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Bosniak category III cysts are more likely to be malignant than we expected in the era of multidetector computed tomography technology.

Bata P, Tarnoki AD, Tarnoki DL, Szasz AM, Poloskei G, Fejer B, Gyebnar J, Nyirady P, Berczi V, Karlinger K, Szendroi A - J Res Med Sci (2014)

Bottom Line: Of the 19 removed lesions, 16 (84%) were malignant, and 3 (16%) were benign (one inflammatory cyst including a nephrolith, one cystic nephroma and one atypical angiomyolipoma).CT and histological findings of 19 Bosniak III cysts were correlated.It may due to the era of modern multidetector CT technology and multiphase protocol.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Oncotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary.

ABSTRACT

Background: Complex indeterminate Bosniak category III renal cystic masses are traditionally considered to be malignant in 50%. Our aim was to retrospectively evaluate the attenuation characteristics in multiphase computed tomography (CT) and to determinate the incidence of malignancy based on histological findings on all Bosniak category III renal cystic masses investigated in our department between April 3, 2007 and November 21, 2013.

Materials and methods: QUADRIPHASIC MULTIDETECTOR CT IMAGES OF NINETEEN PATIENTS (MEAN AGE: 56.5 ± 16.5 years) with radiologically detected Bosniak category III lesions were reviewed retrospectively. All lesions were surgically removed, and the incidence of malignancy, based on pathological results was determined.

Results: Calcification was present in four lesions (21%). The mean largest diameter was 48.7 ± 28.8 mm. All lesions were multilobulated and septated. Of the 19 removed lesions, 16 (84%) were malignant, and 3 (16%) were benign (one inflammatory cyst including a nephrolith, one cystic nephroma and one atypical angiomyolipoma). CT and histological findings of 19 Bosniak III cysts were correlated.

Conclusion: Our study demonstrated much higher prevalence of malignancy (84%) in radiologically detected Bosniak category III cysts than it has been described before. It may due to the era of modern multidetector CT technology and multiphase protocol.

No MeSH data available.


Related in: MedlinePlus

Computed tomography (CT) appearance of the cystic nephroma mimicking a Bosniak III lesion. 78-year-old female with a history of limb and lower back pain, and expansive subcostal pain in the past months. Thickened irregular wall and septa with contrast enhancement can be observed in the upper third of the right kidney. Unenhanced (a), corticomedullary (b), nephrographic (c) and excretory phases (c) axial CT images. Macroscopic documentation (e) with H and E stained histological sections at magnification ×1 (f) and ×20 (g)
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Figure 3: Computed tomography (CT) appearance of the cystic nephroma mimicking a Bosniak III lesion. 78-year-old female with a history of limb and lower back pain, and expansive subcostal pain in the past months. Thickened irregular wall and septa with contrast enhancement can be observed in the upper third of the right kidney. Unenhanced (a), corticomedullary (b), nephrographic (c) and excretory phases (c) axial CT images. Macroscopic documentation (e) with H and E stained histological sections at magnification ×1 (f) and ×20 (g)

Mentions: Histological analysis confirmed that 16 of 19 lesions were conventional clear cell renal cell carcinomas (ccRCC) (84%). According to the TNM stage, eight of them proved to be pT1a (<4 cm in diameter and organ confined), six of them was pT1b (4-7 cm in diameter and organ confined), and two of them was pT2b (>10 cm in diameter and organ confined). The three remaining lesions were histologically proven to be an inflamed cyst including a nephrolith [Figure 2], a cystic nephroma [Figure 3] and an atypical “fat-poor” angiomyolipoma [Figure 4].


Bosniak category III cysts are more likely to be malignant than we expected in the era of multidetector computed tomography technology.

Bata P, Tarnoki AD, Tarnoki DL, Szasz AM, Poloskei G, Fejer B, Gyebnar J, Nyirady P, Berczi V, Karlinger K, Szendroi A - J Res Med Sci (2014)

Computed tomography (CT) appearance of the cystic nephroma mimicking a Bosniak III lesion. 78-year-old female with a history of limb and lower back pain, and expansive subcostal pain in the past months. Thickened irregular wall and septa with contrast enhancement can be observed in the upper third of the right kidney. Unenhanced (a), corticomedullary (b), nephrographic (c) and excretory phases (c) axial CT images. Macroscopic documentation (e) with H and E stained histological sections at magnification ×1 (f) and ×20 (g)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214022&req=5

Figure 3: Computed tomography (CT) appearance of the cystic nephroma mimicking a Bosniak III lesion. 78-year-old female with a history of limb and lower back pain, and expansive subcostal pain in the past months. Thickened irregular wall and septa with contrast enhancement can be observed in the upper third of the right kidney. Unenhanced (a), corticomedullary (b), nephrographic (c) and excretory phases (c) axial CT images. Macroscopic documentation (e) with H and E stained histological sections at magnification ×1 (f) and ×20 (g)
Mentions: Histological analysis confirmed that 16 of 19 lesions were conventional clear cell renal cell carcinomas (ccRCC) (84%). According to the TNM stage, eight of them proved to be pT1a (<4 cm in diameter and organ confined), six of them was pT1b (4-7 cm in diameter and organ confined), and two of them was pT2b (>10 cm in diameter and organ confined). The three remaining lesions were histologically proven to be an inflamed cyst including a nephrolith [Figure 2], a cystic nephroma [Figure 3] and an atypical “fat-poor” angiomyolipoma [Figure 4].

Bottom Line: Of the 19 removed lesions, 16 (84%) were malignant, and 3 (16%) were benign (one inflammatory cyst including a nephrolith, one cystic nephroma and one atypical angiomyolipoma).CT and histological findings of 19 Bosniak III cysts were correlated.It may due to the era of modern multidetector CT technology and multiphase protocol.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Oncotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary.

ABSTRACT

Background: Complex indeterminate Bosniak category III renal cystic masses are traditionally considered to be malignant in 50%. Our aim was to retrospectively evaluate the attenuation characteristics in multiphase computed tomography (CT) and to determinate the incidence of malignancy based on histological findings on all Bosniak category III renal cystic masses investigated in our department between April 3, 2007 and November 21, 2013.

Materials and methods: QUADRIPHASIC MULTIDETECTOR CT IMAGES OF NINETEEN PATIENTS (MEAN AGE: 56.5 ± 16.5 years) with radiologically detected Bosniak category III lesions were reviewed retrospectively. All lesions were surgically removed, and the incidence of malignancy, based on pathological results was determined.

Results: Calcification was present in four lesions (21%). The mean largest diameter was 48.7 ± 28.8 mm. All lesions were multilobulated and septated. Of the 19 removed lesions, 16 (84%) were malignant, and 3 (16%) were benign (one inflammatory cyst including a nephrolith, one cystic nephroma and one atypical angiomyolipoma). CT and histological findings of 19 Bosniak III cysts were correlated.

Conclusion: Our study demonstrated much higher prevalence of malignancy (84%) in radiologically detected Bosniak category III cysts than it has been described before. It may due to the era of modern multidetector CT technology and multiphase protocol.

No MeSH data available.


Related in: MedlinePlus