Schwartz's Principles of Surgery, 10e >Urology

F. Charles Brunicardi, Dana K. Andersen, Timothy R. Billiar, David L. Dunn, John G. Hunter, Jeffrey B. Matthews, Raphael E. Pollock+
Table 40-1.Bosniak renal cyst computed tomography classification

CATEGORY DESCRIPTION RISK OF MALIGNANCY/MANAGEMENT

Thin-walled cyst with water density with no septations or

I 0%/nonsurgical
calcifications.

Thin-walled cyst with few hairline septa that may contain fine or
II very limited thick calcifications. Also includes homogeneously 0%/nonsurgical
hyperdense cysts <3 cm.

Multiple hairline or slightly thickened septa without measurable

II F (follow) enhancement. May contain nodular calcification. Also includes 5%/should be followed for progression
hyperdense cysts >3 cm.

Irregular or smooth thickened walls or septa with measurable

III 50%/surgical
enhancement.

IV Same as III, but with enhancing solid components. 100%/surgical

Source: Adapted with permission from Israel GM, Bosniak MA. An update of the Bosniak renal cyst classification system. Urology. 2005;66:484. Copyright Elsevier.

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