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Hyperattenuating renal masses: etiologies, pathogenesis, and imaging evaluation.

Stuart G Silverman1, Koenraad J Mortele, Kemal Tuncali

  • 1Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA. sgsilverman@partners.org

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|July 11, 2007
PubMed
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Hyperattenuating renal masses on CT scans can be benign or malignant. Differentiating these masses, especially small ones, often requires advanced imaging like MRI or biopsy to guide treatment and avoid unnecessary surgery.

Area of Science:

  • Radiology
  • Oncology
  • Pathology

Background:

  • Hyperattenuating renal masses on computed tomography (CT) present a diagnostic challenge.
  • These masses can be caused by benign conditions like cysts or malignant tumors such as renal cell carcinoma.

Purpose of the Study:

  • To review the differential diagnosis of hyperattenuating renal masses.
  • To highlight the role of CT and MRI in characterizing these lesions.
  • To discuss the utility of biopsy and surgery in definitive diagnosis.

Main Methods:

  • Review of CT and MRI characteristics of hyperattenuating renal masses.
  • Discussion of imaging findings differentiating benign from malignant causes.
  • Evaluation of the diagnostic accuracy of imaging modalities and biopsy.

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Main Results:

  • Most hyperattenuating renal masses are benign (e.g., cysts, hematomas).
  • Solid, enhancing hyperattenuating masses can be malignant (renal cell carcinoma, lymphoma) or benign (angiomyolipoma with minimal fat).
  • CT is useful for simple cysts, but differentiation of solid masses often requires MRI or biopsy.

Conclusions:

  • Accurate diagnosis of hyperattenuating renal masses is crucial to prevent unnecessary interventions.
  • MRI and percutaneous biopsy can aid in differentiating challenging cases where CT is inconclusive.
  • Surgery may be warranted when imaging and biopsy results are not definitive.