CT with and without contrast enhancement.
Bosniak II cyst.
Bosniak III cyst.
Bosniak IV cyst.
Renal cell carcinoma
They are best characterized using the Bosniak criteria to assess risk of harboring a malignancy.
They are the most common benign renal lesions found in the kidney.
They can harbor internal septa, calcifications, and internal debris and still be considered benign according to the Bosniak classification.
They are best imaged using ultrasound to allow classification using the Bosniak criteria.
They rarely require treatment.
There is uniform agreement regarding the clinical and pathologic classification of renal adenoma.
Recent studies suggest that renal adenoma may be a premalignant precursor of papillary renal cell carcinoma (RCC).
They are usually of clear cell histology but can also be found with chromophobe and papillary cells as well.
They are most common in young females.
They can be high grade or low grade, as long as they are less than 3 cm.
can be confirmed by electron microscopy.
can be rendered only if tumor size is less than 1.0 cm.
can be made primarily on the basis of histologic criteria.
requires specific immunohistochemical staining.
is commonly made at autopsy.
A radical nephrectomy without adrenalectomy
Renal exploration with biopsy and intraoperative frozen section analysis determining radical versus partial nephrectomy
A radical nephrectomy with adrenalectomy
Renal exploration, partial nephrectomy with intraoperative frozen section analysis of histology (if malignant, a radical nephrectomy)
laparoscopic exposure and renal cryoablation.
They are readily differentiated from RCC on the basis of appropriate imaging studies.
They are characterized by bimodal age distribution.
They are malignant 2% to 5% of the time.
They are more common in men than in women.
They are complex cystic lesions that are typically classified as Bosniak II.
peak incidence in the fifth decade of life.
characteristic appearance on MRI.
benign clinical course.
specific pattern on immunostain marker panel.
Enhancement of more than 30 Hounsfield units (HU) on CT
Small area of less than −20 HU on nonenhanced CT
Hyperechoic pattern on ultrasonography
Aneurysmal changes on renal arteriogram
Positive signal on T2-weighted images of MRI
Low to moderate grade
Tumor size less than 3 cm
A 6.0-cm complex cyst with four thin septa
An 11-cm cyst with water density and a homogeneous nature
A 2.5-cm hyperechoic complex cyst, with no enhancement after intravenous administration of a contrast agent
A 3.0-cm tumor with fat associated with calcification
A 5.0-cm cyst with thin, curvilinear calcification
central, stellate scar on CT.
trisomy of chromosomes 7 and 17.
multiple mitochondria on electron microscopy.
a spoke-wheel pattern on renal angiography.
multiple microsomes on electron microscopy.
a unique cytokeratin expression pattern.
positive staining for vimentin.
positive staining for HMB-45.
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