Bosniak renal cyst - type IV

Case contributed by Dr Ian Bickle

Presentation

Patient with renal impairment and multiple renal cysts. Attends for ultrasound review.

Patient Data

Age: 50 years
Gender: Male
Ultrasound

Multiple cysts in the left kidney, one of which contains a significant solid component.

Associated 1.3 cm adrenal nodule.

Multiphase CT performed.

Diagram
Illustration of the Bosniak's classification

Case Discussion

This is a classic example of a Bosniak type IV cyst - with an abnormal cyst first identified on ultrasound proceeding to three phase CT imaging.

It is made more difficult by the bilateral cystic renal disease, but the left mid/upper pole cyst contained a significant solid element.

The patient is due for a total nephrectomy - the histopathological outcome will be added when available.

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