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영상 의학과3
영상 의학과3
C/C:
Incidentally found renal mass
Assessment
Probably, renal cell carcinoma
DDx
Oncocytoma
Metastasis from an extra-renal primary neoplasm
Renal lymphoma
Renal parenchymal sarcoma
Transitional cell cancers of the renal pelvis
(more centrally located, involvement of the
collecting system)
Angiomyolipomas
(fat density usually visible by CT)
R EV IEW O F D ISEA SE
Essentials of Diagnosis
Gross or microscopic hematuria
Flank pain or mass in some patients
Systemic symptoms
such as fever, weight loss may be prominent
Solid renal mass on imaging
Diagnostic Procedures
CT scanning
for character of the mass, stages the lesion
Chest radiographs
for pulmonary metastases
Bone scans
for large tumors, bone pain, elevated alkaline phosphatase levels
Radiologic characters
On ultrasound
nonspecific renal mass
these lesions may be hyperechoic, isoechoic
central necrosis mimicking the central scar of oncocytomas
By CT
rounded, soft-tissue masses
enhancing after the administration of intravenous contrast ag
ent
often homogeneous on small lesion
heterogeneous frequently with necrosis and often with calcifi
cations on large lesion
Reference
pollack, mcclennan: clinical urography 2nd volume 2, p.14131641
Judson R. Gash & D. Matthew Bowen: Basic Radiology, Part
4. Abdomen, Chapter 9. Radiology of the Urinary Tract
: , p.323
Maxine A. Papadakis and Stephen J. McPhee: 2007 Current
Consult: Medicine
Hope S. Rugo, MD: Current Medical Dx & Tx, Oncology
Thank you ~