases of extrathoracic tumors, but endobronchial metastasis is very rare. In this report, we present a case of endobronchial metastases from renal cell carcinoma (RCC), and this was managed by performing operative resection. A 63-year-old man presented with frequent dry cough; he had previously undergone left nephrectomy and postoperative chemotherapy for grade 2 RCC eight years ago. Computed tomography and bronchoscopy showed an endobronchial tumor from the left lower lobe bronchus to the second carina, and this mass was diagnosed as a necrotic tissue with chronic inflammation at biopsy. During the operation, the mass was revealed to be a metastatic renal cell carcinoma on the frozen section diagnosis and there was no mucosal invasion on the resection margin of the left lower lobe bronchus. We performed lobectomy of the left lower lobe with systemic dissection of the mediastinal lymph nodes. The final histopathologic diagnosis of the endobrochial mass was metastatic RCC and any mediastinal lymph node metastasis was not found. The patient was discharged on postoperative day 10 without any postoperative complications.

Imaging Findings of Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusion in a 4-Year-Old Male: Case Report and Review of Literature (4세 남아에서 발견된 Xp11.2 염색체 재배열/TFE3 유전자 융합 연관 신세포 암의 영상 소견: 증례보고 및 문헌고찰)

  • Kim, Hyun Gi;Lee, Mi-Jung;Lee, Sarah;Kim, Myung-Joon;Hong, Chang Hee
    • Investigative Magnetic Resonance Imaging
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    • 제17권1호
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    • pp.41-46
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    • 2013
  • We represent a pathologically proven case of a four-year-old male patient with renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion, which is rare but more frequent in children or young adults. Computed tomography showed about 2.5 cm size ill-defined mass in the right kidney. The mass was hyperechoic on ultrasound. Magnetic resonance imaging demonstrated a mass with capsular enhancement and diffusion restriction. We present a case of Xp11.2 renal cell carcinoma and provide review of the literature.

A Case of Renal Cortical Necrosis in a 15-year-old Boy with Acute Kidney Injury

  • Lee, Mi-ji;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • 제23권1호
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    • pp.53-57
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    • 2019
  • Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.

Thin Glomerular Basement Membrane Disease with Herlyn-Werner-Wunderlich Syndrome : Uterus Didelphys, Blind Hemivagina and Ipsilateral Renal Agenesis (비박형 사구체 기저막 질환이 동반된 중복 자궁 일측성 폐쇄질 및 동측 신장 무형성 증후군 ( Herlyn - Werner- Wunderlich syndrome ) 1례)

  • Kim, Myoung-Soo;Park, Yong-Jun;Park, Young-Jun;Park, Noh-Hyuck;Song, Ji-Sun;Kim, Pyung-Kil
    • Childhood Kidney Diseases
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    • 제11권2호
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    • pp.299-305
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    • 2007
  • Herlyn-Werner-Wunderlich syndrome(HWWs) is a rare variant of Mullerian ductal anomalies characterized by the presence of a hemivaginal septum, a didelphic uterus, and ipsilateral renal agenesis. It usually presents after menarche with progressive pelvic pain, and palpable mass due to hemihematocolpos. If a cystic mass is detected behind the urinary bladder in children, in association with the absence of a kidney, the diagnosis of uterus didelphys with imperforate vagina and hydrocolpos should be considered. When renal agenesis is found in asymptomatic children, the small size and the tubular shape of the uterus makes it almost impossible to evaluate uterine anomalies, so follow-up should be performed until the end of puberty. Appropriate preoperative diagnosis and treatment will prevent unnecessary procedures and offer relief of symptoms. We report one case of didelphic uterus with blind hemivagina and ipsilateral renal agenesis with biopsy- proven thin glomerular basement membrane disease which is not related to the above syndrome.

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CT and US Findings of Multilocular Cystic Renal Cell Carcinoma

  • Jong Chul Kim;Kie Hwan Kim;Jun Woo Lee
    • Korean Journal of Radiology
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    • 제1권2호
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    • pp.104-109
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    • 2000
  • Objective: Multilocular cystic renal cell carcinoma (MCRCC) is a recently described variety of renal cell carcinoma with characteristic pathologic and clinical features. The purpose of this study was to analyze the imaging findings of MCRCCs. Materials and Methods: Ten adult patients with pathologically proven unilateral MCRCC who underwent renal US and CT were included in this study. The radiologic findings were retrospectively evaluated for cystic content, wall, septum, nodularity, calcification and solid portion by three radiologists who established a consensus. Imaging and postnephrectomy pathologic findings were compared. Results: All patients were adults (six males and four females) and their ages ranged from 33 to 68 years (mean, 46). On US and CT images, all tumors appeared as well-defined multilocular cystic masses composed of serous or complicated fluid. In all patients, unenhanced CT scans revealed hypodense cystic portions, and in four tumors, due to the presence of hemorrhage or gelatinous fluid, some hyperdense areas were also noted. In no tumor was an expansile solid nodule seen in the thin septa, and in only one was there dystrophic calcification in a septum. Small areas of solid portion constituting less than 10% of the entire lesion were found in six of the ten tumors, and these areas were slightly enhanced on enhanced CT scans. In all patients, imaging and pathologic findings correlated closely. Conclusion: On US and CT images, MCRCC appeared as a well-defined multilocular cystic mass with serous, proteinaceous or hemorrhagic fluid, with no expansile solid nodules in the thin septa, and sometimes with small slightly enhanced solid areas. Where radiologic examinations demonstrate a cystic renal mass of this kind in adult males, MCRCC should be included in the differential diagnosis.

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Renal Tubular Carcinoma in a Cocker Spaniel Dog (코커 스파니엘에서 신장세포암종)

  • Kye, Eun-Young;Yun, Sung-Ho;Jang, Hwan-Soo;Kwak, Dong-Mi;Ku, Sae-Kwang;Jang, Kwang-Ho;Kwon, Young-Sam
    • Journal of Veterinary Clinics
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    • 제28권4호
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    • pp.431-434
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    • 2011
  • A 7-year-old neutered male Cocker spaniel was referred to Veterinary Medical Teaching Hospital, Kyungpook National University with a left abdominal mass, anorexia and weight loss. Hematologic test and biochemical panel showed severe leukocytosis, mild anemia, mild hypoalbuminemia and a marked elevation in gamma glutamyl transferase (GGT). Radiography demonstrated a large mass on the left kidney and there was no evidence of pulmonary metastases. Histopathologic features of the mass were consistent with renal tubular carcinoma. The dog was treated with unilateral nephrectomy. During the follow-up, the dog died 6 months after surgery.

A Female Infant with Segmental Multicystic Dysplastic Kidney (분절형 다낭성 이형성신 영아 보고 1례)

  • Lee, Jun Ho;Kim, Moon Kyu
    • Childhood Kidney Diseases
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    • 제17권1호
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    • pp.25-28
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    • 2013
  • There have only been 35 pediatric cases and one adult case reported on segmental multicystic dysplastic kidney (MCDK) from our search in PubMed, including 19 cases detected antenatally. There is little documentation of segmental MCDK, particularly concerning its natural history. Segmental MCDK can be presented atypically, making diagnosis more difficult. We report an another case with segmental MCDK. Multicystic abdominal mass detected on antenatal sonogram in this infant was diagnosed as segmental MCDK by renal ultrasonography and computed tomography. If a definitive diagnosis of segmental MCDK can be made on imaging, surgery is not required for a diagnostic biopsy.

Renomedullary Interstitial Cell Tumor Mimicking Renal Cell Carcinoma: A Case Report (신세포암으로 오인한 신수질 간질세포 종양: 증례 보고)

  • Hyunji Oh;Sung Bin Park;Tae-Jin Lee;Byung Hoon Chi;Hyun Jeong Park;Eun Sun Lee
    • Journal of the Korean Society of Radiology
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    • 제83권6호
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    • pp.1412-1417
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    • 2022
  • Renomedullary interstitial cell tumors are often incidentally identified either upon autopsy or kidney resection for other reasons. However, rare renomedullary interstitial cell tumor cases resulting in a clinical symptomatic mass have been reported. We present a case of renomedullary interstitial cell tumor that was manifested as an incidentally detected renal mass and mimicked renal cell carcinoma on the imaging features.

Successful Transplantation of 3 Cases of Oligomeganephronia (신장이식 수술로 치험한 Oligomeganephronia 3례)

  • Bae Hyun-Chul;Kim Ji-Hong;Kim Pyung-Kil;Kim Yoo-Seon;Park Ki-Il;Jeong Hyun-Ju;Choi In-Jun
    • Childhood Kidney Diseases
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    • 제1권2호
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    • pp.189-194
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    • 1997
  • Oligomeganephronia is a rare congenital form of bilateral renal hypoplasia histologically characterized by reduction in number and hypertrophy of nephrons. Clinically, this condition is presented in early infancy with vomiting, polyuria, polydipsia and dehydration. The problems are readily corrected, but slowly progressive renal failure follows accompanied by failure to thrive, short stature, and renal osteodystrophy. We experienced three cases of oligomeganephronia. Case 1. : A 3 2/12 years old female child was incidentally diagnosed as renal failure at age of 2 months when she was hospitalized due to pneumonia. She had open renal biopsy and was diagnosed as bilateral dysplastic kidney. On OPD follow-up, she progressed to end-stage renal failure (BUN/Cr 114/4.6 mg/dl) and had renal transplantation. The specimen was shrunk remarkably and light microscopy showed oligomeganephronia. Case 2. : A 14 8/12 years old female child with proteinuria was detected in an annual urine screening program for school children, she was diagnosed as renal failure (BUN/Cr 33.9/4.1 mg/dl), and had $5{\times}4{\times}3\;cm$ sized mass on abdominal CT scan. She had renal biopsy, and the specimen showed oligomeganephronia. She had hemodialysis for six months, and renal transplantation along with bilateral nephrectomy was performed. Case 3. : A 14 8/12 years old male child was diagnosed having chronic nephritis and chronic renal failure at 3 years old, progressed to end-stage renal failure (BUN/Cr 87/9.6 mg/dl) on OPD follow-up, and had a rephrectomy and renal transplantation. The biopsy specimen showed oligomeganephronic hypoplasia, secondary focal segmental glomerolosclerosis, and chronic interstitial nephritis. We report 3 cases of oligomeganephronia that progressed to end-stage renal failure and had successful renal transplantation with a brief review of related literatures.

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