Cystic Diseases of the Kidney Differential Diagnoses

  • Author: Thomas Patrick Frye, DO; Chief Editor: Bradley Fields Schwartz, DO, FACS   more...
 
Updated: Dec 15, 2010
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Thomas Patrick Frye, DO  Resident

Disclosure: Nothing to disclose.

Coauthor(s)

Alex Gorbonos, MD  Assistant Professor, Division of Urology, Director, Robotic Surgery, Southern Illinois University School of Medicine

Alex Gorbonos, MD is a member of the following medical societies: Alpha Omega Alpha, American Urological Association, Endourological Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Edmund S Sabanegh Jr, MD  Director, Center for Male Fertility, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation

Edmund S Sabanegh Jr, MD is a member of the following medical societies: American Medical Association, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, Society for the Study of Male Reproduction, Society of Reproductive Surgeons, and Southwest Oncology Group

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

J Stuart Wolf Jr, MD, FACS  The David A Bloom Professor of Urology, Director, Division of Endourology and Stone Disease, Department of Urology, University of Michigan Medical School

J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology

Disclosure: Baxter Healthcare Consulting fee Consulting

Chief Editor

Bradley Fields Schwartz, DO, FACS  Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine

Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, and Society of University Urologists

Disclosure: Nothing to disclose.

References

  1. Bisceglia M, Galliani CA, Senger C, Stallone C, Sessa A. Renal cystic diseases: a review. Adv Anat Pathol. Jan 2006;13(1):26-56. [Medline].

  2. Kalyoussef E, Hwang J, Prasad V, Barone J. Segmental multicystic dysplastic kidney in children. Urology. Nov 2006;68(5):1121.e9-11. [Medline].

  3. Guay-Woodford LM. Renal cystic diseases: diverse phenotypes converge on the cilium/centrosome complex. Pediatr Nephrol. Oct 2006;21(10):1369-76. [Medline].

  4. Thomsen HS, Levine E, Meilstrup JW, Van Slyke MA, Edgar KA, Barth JC, et al. Renal cystic diseases. Eur Radiol. 1997;7(8):1267-75. [Medline].

  5. Choyke PL. Acquired cystic kidney disease. Eur Radiol. 2000;10(11):1716-21. [Medline].

  6. Avner ED, Sweeney WE. Renal cystic disease: new insights for the clinician. Pediatr Clin North Am. Oct 2006;53(5):889-909, ix. [Medline].

  7. Gunay-Aygun M, Avner ED, Bacallao RL, Choyke PL, Flynn JT, Germino GG, et al. Autosomal recessive polycystic kidney disease and congenital hepatic fibrosis: summary statement of a first National Institutes of Health/Office of Rare Diseases conference. J Pediatr. Aug 2006;149(2):159-64. [Medline].

  8. Saunier S, Salomon R, Antignac C. Nephronophthisis. Curr Opin Genet Dev. Jun 2005;15(3):324-31. [Medline].

  9. Siqueira Rabelo EA, Oliveira EA, Silva JM, Oliveira DS, Colosimo EA. Ultrasound progression of prenatally detected multicystic dysplastic kidney. Urology. Nov 2006;68(5):1098-102. [Medline].

  10. Welch TR, Wacksman J. The changing approach to multicystic dysplastic kidney in children. J Pediatr. Jun 2005;146(6):723-5. [Medline].

  11. Grantham JJ, Torres VE, Chapman AB, Guay-Woodford LM, Bae KT, King BF, et al. Volume progression in polycystic kidney disease. N Engl J Med. May 18 2006;354(20):2122-30. [Medline].

  12. Wilson PD. Polycystic kidney disease. N Engl J Med. Jan 8 2004;350(2):151-64. [Medline].

  13. Gusmano R, Caridi G, Marini M, Perfumo F, Ghiggeri GM, Piaggio G, et al. Glomerulocystic kidney disease in a family. Nephrol Dial Transplant. May 2002;17(5):813-8. [Medline].

  14. Onal B, Kogan BA. Natural history of patients with multicystic dysplastic kidney-what followup is needed?. J Urol. Oct 2006;176(4 Pt 1):1607-11. [Medline].

  15. Mostov KE. mTOR is out of control in polycystic kidney disease. Proc Natl Acad Sci U S A. Apr 4 2006;103(14):5247-8. [Medline].

  16. Shillingford JM, Murcia NS, Larson CH, Low SH, Hedgepeth R, Brown N, et al. The mTOR pathway is regulated by polycystin-1, and its inhibition reverses renal cystogenesis in polycystic kidney disease. PNAS. Apr 4 2006;103:5466-5471. [Medline].

  17. Torres, Vicente, Harris, Peter, Yves, Pirson. Autosomal dominant polycystic kidney disease. The Lancet. April 14, 2007;369:1287-1301.

  18. Mercado-Deane MG, Beeson JE, John SD. US of renal insufficiency in neonates. Radiographics. Nov-Dec 2002;22(6):1429-38. [Medline].

  19. Borges Oliva MR, Hsing J, Rybicki FJ, Fennessy F, Mortele KJ, Ros PR. Glomerulocystic kidney disease: MRI findings. Abdominal Imaging. Nov 2003;28:889-892. [Medline].

  20. Bosniak MA. The use of the Bosniak classification system for renal cysts and cystic tumors. J Urol. May 1997;157(5):1852-3. [Medline].

  21. Song C., et al. Differential Diagnosis of Complex Cystic Renal Mass Using Multiphase Computerized Tomography. Journal of Urology. 2009/06;181:2446-2450.

  22. Garcia-Rojo, D. Comparison of Contrast-Enhanced Ultrasound (CE-US) and Computed Tomography (CT) in the Evaluation of Complex Cystic Renal Masses. Journal of Urology. May 31, 2010;183:e243.

  23. Li, G.,, et al. CA9 molecular marker for differential diagnosis of cystic renal tumors. Urologic Oncology. Sept. 3, 2010.

  24. Torres VE, Harris PC. Mechanisms of Disease: autosomal dominant and recessive polycystic kidney diseases. Nat Clin Pract Nephrol. Jan 2006;2(1):40-55; quiz 55. [Medline].

  25. Zerem, E. Simple renal cysts and arterial hypertension: does their evacuation decrease the blood pressure?. Journal of Hypertension. Oct. 27, 2009;10:2074-2078.

  26. Sweeney WE, Chen Y, Nakanishi K, Frost P, Avner ED. Treatment of polycystic kidney disease with a novel tyrosine kinase inhibitor. Kidney Int. Jan 2000;57(1):33-40. [Medline].

  27. Aperis G. Tolvaptan: A new therapeutic agent. Review Recent Clinical Trials. Sept. 22, 2010.

  28. Serra A., et al. Sirolimus and kidney growth in autosomal dominant polycystic kidney disease. New England Journal of Medicine. Aug. 26, 2010;9:820-829.

  29. Rane, A. Laparoscopic management of symptomatic simple renal cysts. International Urology Nephrology. 2004;36:5-9.

  30. Emre, H. "Stepped procedure" in laparoscopic cyst decortications during the learning period of laparoscopic surgery: Detailed evaluation of initial experiences. Journal of Minimal Access Surgery. Apr 6, 2010;2:37-41.

  31. Kilciler, M. Finger assisted laparoscopic renal cyst excision: a simple technique. Urology Journal. Jun 10, 2010;7:90-94.

  32. Busato, W. Percutaneous endocystolysis, a safe and minimally invasive treatment for renal cysts: a 13-year experience. Journal of Endourology. Sept. 2010;24:1405-1410.

  33. Lucas, S. Staged Nephrectomy Versus Bilateral Laparoscopic Nephrectomy in Patients with Autosomal Dominant Polycycstic Kidney Disease. Journal of Urology. Nov. 2010;184:2054-2059.

  34. Webster, W. Surgical Resection Provides Excellent Outcomes for Patients with Cystic Clear Cell Renal Cell Carcinoma. Urology. May 2007;900-904.

  35. Bloom DA, Brosman S. The multicystic kidney. J Urol. Aug 1978;120(2):211-5. [Medline].

  36. Bonsib SM. Non-neoplastic diseases of the kidney. In: Bostwick DG. Urologic Surgical Pathology. St Louis, Mo: Mosby-Year Book; 1997.

  37. Bosniak MA. How does one deal with a renal cyst that appears to be Bosniak class II on a CT scan but that has sonographic features suggestive of malignancy (e.g., nodularity of wall or a nodular, irregular septum)?. AJR Am J Roentgenol. Jul 1994;163(1):216. [Medline].

  38. Bosniak MA. The current radiological approach to renal cysts. Radiology. Jan 1986;158(1):1-10. [Medline].

  39. Brook-Carter PT, Peral B, Ward CJ, Thompson P, Hughes J, Maheshwar MM, et al. Deletion of the TSC2 and PKD1 genes associated with severe infantile polycystic kidney disease--a contiguous gene syndrome. Nat Genet. Dec 1994;8(4):328-32. [Medline].

  40. Chauveau D, Duvic C, Chretien Y, Paraf F, Droz D, Melki P, et al. Renal involvement in von Hippel-Lindau disease. Kidney Int. Sep 1996;50(3):944-51. [Medline].

  41. Clarke A, Hancock E, Kingswood C, Osborne JP. End-stage renal failure in adults with the tuberous sclerosis complex. Nephrol Dial Transplant. Apr 1999;14(4):988-91. [Medline].

  42. Davidson AJ, Hartman DS, Choyke PL, Wagner BJ. Radiologic assessment of renal masses: implications for patient care. Radiology. Feb 1997;202(2):297-305. [Medline].

  43. Fick GM, Johnson AM, Hammond WS, Gabow PA. Causes of death in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. Jun 1995;5(12):2048-56. [Medline].

  44. Freire M, Remer EM. Clinical and radiologic features of cystic renal masses. AJR Am J Roentgenol. May 2009;192(5):1367-72. [Medline].

  45. Grantham JJ. Clinical practice. Autosomal dominant polycystic kidney disease. N Engl J Med. Oct 2 2008;359(14):1477-85. [Medline].

  46. Grantham JJ, Nair V, Winklhofer F. Cystic disease of the kidney. In: Brenner BM, ed. Brenner and Rector's the Kidney. 6th ed. Philadelphia, Pa: WB Saunders Co; 2000:1171-1200.

  47. Israel GM, Bosniak MA. Follow-up CT of moderately complex cystic lesions of the kidney (Bosniak category IIF). AJR Am J Roentgenol. Sep 2003;181(3):627-33. [Medline].

  48. Israel GM, Hindman N, Bosniak MA. Evaluation of cystic renal masses: comparison of CT and MR imaging by using the Bosniak classification system. Radiology. May 2004;231(2):365-71. [Medline].

  49. Lang EK, Macchia RJ, Gayle B, Richter F, Watson RA, Thomas R. CT-guided biopsy of indeterminate renal cystic masses (Bosniak 3 and 2F): accuracy and impact on clinical management. Eur Radiol. Oct 2002;12(10):2518-24. [Medline].

  50. Laube M, Hess B, Terrier F, Vock P, Jaeger P. [Prevalence of medullary sponge kidney in patients with and without nephrolithiasis]. Schweiz Rundsch Med Prax. Oct 24 1995;84(43):1224-30. [Medline].

  51. Levine E, Slusher SL, Grantham JJ, Wetzel LH. Natural history of acquired renal cystic disease in dialysis patients: a prospective longitudinal CT study. AJR Am J Roentgenol. Mar 1991;156(3):501-6. [Medline].

  52. Lonergan GJ, Rice RR, Suarez ES. Autosomal recessive polycystic kidney disease: radiologic-pathologic correlation. Radiographics. May-Jun 2000;20(3):837-55. [Medline].

  53. Matson MA, Cohen EP. Acquired cystic kidney disease: occurrence, prevalence, and renal cancers. Medicine (Baltimore). Jul 1990;69(4):217-26. [Medline].

  54. Miller MA, Brown JJ. Renal cysts and cystic neoplasms. Magn Reson Imaging Clin N Am. Feb 1997;5(1):49-66. [Medline].

  55. Ohlson L. Normal collecting ducts: visualization at urography. Radiology. Jan 1989;170(1 Pt 1):33-7. [Medline].

  56. Ravine D, Gibson RN, Walker RG, Sheffield LJ, Kincaid-Smith P, Danks DM. Evaluation of ultrasonographic diagnostic criteria for autosomal dominant polycystic kidney disease 1. Lancet. Apr 2 1994;343(8901):824-7. [Medline].

  57. Siegel CL, McFarland EG, Brink JA, Fisher AJ, Humphrey P, Heiken JP. CT of cystic renal masses: analysis of diagnostic performance and interobserver variation. AJR Am J Roentgenol. Sep 1997;169(3):813-8. [Medline].

  58. Silverman SG, Israel GM, Herts BR, Richie JP. Management of the incidental renal mass. Radiology. Oct 2008;249(1):16-31. [Medline].

  59. Wolf JS Jr. Evaluation and management of solid and cystic renal masses. J Urol. Apr 1998;159(4):1120-33. [Medline].

  60. Yent ER. Medullary sponge kidney. In: Schrier RE, Gottschalk CW. Disease of the Kidney. 5th ed. Little Brown: Boston, Mass; 1993:525-32.

 
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Cut surface of a nephrectomy specimen from a patient with a multicystic dysplastic kidney (MCDK).
Nephrectomy specimen from a patient with a large benign simple cyst.
External surface of a nephrectomy specimen from a patient with autosomal dominant polycystic kidney disease (ADPKD).
Cut surface of the same nephrectomy specimen from a patient with autosomal dominant polycystic kidney disease (ADPKD).
Cut section of nephrectomy specimen demonstrating renal cell carcinoma (RCC), with an adjacent simple cyst.
Close-up photograph of the cut surface of the same nephrectomy specimen demonstrating a simple cyst adjacent to a renal cell carcinoma (RCC).
A prenatal sonogram of a fetus with a multicystic dysplastic kidney. The right kidney is appreciated as a large multicystic paraspinal mass. The left kidney and bladder are normal, and a normal amount of amniotic fluid is present.
CT examination of the abdomen of a 70-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) is shown. The kidneys are bilaterally enlarged with multiple cysts.
CT scan of the same patient (70-year-old woman with autosomal dominant polycystic kidney disease [ADPKD]) demonstrating multiple hepatic cysts.
This CT scan demonstrates acquired renal cystic disease (ARCD) in a 70-year-old man who is dialysis-dependent. The CT scan demonstrates bilateral atrophic kidneys with multiple renal cysts.
A CT scan of a 38-year-old man with von Hippel-Lindau syndrome (VHLS). The patient previously underwent resection of multiple bilateral renal cell carcinomas (RCCs). CT scan demonstrates multiple cysts in the kidneys and pancreas, as well as solid renal lesions suggestive of malignancy.
 
 
 
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