An unusual vascular impression on the renal pelvis

In a female patient who presented with the complaint of dysuria, angiography was required to distinguish a vascular impression on the renal pelvis from a possible tumor or calculus. Neither intravenous urography nor retrograde pyelogram clarified the smooth filling defect sufficiently to rule out the possibility of a urothelial tumor.     

An unusual appearance of renal lymphoma

The kidney is a relatively common site of extranodal involvement by lymphoma and various patterns have been documented (Richmond et al., 1962). We describe a patient in whom renal involvement by non-Hodgkin's lymphoma produced unusual appearances on ultrasound and computed tomography (CT). The possible causes and relevance of these findings are discussed.     

Spontaneous rupture of the renal pelvis

The object of the case report is to present a case of spontaneous rupture of the renal pelvis with no underlying pathological condition to account for the rupture, a very rare and unusual occurrence. The patient was a 46-year-old Korean who presented with severe left loin pain and vomiting. The diagnosis was suspected on intravenous urography and confirmed by CT. Treatment was by ureteral stenting. The patient made a complete recovery. The differential diagnosis of this condition is discussed and the literature is reviewed.     

An unusual combination of findings in renal transplantation

Three cases involving renal scans that showed both severe photopenia and also increase in uptake in a rim surrounding the renal graft are presented. As previously mentioned in the literature, the bad prognostic import of photopenia is confirmed. The increased rim of activity has been rarely mentioned in the literature in the past and its possible causes are discussed.     

Pseudotumor of the renal pelvis caused by renal artery aneusysm

Urographic abnormalities caused by renal artery aneurysms are discussed on the basis of seven cases. Angiography is the diagnostic procedure of choice to make the correct diagnosis. In cases of completely thrombosed aneurysms angiography may only demonstrate an avascular mass with displacement of vessels. At ultrasound examination renal artery aneurysms should be included in the differential diagnosis of echo-free renal masses.     

Imaging of vascular disorders of the female pelvis

Clinical presentation of vascular disorders of female pelvis including placental adhesion, retained product of conception, ovarian venous thrombosis, varices, torsion and haemorrhagic infarct of ovary is often non-specific. Because of its availability, safety, and cost-effectiveness, ultrasound is the first investigation of choice. Computed tomography and MRI clearly depict the pelvic and retroperitoneal anatomy. This pictorial essay illustrates the complementary role of US, CT, and MRI in diagnosing vascular disorders of female pelvis.     

Calcified transitional cell carcinoma of the renal pelvis

Six patients with calcified transitional cell carcinoma of the renal pelvis were encountered over a 10-year period, and the radiographic features in these cases are presented. Radiographically discernible calcification is one of the less common manifestations of this lesion, and the pattern of calcification may be variable. However, the combination of a coarse, punctate pattern with a mucosal lesion on excretory or retrograde urography should suggest the diagnosis and prompt further investigation.     

Primary amyloidosis of the ureter and renal pelvis

We present a rare case of primary amyloidosis involving the ureter and renal pelvis. Histologic examination is required to distinguish this condition from transitional cell carcinoma. Intra-operative diagnosis of amyloidosis by frozen section may allow for a conservative surgical approach.     

CT of carcinoma of the renal pelvis.

CT in 28 histologically proven carcinomas of the renal pelvis (pTa-2, n = 12; pT3-4, n = 16) in 26 patients was evaluated retrospectively. Twenty-four of 28 tumors could be identified at CT, 17/28 at urography, and 12/14 at retrograde pyelography. Nineteen tumors appeared as a discrete intrapelvic mass with an attenuation close to that of the kidney on noncontrast scans. There was slight to moderate enhancement of the tumors following i.v. contrast medium injection but they appeared hypodense relative to the renal parenchyma. Five tumors caused only a diffuse obliteration of the renal sinus. Criteria to define peripelvic tumor growth are proposed, i.e. tumors obliterating fat planes or abutting of renal parenchyma should not be regarded as signs of extrapelvic extension, while inhomogeneous attenuation of peripelvic fat and renal parenchyma (in the absence of other explanation) should, or if the tumor mass is seen interdigitizing with surrounding structures. Thickening of Gerota's fascia or septa in the perirenal space are unspecific findings. With CT we were able to differentiate tumors confined to the renal pelvic wall from those with more advanced disease including metastases in 22 of 26 patients.