CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 34Perinephric Mass on
Computed Tomography and
Magnetic Resonance Imaging

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig GU 34-1 Renal cell carcinoma. Contrast CT
scan demonstrates a large heterogeneous and
necrotic mass (asterisk) invading the
perinephric space. Significant thickening of
the renal fascia is also seen.39

4. Fig GU 34-2 Non-Hodgkin's lymphoma. Contrast CT scan shows
bilateral perinephric (arrows) and right peripelvic (asterisk)
masses.39

5. • Fig GU 34-3 Retroperiotoneal liposarcoma.
Contrast CT scan shows a large
heterogeneous, predominantly fat-containing
mass (arrows) in the right upper quadrant,
which invades the perinephric space and renal
hilum.39

6. • Fig GU 34-4 Hematoma. CT in a patient with
acute flank pain demonstrates a perirenal
hematoma (arrow) originating from a
ruptured angiomyolipoma (asterisk).39

7. • Fig GU 34-5 Urinoma. Delayed contrast CT scan shows
excreted contrast material passing from the left renal
pelvis (arrow) into a perinephric fluid collection
(asterisk), confirming the diagnosis. The patient
developed flank pain after aortic aneurysm repair.39

8. • Fig GU 34-6 Xanthogranulomatous
pyelonephritis. Contrast CT scan shows an
enlarged right kidney with an abscess-like low-
attenuation cavity (asterisk) in the right hilum.
The staghorn calculus (arrowhead) was also seen
on unenhanced images. The inflammatory
process extends to the perinephric space
(arrow).39

9. • Fig GU 34-7 Extramedullary hematopoiesis.
Contrast-enhanced CT scan shows a large
hypodense, hypervascular mass encasing the
right renal hilum and distorting the collecting
system (asterisk). There is involvement of the
perirenal space bilaterally (arrows). Note the
preservation of the contours of the kidneys.39

10. • Fig GU 34-8 Erdheim-Chester disease. Contrast
CT scan shows a left perinephric hypovascular
mass (arrow) associated with fat stranding and
moderate hydronephrosis (asterisk).39

11. • Fig GU 34-9 Cortical necrosis. In this patient
with acute renal failure following severe
antepartum hemorrhage, a contrast CT scan
demonstrates a lack of enhancement of the
renal cortex (arrow) but normal renal medulla
enhancement. Note the slight enhancement
of the renal capsule (arrowheads).39

12. • Fig GU 34-10 Nephroblastomatosis. Contrast
CT scan shows bilateral enlargement of the
kidneys caused by hypodense, nonenhancing,
cortical soft-tissue masses (arrows). Note the
distortion of the renal parenchyma centrally.39