Fibromuscular dysplasia - renal arterial involvement

Case contributed by Dr Nicoletti Domenico Nicoletti

Presentation

Elevation of lipases in smokers with hypertension. Incidental finding.

Patient Data

Age: 75 years
Gender: Female

Nodularity (string-of-beads sign) of the right and left renal artery (arrows). In delayed phase, axial images show some focal nodular areas of enhancement in proximal jejunum undetectable on arterial phase, referable to angioectasis. There is also a cyst in the right ovary. The pancreas is normal.

Case Discussion

Fibromuscular dysplasia is a non-atherosclerotic, non-inflammatory arterial disease. Dysplasia of the media is characterized by the presence in the context of the media tunic, fibromuscular bands containing collagen. It most commonly affects the renal, extra-cranial carotid, and vertebral arteries. May cause stenosis, aneurysm, dissection and occlusion in affected vascular bed. The most common manifestations of renal artery FMD are hypertension and headache.

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