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Benign Kidney Tumours
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==== Imaging ==== * '''<span style="color:#ff0000">Any renal lesion that is not a simple cyst should be further characterized with contrast-enhanced axial imaging to better characterize the cyst</span>''' ===== Bosniak classification of renal cysts ===== * '''Originally devised using CT scans''' ** Can be used in MRI, but '''MRI tends to exaggerate some findings related to cysts''' {| class="wikitable" |'''<span style="color:#ff0000">Bosniak category</span>''' |'''<span style="color:#ff0000">Key features</span>''' |'''<span style="color:#ff0000">Risk of malignancy</span>''' '''<span style="color:#0000ff">(5-15-55-90)</span>''' |'''CT Appearance''' |- |'''<span style="color:#ff0000">I (simple cyst)</span>''' | * '''Usually round or oval shape''' * '''Anechoic with posterior enhancement on US''' * '''Regular contour with clear interface with renal parenchyma''' * '''<span style="color:#ff0000">No septa, calcification or enhancement</span>''' | | |- |'''<span style="color:#ff0000">II</span>''' | * '''<span style="color:#ff0000">Single thin septum (<1 mm)</span>''' * '''<span style="color:#ff0000">Fine calcification (often small, linear, parietal, or septal)</span>''' * '''<span style="color:#ff0000">No perceived contrast enhancement</span>''' * '''<span style="color:#ff0000">Hypderdense cyst <3 cm; >20 HU</span>''' |'''<span style="color:#ff0000">5%</span>''' Likely gross overestimation of the true risk, as most of the malignant category II lesions had features that made them too complex to be considered a true category II cyst | |- |'''<span style="color:#ff0000">IIF</span>''' | * '''Cyst unequivocally categorized as category II or III cysts''' * '''<span style="color:#ff0000">Multiple thin septae or a slightly thickened, but smooth septa</span>''' * '''<span style="color:#ff0000">Calcifications β thick or nodular</span>''' * '''<span style="color:#ff0000">No perceived contrast enhancement</span>''' * '''<span style="color:#ff0000">Hyperdense cysts β₯3 cm</span>''' |'''<span style="color:#ff0000">8-27%</span>''' | |- |'''<span style="color:#ff0000">III</span>''' | * '''Uniform wall thickening and/or nodularity''' * '''Irregular, thickened, and/or calcified septa''' * '''<span style="color:#ff0000">Contrast-enhancing septa</span>''' |'''<span style="color:#ff0000">54%</span>''' | |- |'''<span style="color:#ff0000">IV</span>''' | * '''Wall-thickening''' * '''Gross, irregular, and nodular septal thickening</span>''' * '''<span style="color:#ff0000">Solid contrast-enhancing component, independent of septa</span>''' |'''<span style="color:#ff0000">88%</span>''' | |} * '''[https://pubs.rsna.org/doi/10.1148/radiol.2019182646 Proposed updated 2019 classification]''' * [https://radiopaedia.org/articles/bosniak-classification-system-of-renal-cystic-masses Radiopaedia article] on Bosniak classification of renal cysts
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