Bosniak grading system
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Indications
- Bosniak grading system is used with CT scanning to characterize renal cysts
Interpretation
- Septa, enhancing nodules, & calcifications are considered in the grading system
- Bosniak 1 lesion: a completely fluid simple renal cyst
- Bosniak 2 lesion:
- a renal cyst with thin hairline septa that do not enhance or thin calcifications in the septa or wall
- risk of malignancy is ~0%[1]
- Bosniak 2F lesion:
- cystic lesions with multiple thin septa, septa thicker than hairline, a slightly thick cyst wall, or calcification, which may be thick
- intrarenal, nonenhancing, high-attenuation cysts >= 3 cm
- examples of moderately complex renal cysts Bosniak category IIF in refs[1][2]
- cannot be fully characterized as benign
- 5-25% of lesions malignant[1]
- Bosniak 3 lesion:
- renal cyst with uniform wall thickening or mural nodule, thick or irregular calcification, & thick enhancing septa
- ~50% are malignant
- complex renal abscess due pyelonephritis may masquarade as a Bosniak 3 complex renal cyst[1]
- Boniak 4 lesion:
- all the characteristics of Bosniak 3 lesions plus enhancing soft-tissue components adjacent to, but independent of, the wall or septa
- >90% risk of malignancy[1]
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 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
- ↑ 2.0 2.1 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