HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2261011704v1 226/1/47    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Israel, G. M. Articles by Bosniak, M. A. Search for Related Content PubMed PubMed Citation Articles by Israel, G. M. Articles by Bosniak, M. A.

Calcification in Cystic Renal Masses: Is It Important in Diagnosis?¹

¹ From the Department of Radiology, New York University Medical Center, 560 First Ave, Suite HW 202, New York, NY 10016. From the 2001 RSNA scientific assembly. Received October 17, 2001; revision requested January 10, 2002; final revision received April 29; accepted April 30. Address correspondence to G.M.I. (e-mail: gary.israel@med.nyu.edu).

PURPOSE: To determine whether the presence of calcifications in cystic renal masses is important in diagnosis and to suggest an approach to the management of calcified cystic renal masses.

MATERIALS AND METHODS: Eighty-one cystic renal masses containing calcification in a wall or septum were evaluated by means of review of computed tomographic (CT) images (n = 81), follow-up CT images (n = 28), and results of pathologic examination (n = 40) by the authors in consensus. Images were evaluated for lesion size, amount and morphology of calcification, and any association of calcification with soft-tissue structures. Lesions were categorized according to the Bosniak cyst classification system; the amount of calcification was determined with a subjective grading system. Progression of calcification was qualitatively determined with available follow-up CT scans.

RESULTS: Twenty-one lesions were Bosniak category II (benign) and showed small amounts and thin strands of calcification. Nineteen lesions containing more extensive calcification but no enhancing tissue were category IIF. Follow-up CT results available for 16 of these lesions (average follow-up length, 5 years 8 months) showed no substantial change. The three remaining lesions were proved benign at surgery. Twenty-five lesions were category III; surgical intervention was performed in 21 of these (benign, n = 12; malignant, n = 9). Sixteen lesions that contained obvious areas of enhancing soft tissue were category IV and proved malignant at surgery.

CONCLUSION: Calcification in a cystic renal mass is not as important in diagnosis as is the presence of associated enhancing soft-tissue elements. This information should enable a reasonable approach to the management of calcium-containing renal cystic lesions.

© RSNA, 2002

Index terms: Kidney, calcification, 81.814, 81.816 • Kidney, cysts, 81.3111, 81.3112 • Kidney neoplasms, CT, 81.12112

This article has been cited by other articles:

				S. G. Silverman, G. M. Israel, B. R. Herts, and J. P. Richie Management of the Incidental Renal Mass Radiology, October 1, 2008; 249(1): 16 - 31. [Abstract] [Full Text] [PDF]

				G. M. Israel and M. A. Bosniak Pitfalls in Renal Mass Evaluation and How to Avoid Them RadioGraphics, September 1, 2008; 28(5): 1325 - 1338. [Abstract] [Full Text] [PDF]

				L R Williams, M J Oldale, and A J Bradley Imaging renal masses and staging renal tumours Imaging, March 1, 2008; 20(1): 73 - 86. [Abstract] [Full Text] [PDF]

				J. Zhang, R. A. Lefkowitz, N. M. Ishill, L. Wang, C. S. Moskowitz, P. Russo, H. Eisenberg, and H. Hricak Solid Renal Cortical Tumors: Differentiation with CT Radiology, August 1, 2007; 244(2): 494 - 504. [Abstract] [Full Text] [PDF]

				O. Benjaminov, M. Atri, M. O'Malley, K. Lobo, and G. Tomlinson Enhancing Component on CT to Predict Malignancy in Cystic Renal Masses and Interobserver Agreement of Different CT Features. Am. J. Roentgenol., March 1, 2006; 186(3): 665 - 672. [Abstract] [Full Text] [PDF]

				G. M. Israel and M. A. Bosniak How I Do It: Evaluating Renal Masses Radiology, August 1, 2005; 236(2): 441 - 450. [Abstract] [Full Text] [PDF]

				D. S. Hartman, P. L. Choyke, and M. S. Hartman From the RSNA Refresher Courses: A Practical Approach to the Cystic Renal Mass RadioGraphics, October 1, 2004; 24(suppl_1): S101 - S115. [Abstract] [Full Text] [PDF]

				G. M. Israel, N. Hindman, and M. A. Bosniak Evaluation of Cystic Renal Masses: Comparison of CT and MR Imaging by Using the Bosniak Classification System Radiology, May 1, 2004; 231(2): 365 - 371. [Abstract] [Full Text] [PDF]

				S. A. Joffe, S. Servaes, S. Okon, and M. Horowitz Multi-Detector Row CT Urography in the Evaluation of Hematuria RadioGraphics, November 1, 2003; 23(6): 1441 - 1455. [Abstract] [Full Text] [PDF]