Bilateral Parapelvic Cyst Misdiagnosed as Hydronephrosis · 65 Images in Clinical Medicine ...
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65 Images in Clinical Medicine www.cmj.ac.kr https://doi.org/10.4068/cmj.2019.55.1.65 Ⓒ Chonnam Medical Journal, 2019 Chonnam Med J 2019;55:65 Corresponding Author: Soo Wan Kim Department of Internal Medicine, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6271, Fax: +82-62-225-8578, E-mail: [email protected] Article History: Received September 27, 2018 Revised October 8, 2018 Accepted October 15, 2018 FIG. 1. Ultrasonography image of left kidney. Septa between the parapelvic cysts are well defined on ultrasonographic exam. FIG. 2. Abdominal computed tomography scan with intravenous pyelogram (CT IVP) image. (A) Axial view of the CT IVP scan with contrast showing low attenuated lesions involving both the renal pelvis and calyces. (B) Urinary tract obstruction was not observed on reconstructed CT IVP image. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Bilateral Parapelvic Cyst Misdiagnosed as Hydronephrosis Hong Sang Choi, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, and Soo Wan Kim * Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea A 36-year-old man visited our hospital with a suspected bilateral hydronephrosis that was detected during a rou- tine check-up. Ultrasonography at the local clinic revealed a wide hypoechoic area in the center of both kidneys instead of a central echogenic complex (Fig. 1). Oliguria or abnor- mal laboratory values were not observed. On an axial view of the computed tomography with intravenous pyelogram (CT IVP) scan, low attenuated lesions with a cauliflower appearance were observed in the pelvises and calyces of both kidneys (Fig. 2A). No hydronephrosis or obstructive lesions in the urinary tract were observed on reconstructed intravenous pyelogram (IVP) image (Fig. 2B). A parapelvic cyst is a hypoechoic lesion located in the renal pelvis, which is often misdiagnosed as hydronephrosis because of its thin wall. 1,2 In conclusion, CT IVP is a useful test for the differ- ential diagnosis of parapelvic cysts. CONFLICT OF INTEREST STATEMENT None declared. REFERENCES 1. Koratala A, Alquadan KF. Parapelvic cysts mimicking hydro- nephrosis. Clin Case Rep 2018;6:760-1. 2. Tarzamni MK, Sobhani N, Nezami N, Ghiasi F. Bilateral para- pelvic cysts that mimic hydronephrosis in two imaging modalities: a case report. Cases J 2008;1:161.
Transcript of Bilateral Parapelvic Cyst Misdiagnosed as Hydronephrosis · 65 Images in Clinical Medicine ...
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Images in Clinical Medicine
www.cmj.ac.kr
https://doi.org/10.4068/cmj.2019.55.1.65Ⓒ Chonnam Medical Journal, 2019 Chonnam Med J 2019;55:65
Corresponding Author:Soo Wan KimDepartment of Internal Medicine, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, KoreaTel: +82-62-220-6271, Fax: +82-62-225-8578, E-mail: [email protected]
Article History:Received September 27, 2018Revised October 8, 2018Accepted October 15, 2018
FIG. 1. Ultrasonography image of left kidney. Septa between theparapelvic cysts are well defined on ultrasonographic exam.
FIG. 2. Abdominal computed tomography scan with intravenous pyelogram (CT IVP) image. (A) Axial view of the CT IVP scan withcontrast showing low attenuated lesions involving both the renalpelvis and calyces. (B) Urinary tract obstruction was not observedon reconstructed CT IVP image.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Bilateral Parapelvic Cyst Misdiagnosed as HydronephrosisHong Sang Choi, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, and Soo Wan Kim*
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
A 36-year-old man visited our hospital with a suspected bilateral hydronephrosis that was detected during a rou-tine check-up. Ultrasonography at the local clinic revealed a wide hypoechoic area in the center of both kidneys instead of a central echogenic complex (Fig. 1). Oliguria or abnor-mal laboratory values were not observed. On an axial view of the computed tomography with intravenous pyelogram (CT IVP) scan, low attenuated lesions with a cauliflower appearance were observed in the pelvises and calyces of both kidneys (Fig. 2A). No hydronephrosis or obstructive lesions in the urinary tract were observed on reconstructed intravenous pyelogram (IVP) image (Fig. 2B). A parapelvic cyst is a hypoechoic lesion located in the renal pelvis, which is often misdiagnosed as hydronephrosis because of its thin
wall.1,2 In conclusion, CT IVP is a useful test for the differ-ential diagnosis of parapelvic cysts.
CONFLICT OF INTEREST STATEMENT
None declared.
REFERENCES
1. Koratala A, Alquadan KF. Parapelvic cysts mimicking hydro-nephrosis. Clin Case Rep 2018;6:760-1.
2. Tarzamni MK, Sobhani N, Nezami N, Ghiasi F. Bilateral para-pelvic cysts that mimic hydronephrosis in two imaging modalities: a case report. Cases J 2008;1:161.
