CT with and without contrast enhancement.
Bosniak III cyst.
Bosniak II cyst.
Bosniak IV cyst.
Renal cell carcinoma
They can harbor internal septa, calcifications, and internal debris and still be considered benign according to the Bosniak classification.
They rarely require treatment.
They are best characterized using the Bosniak criteria to assess risk of harboring a malignancy.
They are best imaged using ultrasound to allow classification using the Bosniak criteria.
They are the most common benign renal lesions found in the kidney.
They are usually of clear cell histology but can also be found with chromophobe and papillary cells as well.
Recent studies suggest that renal adenoma may be a premalignant precursor of papillary renal cell carcinoma (RCC).
They can be high grade or low grade, as long as they are less than 3 cm.
There is uniform agreement regarding the clinical and pathologic classification of renal adenoma.
They are most common in young females.
requires specific immunohistochemical staining.
is commonly made at autopsy.
can be confirmed by electron microscopy.
can be made primarily on the basis of histologic criteria.
can be rendered only if tumor size is less than 1.0 cm.
Renal exploration, partial nephrectomy with intraoperative frozen section analysis of histology (if malignant, a radical nephrectomy)
Renal exploration with biopsy and intraoperative frozen section analysis determining radical versus partial nephrectomy
A radical nephrectomy without adrenalectomy
A radical nephrectomy with adrenalectomy
laparoscopic exposure and renal cryoablation.
They are more common in men than in women.
They are readily differentiated from RCC on the basis of appropriate imaging studies.
They are characterized by bimodal age distribution.
They are complex cystic lesions that are typically classified as Bosniak II.
They are malignant 2% to 5% of the time.
benign clinical course.
characteristic appearance on MRI.
specific pattern on immunostain marker panel.
peak incidence in the fifth decade of life.
Hyperechoic pattern on ultrasonography
Enhancement of more than 30 Hounsfield units (HU) on CT
Aneurysmal changes on renal arteriogram
Positive signal on T2-weighted images of MRI
Small area of less than −20 HU on nonenhanced CT
Low to moderate grade
Tumor size less than 3 cm
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 6.0-cm complex cyst with four thin septa
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.
positive staining for vimentin.
a unique cytokeratin expression pattern.
multiple microsomes on electron microscopy.
positive staining for HMB-45.
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