Bosniak renal cyst (type II)
Complex cyst seen on ultrasound (images not available), for further IVP work-up.
CT Abdomen and pelvis (selected images)
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Images: no contrast, arterial phase, portal venous phase, and delayed. Exophytic cyst in the upper third of the right kidney measuring 2.3 cm in diameter and showing spontaneous attenuation greater than 20HU that does not significantly changed on the post contrast sequences.
This cases illustrates a renal cyst with non-enhancing high-attenuation likely due to proteinaceous or hemorrhagic contents. It measures less than 3 cm and does not have any imaging worrisome features, in keeping with a Bosniak 2 category. No further imaging is required.
The Bosniak classification system for CT evaluation of renal cysts is helpful in determining both malignant risk and required follow up / treatment.