30 Solid Renal Masses

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GU 30-1 Renal cell carcinoma. Echo-filled solid mass (arrows) with no posterior enhancement.

• Fig GU 30-2 Renal cell carcinoma. Solid hypoechoic mass (arrow) in the inferior half of the kidney (KID) that disrupts the collecting system and distorts the renal outline.27

• Fig GU 30-3 Renal cell carcinoma with venous extension. (A) Transverse sonogram reveals a thrombus in the inferior vena cava (IVC) and metastatic deposits (arrowheads) in the liver (L). (B) Sagittal scan identifies the distended IVC containing thrombus (large arrow) that extends into the right atrium (arrowhead).27

• Fig GU 30-4 Angiomyolipoma. Sonography of the right kidney in an asymptomatic woman demonstrates a highly echogenic mass (arrow).28

• Fig GU 30-5 Renal cell carcinoma mimicking angiomyolipoma. Ultrasound shows a small echogenic mass.28

• Fig GU 30-6 Adenoma. Highly echogenic mass (arrow) in the upper pole of the kidney.27

• Fig GU 30-7 Wilms' tumor. Parasagittal supine sonogram demonstrates a huge mass (W) involving the lower pole of the right kidney and resulting in hydronephrosis of the upper collecting system (Hy). Wilms' tumors tend to have a moderately low internal echogenicity and, as in this patient, often contain multiple tiny cystic spaces. The large mass dramatically displaces the liver (L). (D, diaphragm; H, head.)2

• Fig GU 30-8 Metastases. Infiltration of the upper pole of the kidney (arrow) by metastatic spindle cell carcinoma.27

• Fig GU 30-9 Leukemia. Multiple echogenic deposits representing infiltration (arrowheads).29

• Fig GU 30-10 Lymphoma. Transverse sonogram demonstrates a hypoechoic mass (arrow) in the kidney.27