[Considerations regarding the differential diagnosis during the angiography of non-functioning kidneys (author's...

Utilizing selective renal arteriograms and phlebograms in 7 patients, the differential diagnostic difficulties in separating poorly vascularized tumors from inflammatory lesions are discussed. Retrograde studies either offered no help, or could technically not be accomplished; arteriography proved equivocal in most cases. However, renal phlebography was found to be quite helpful, in that a non-visualized or reduced opacification of the intrarenal venous system, along with irregular extrinsic venous impressions, spoke more for a malignant tumor. When the contrast was able to fill the veins out to the periphery, a tumor could with great certainty be ruled out. Severe inflammatory conditions, while demonstrating a generalized reduction in the opacification of the venous system, did not show the bizarre venous wall irregularities seen with tumors. Retroperitoneal fibrosis and its special diagnostic difficulties are discussed.