Presentation
Patient with renal impairment and multiple renal cysts. Attends for ultrasound review.
Patient Data
Age: 50 years
Gender: Male
From the case:
Bosniak renal cyst - type IV
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Transverse

Multiple cysts in the left kidney, one of which contains a significant solid component.
Associated 1.3 cm adrenal nodule.
From the case:
Bosniak renal cyst - type IV
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Axial non-contrast

Multiphase CT performed.
From the case:
Bosniak renal cyst - type IV
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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.