renal cyst
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Epidemiology
- overall prevalence 12%; 15% men vs 8% women
- prevalence increases with age
- 5% of patients 30-40 years
- 25-30% of patients > 50 years
- 35% of patients > 70 years
Pathology
- average yearly increase in cyst size = 2.8 mm[2]
- mean # of cysts/kidney increased from 0.8-1.3 over 5 years
- only predictor of rapid growth is multilocular shape[2]
- simple cyst:[3]
- complex cyst:[3]
- many thin septae
- thickening of a septum or wall
- nodular calcification
Clinical manifestations
- most cysts are asymptomatic
Radiology
- renal ultrasound
- computed tomography
- evaluate renal function before use of contrast
- Bosniak grading system used to characterize renal cysts[4]
- renal CT includes a noncontrast phase; a contrast-enhanced, nephrographic phase; & a delayed phase
- magnetic resonance imaging (MRI)
Management
- simple cysts:
- no malignant transformation[2][3]
- no further imaging studies or intervention needed[1]
- complex renal cysts or mass lesions > 4 cm
More general terms
Additional terms
References
- ↑ 1.0 1.1 1.2 Medical Knowledge Self Assessment Program (MKSAP) 11, 15, American College of Physicians, Philadelphia 1998, 2009
- ↑ 2.0 2.1 2.2 2.3 Journal Watch 22(4):28, 2002 Terada N, Ichioka K, Matsuta Y, Okubo K, Yoshimura K, Arai Y. The natural history of simple renal cysts. J Urol 167:21, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11743266
Terada N, Arai Y, Kinukawa N, Terai A. The 10-year natural history of simple renal cysts. Urology. 2008 Jan;71(1):7-11; discussion 11-2. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18242354 - ↑ 3.0 3.1 3.2 3.3 3.4 Journal Watch 23(21):166-67, 2003 Israel GM & Bosniak MA Follow-up CT of moderately complex cystic lesions of the kidney (Bosniak category IIF). AJR AM J Roentgenol 181:627, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12933451
- ↑ 4.0 4.1 Thomas S, Grimm L, Brady MP Renal Cell Carcinoma: Recognition and Follow-up. Medscape. April 18, 2016 http://reference.medscape.com/features/slideshow/renal-cell-carcinoma
- ↑ 5.0 5.1 Chandrasekar T, Ahmad AE, Fadaak K et al. Natural history of complex renal cysts: Clinical evidence supporting active surveillance. J Urol 2018 Mar; 199:633 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28941915 <Internet> http://www.jurology.com/article/S0022-5347(17)77564-7/fulltext
- ↑ Smith AD, Allen BC, Sanyal R et al. Outcomes and complications related to the management of Bosniak cystic renal lesions. AJR Am J Roentgenol 2015 May; 204:W550 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25905961
- ↑ Richard PO, Violette PD, Jewett MA et al. CUA guideline on the management of cystic renal lesions. Can Urol Assoc J 2017 Mar-Apr; 11:E66 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28360949 Free PMC Article
- ↑ 8.0 8.1 NEJM Knowledge+ Complex Medical Care
- ↑ Simple Kidney Cysts http://kidney.niddk.nih.gov/kudiseases/pubs/cysts/index.htm