PURPOSE: To evaluate the prevalance of morphological variation of the kidney secondary to junctional parenchyma, as well as to analyze the ultrasonographic features of junctional parenchyma. MATERIALS AND METHODS: Two hundred and eighty two kidneys of 141 patient without clinical or radiologic evidence of renal disease were prospectively analysed using ultrasound. In all patients, ultrasonograms were obtained in sagittal, coronal and transaxial planes. The kidney was considered to have morphological variation if the ulrasonogram demonstrated junctional parenchymal defect or line ; those showing such variation were classified as one of three types :continuous, discontinuous, or junctional parenchymal line or defect without junctional parenchyma. The prevalance and ultrasonographic features of the kidneys were evaluated. RESULTS: Morphological variation was noted in 71 cases(25%). the continuous type accounted for 54% of these, the discontinuous type for 38%, and junctional parenchymal defect or line without junctional parenchyma for 8%. In all cases, junctional parenchyma was located approximately at the junction of the upper and middle third of the kidny, and had the same echogenecity as the renal cortex. CONCLUSION: An understanding of the morphological variation of the kidney resulting from junctional renal parenchyma would be helpful in differentiating pseudo tumor from true renal neoplasm.
Humans ; Kidney Neoplasms ; Kidney* ; Ultrasonography*

Mesoblastic nephroma is an important differential diagnosis of a renal mass occurring in the neonatal period or in early childhood. It is a rare monomorphous congenital renal neoplasm most commonly recognized during the first 3 months of life. With the widespread application of ultrasound imaging, many cases are recognized prior to birth. We report a case of mesoblastic nephroma detected by ultrasonograph at 36 weeks of intrauterine fetal life and removed after birth. It showed a well circumscribed, grayish white, solid mass measuring 4x3x2 cm. The tumor was predominantly a classic type with a focal cellular pattern. Immunohistochemical and electron microscopic studies were done.
Diagnosis, Differential ; Kidney ; Kidney Neoplasms ; Nephroma, Mesoblastic* ; Parturition ; Ultrasonography

Cystic renal cell carcinoma represents approximately 15 percent of all renal cell carcinoma. The multilocular cystic renal cell carcinoma is comprised of multiple variable sized. non-communicating, fluid-filled cystic spaces and often extremely difficult to differentiate from non-neoplastic, and other malignant neoplastic masses clinically and radiologically. We have encountered a case of multilocular cystic renal cell carcinoma whose sonographic, computed topographic findings and gross pathologic characteristics were similar to multilocular renal cyst. If multilocular cyst is suspected preoperatively. a more cautious operative approach consisting of in vivo inspection of the lesion and it nessary, frozen section examination of tissue should be followed.
Carcinoma, Renal Cell* ; Frozen Sections ; Kidney Neoplasms ; Ultrasonography

Histopathologic study was performed to observe the effects of M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin), widely used for advanced bladder cancer and its metastatic lesion, on the visceral organs of the experimental animal. M-VAC was used intraperitoneally throughout the study and the following results were obtained : 1. There were severe adhesions of visceral organs in all of experimental groups, compared with the control group. 2. Compared with the control group(15.0%), significant increase of incidence in renal cystic changes in experimental group(89.6%) was observed. The lesions were similar to polycystic kidney type I and considered to be irreversible. Therefore, ultrasonography of the kidney during the M-VAC regimen may be clinically worthwhile. 3. Portal triaditis ( 27.5% ) and fatty metamorphosis of the liver(24.1%) were observed significantly in the experimental group but they were limited, localized changes and thought to be reversible. Deterioration in hepatic function may not be seriously considered.
Animals* ; Doxorubicin* ; Incidence ; Kidney ; Polycystic Kidney Diseases ; Ultrasonography ; Urinary Bladder Neoplasms ; Vinblastine*

Multilocular cyst of the kidney is a rare pathologic entity, noninherited benign renal neoplasm occurring in the both children and adults. The entities commonly were known as multilocular cyst of the kidney or multilocular cystic nephroma. The controversy over the pathogenesis of multilocular cyst-neoplasm versus developmental anomaly- is still unsettled. We report two cases of multilocular renal cyst, one in a 8-year-old child with a chief complaint of gross hematuria and another in a 44-year-old woman with epigastric discomfortness. They were preoperatively suspected multilocular cyst by ultrasonography and computed tomography. We performed a simple nephrectomy as the treatment of choice because of the difficulty in accurate diagnosis and the documented association with renal neoplasia.
Adult ; Child ; Diagnosis ; Female ; Hematuria ; Humans ; Kidney ; Kidney Neoplasms ; Nephrectomy ; Ultrasonography

PURPOSE: We report here on our initial experience with 3rd generation nephron-sparing renal cryoablation, which is one of the minimal invasive nephron-sparing surgeries. MATERIALS AND METHODS: We enrolled 10 patients who had renal neoplasm identified on computed tomography (CT) and who underwent 3rd generation cryoablation from August 2004 to May 2006. The operative indications were a tumor less than 4cm in diameter, an exophytic mass with malignant potential and those cases like solitary kidney, bilateral tumor or renal insufficiency that needed preservation of renal function. Eight patients underwent minimal incision open cryoablation, and the other two underwent laparoscopic cryoablation. In every case, there were 2-3 cycles of freeze and thawing and we monitored the tumor and ice ball via intraoperative ultrasound. RESULTS: The size of the iceball was maintained more than 1cm apart from the margin of the tumor to secure a safety margin. The average operation time of open cryoablation was 1.7 hr and that of laparoscopic cryoablation was 2.2 hr; the average blood loss was 194cc and 55cc, respectively. The average period of hospitalization after operation was 6.6 days and 3 days, respectively, and there was no complication except for one patient who had postoperative pulmonary effusion. During a mean follow-up of 14.1 months, no patient died and all the patients except one remained without local recurrence. CONCLUSIONS: As a result of our initial experience, renal cryoablation turned out to have an excellent effect of tumor erradication and few complications. Although long term follow-up results are necessary, laparoscopic renal cryoablation is considered a minimal invasive nephron- sparing surgery that could be substituted for laparoscopic partial nephrectomy in the future.
Cryosurgery* ; Follow-Up Studies ; Hospitalization ; Humans ; Ice ; Kidney ; Kidney Neoplasms ; Nephrectomy ; Recurrence ; Renal Insufficiency ; Ultrasonography

Carcinosarcomas are rare biphasic malignant neoplasms with an epithelial and a spindle cell component. We present a 62-year-old man with a history of noticeably abdominal distension, proved by surgery to be caused by carcinosarcoma of the renal pelvis and urinary bladder, occupying the entire left abdominal flank. We also illustrate the appearance of this rare entity on sonography and computed tomography.
Bladder/*pathology/radiography/surgery/ultrasonography ; Bladder Neoplasms/radiography/*surgery/ultrasonography ; Carcinosarcoma/radiography/*surgery/ultrasonography ; Contrast Media/administration & dosage ; Human ; Kidney Neoplasms/radiography/*surgery/ultrasonography ; Kidney Pelvis/*pathology/radiography/surgery/ultrasonography ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVE: Multilocular cystic renal cell carcinoma (MCRCC) is a recently described variety of renal cell carcinoma with characteristic pathologic and clinical features. The purpose of this study was to analyze the imaging findings of MCRCCs. MATERIALS AND METHODS: Ten adult patients with pathologically proven unilateral MCRCC who underwent renal US and CT were included in this study. The radiologic findings were retrospectively evaluated for cystic content, wall, septum, nodularity, calcification and solid portion by three radiologists who established a consensus. Imaging and postnephrectomy pathologic findings were compared. RESULTS: All patients were adults (six males and four females) and their ages ranged from 33 to 68 years (mean, 46). On US and CT images, all tumors appeared as well-defined multilocular cystic masses composed of serous or complicated fluid. In all patients, unenhanced CT scans revealed hypodense cystic portions, and in four tumors, due to the presence of hemorrhage or gelatinous fluid, some hyperdense areas were also noted. In no tumor was an expansile solid nodule seen in the thin septa, and in only one was there dystrophic calcification in a septum. Small areas of solid portion constituting less than 10% of the entire lesion were found in six of the ten tumors, and these areas were slightly enhanced on enhanced CT scans. In all patients, imaging and pathologic findings correlated closely. CONCLUSION: On US and CT images, MCRCC appeared as a well-defined multilocular cystic mass with serous, proteinaceous or hemorrhagic fluid, with no expansile solid nodules in the thin septa, and sometimes with small slightly enhanced solid areas. Where radiologic examinations demonstrate a cystic renal mass of this kind in adult males, MCRCC should be included in the differential diagnosis.
Carcinoma, Renal Cell/*radiography/*ultrasonography ; Female ; Human ; Kidney Neoplasms/*radiography/*ultrasonography ; Kidney, Cystic/radiography/ultrasonography ; Male ; Middle Age ; *Tomography, X-Ray Computed

OBJECTIVE: Multilocular cystic renal cell carcinoma (MCRCC) is a recently described variety of renal cell carcinoma with characteristic pathologic and clinical features. The purpose of this study was to analyze the imaging findings of MCRCCs. MATERIALS AND METHODS: Ten adult patients with pathologically proven unilateral MCRCC who underwent renal US and CT were included in this study. The radiologic findings were retrospectively evaluated for cystic content, wall, septum, nodularity, calcification and solid portion by three radiologists who established a consensus. Imaging and postnephrectomy pathologic findings were compared. RESULTS: All patients were adults (six males and four females) and their ages ranged from 33 to 68 years (mean, 46). On US and CT images, all tumors appeared as well-defined multilocular cystic masses composed of serous or complicated fluid. In all patients, unenhanced CT scans revealed hypodense cystic portions, and in four tumors, due to the presence of hemorrhage or gelatinous fluid, some hyperdense areas were also noted. In no tumor was an expansile solid nodule seen in the thin septa, and in only one was there dystrophic calcification in a septum. Small areas of solid portion constituting less than 10% of the entire lesion were found in six of the ten tumors, and these areas were slightly enhanced on enhanced CT scans. In all patients, imaging and pathologic findings correlated closely. CONCLUSION: On US and CT images, MCRCC appeared as a well-defined multilocular cystic mass with serous, proteinaceous or hemorrhagic fluid, with no expansile solid nodules in the thin septa, and sometimes with small slightly enhanced solid areas. Where radiologic examinations demonstrate a cystic renal mass of this kind in adult males, MCRCC should be included in the differential diagnosis.
Carcinoma, Renal Cell/*radiography/*ultrasonography ; Female ; Human ; Kidney Neoplasms/*radiography/*ultrasonography ; Kidney, Cystic/radiography/ultrasonography ; Male ; Middle Age ; *Tomography, X-Ray Computed

Here we report a case in a 41-year-old woman histologically proven cystic embryonal sarcoma of the kidney, with emphasis on the imaging findings and pathological features. A large lobulated solid mass in the cystically dilated pelvocalyceal region was accompanied with hydroureter as depicted on both ultrasound and contrast-enhanced CT images.
Adult ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Imaging, Three-Dimensional/methods ; Kidney/radiography/surgery/ultrasonography ; Kidney Neoplasms/*radiography/surgery/*ultrasonography ; Neoplasms, Germ Cell and Embryonal/*radiography/surgery/*ultrasonography ; Sarcoma/*radiography/surgery/*ultrasonography ; Tomography, X-Ray Computed/methods