SpringerLink
Log in

Predominantly multiple focal non-cystic renal lesions: an imaging approach

  • Special Section: Editor’s Invite
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Multiple non-cystic renal lesions are occasionally discovered during imaging for various reasons and poses a diagnostic challenge to the practicing radiologist. These lesions may appear as a primary or dominant imaging finding or may be an additional abnormality in the setting of multiorgan involvement. Awareness of the imaging appearance of the various entities presenting as renal lesions integrated with associated extrarenal imaging findings along with clinical information is crucial for a proper diagnostic approach and patient work-up. This review summarizes the most relevant causes of infectious, inflammatory, vascular, and neoplastic disorders presenting as predominantly multiple focal non-cystic lesions.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21
Fig. 22
Fig. 23
Fig. 24
Fig. 25
Fig. 26
Fig. 27
Fig. 28
Fig. 29
Fig. 30
Fig. 31
Fig. 32
Fig. 33
Fig. 34
Fig. 35
Fig. 36
Fig. 37
Fig. 38
Fig. 39
Fig. 40
Fig. 41
Fig. 42
Fig. 43

Similar content being viewed by others

References

  1. Herts BR, Silverman SG, Hindman NM, Uzzo RG, Hartman RP, Israel GM, Baumgarten DA, Berland LL, Pandharipande PV. Management of the Incidental Renal Mass on CT: A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2018 Feb;15(2):264-273. https://doi.org/10.1016/j.jacr.2017.04.028.

    Article  PubMed  Google Scholar 

  2. Shetty AS, Fraum TJ, Ballard DH, Hoegger MJ, Itani M, Rajput MZ, Lanier MH, Cusworth BM, Mehrsheikh AL, Cabrera-Lebron JA, Chu J, Cunningham CR, Hirschi RS, Mokkarala M, Unteriner JG, Kim EH, Siegel CL, Ludwig DR. Renal Mass Imaging with MRI Clear Cell Likelihood Score: A User's Guide. Radiographics. 2023 Jul;43(7):e220209. https://doi.org/10.1148/rg.220209. PMID: 37319026.

    Article  PubMed  Google Scholar 

  3. Nicolau C, Aldecoa I, Bunesch L, Mallofre C, Sebastia C. The role of contrast agents in the diagnosis of renal diseases. Curr Probl Diagn Radiol. 2015 Jul-Aug;44(4):346-59. https://doi.org/10.1067/j.cpradiol.2015.02.001.

    Article  PubMed  Google Scholar 

  4. Ballard DH, De Alba L, Migliaro M, Previgliano CH, Sangster GP. CT imaging spectrum of infiltrative renal diseases. Abdom Radiol (NY). 2017 Nov;42(11):2700-2709. https://doi.org/10.1007/s00261-017-1193-5.

    Article  PubMed  Google Scholar 

  5. Sweet DE, Ward RD, Wang Y, Tanaka H, Campbell SC, Remer EM. Infiltrative Renal Malignancies: Imaging Features, Prognostic Implications, and Mimics. Radiographics. 2021 Mar-Apr;41(2):487-508. https://doi.org/10.1148/rg.2021200123.

    Article  PubMed  Google Scholar 

  6. Roussel E, Capitanio U, Kutikov A, Oosterwijk E, Pedrosa I, Rowe SP, Gorin MA. Novel Imaging Methods for Renal Mass Characterization: A Collaborative Review. Eur Urol. 2022 May;81(5):476-488. https://doi.org/10.1016/j.eururo.2022.01.040.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kochhar R, Brown RK, Wong CO, Dunnick NR, Frey KA, Manoharan P. Role of FDG PET/CT in imaging of renal lesions. J Med Imaging Radiat Oncol. 2010 Aug;54(4):347-57. https://doi.org/10.1111/j.1754-9485.2010.02181.x.

    Article  CAS  PubMed  Google Scholar 

  8. Zukotynski K, Lewis A, O'Regan K, Jacene H, Sakellis C, Almodovar S, Israel D. PET/CT and renal pathology: a blind spot for radiologists? Part 2--lymphoma, leukemia, and metastatic disease. AJR Am J Roentgenol. 2012 Aug;199(2):W168-74. https://doi.org/10.2214/AJR.11.7923.

    Article  PubMed  Google Scholar 

  9. Johnson JR, Russo TA. Acute Pyelonephritis in Adults. N Engl J Med. 2018;378(1):48-59. https://doi.org/10.1056/nejmcp1702758. Erratum in: N Engl J Med. 2018;378(11):1069.

  10. Expert Panel on Urological Imaging; Smith AD, Nikolaidis P, Khatri G, Chong ST, De Leon AD, Ganeshan D, Gore JL, Gupta RT, Kwun R, Lyshchik A, Nicola R, Purysko AS, Savage SJ, Taffel MT, Yoo DC, Delaney EW, Lockhart ME. ACR Appropriateness Criteria® Acute Pyelonephritis: 2022 Update. J Am Coll Radiol. 2022;19(11S):S224-S239. https://doi.org/10.1016/j.jacr.2022.09.017.

  11. Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010 Dec;7(12):653-60. https://doi.org/10.1038/nrurol.2010.190.

    Article  PubMed  Google Scholar 

  12. Stamm WE, Hooton TM, Johnson JR, Johnson C, Stapleton A, Roberts PL, Moseley SL, Fihn SD. Urinary tract infections: from pathogenesis to treatment. J Infect Dis. 1989 Mar;159(3):400-6. https://doi.org/10.1093/infdis/159.3.400.

    Article  CAS  PubMed  Google Scholar 

  13. Craig WD, Wagner BJ, Travis MD. Pyelonephritis: radiologic-pathologic review. Radiographics. 2008;28(1):255–77; quiz 327–8. https://doi.org/10.1148/rg.281075171.

  14. Choong FX, Antypas H, Richter-Dahlfors A. Integrated Pathophysiology of Pyelonephritis. Microbiol Spectr. 2015;3(5). https://doi.org/10.1128/microbiolspec.UTI-0014-2012.

  15. Wolin EA, Hartman DS, Olson JR. Nephrographic and pyelographic analysis of CT urography: principles, patterns, and pathophysiology. AJR Am J Roentgenol. 2013 Jun;200(6):1210-4. https://doi.org/10.2214/AJR.12.9691.

    Article  PubMed  Google Scholar 

  16. Goel RH, Unnikrishnan R, Remer EM. Acute Urinary Tract Disorders. Radiol Clin North Am. 2015 Nov;53(6):1273-92. https://doi.org/10.1016/j.rcl.2015.06.011.

    Article  PubMed  Google Scholar 

  17. Shah JN, Gandhi D, Prasad SR, Sandhu PK, Banker H, Molina R, Khan S, Garg T, Katabathina VS. Wunderlich Syndrome: Comprehensive Review of Diagnosis and Management. Radiographics. 2023;43(6):e220172. https://doi.org/10.1148/rg.220172. Erratum in: Radiographics. 2023;43(7):e239007.

  18. Global tuberculosis report 2023. Geneva: World Health Organization; 2023. Licence: CC BY-NC-SA 3.0 IGO.

  19. Figueiredo AA, Lucon AM, Junior RF, Srougi M. Epidemiology of urogenital tuberculosis worldwide. Int J Urol 2008;15(9):827–832.

    Article  PubMed  Google Scholar 

  20. Merchant S, Bharati A, Merchant N. Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part I. Indian J Radiol Imaging. 2013 Jan;23(1):46-63. https://doi.org/10.4103/0971-3026.113615.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Naeem M, Menias CO, Cail AJ, Zulfiqar M, Ballard DH, Pickhardt PJ, Kim DH, Lubner MG, Mellnick VM. Imaging Spectrum of Granulomatous Diseases of the Abdomen and Pelvis. Radiographics. 2021 May-Jun;41(3):783-801. https://doi.org/10.1148/rg.2021200172.

    Article  PubMed  Google Scholar 

  22. Muneer A, Macrae B, Krishnamoorthy S, Zumla A. Urogenital tuberculosis - epidemiology, pathogenesis and clinical features. Nat Rev Urol. 2019 Oct;16(10):573-598. https://doi.org/10.1038/s41585-019-0228-9.

    Article  PubMed  Google Scholar 

  23. Merchant S, Bharati A, Merchant N. Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II. Indian J Radiol Imaging. 2013 Jan;23(1):64-77. https://doi.org/10.4103/0971-3026.113617.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lester R, Rex J. Fungaemia and disseminated infection. In: Kibbler C.C., and others (eds), Oxford Textbook of Medical Mycology. Oxford University Press; 2018. pp. 163–170. https://doi.org/10.1093/med/9780198755388.003.0025, accessed 13 Feb. 2024.

  25. Sobel J. Genito-urinary fungal infections. In: Kibbler C.C., and others (eds), Oxford Textbook of Medical Mycology. Oxford University Press; 2018. pp. 177.182. https://doi.org/10.1093/med/9780198755388.003.0025, accessed 13 Feb. 2024.

  26. Maziarz E, Perfect J. Fungal infections of the kidney and those associated with renal failure, dialysis, and renal transplantation. In: Kibbler C.C., and others (eds), Oxford Textbook of Medical Mycology. Oxford University Press; 2018. pp. 190–204. https://doi.org/10.1093/med/9780198755388.003.0025, accessed 13 Feb. 2024.

  27. Orlowski HLP, McWilliams S, Mellnick VM, Bhalla S, Lubner MG, Pickhardt PJ, Menias CO. Imaging Spectrum of Invasive Fungal and Fungal-like Infections. Radiographics. 2017 Jul-Aug;37(4):1119-1134. https://doi.org/10.1148/rg.2017160110.

    Article  PubMed  Google Scholar 

  28. Fisher JF, Kavanagh K, Sobel JD, Kauffman CA, Newman CA. Candida urinary tract infection: pathogenesis. Clin Infect Dis. 2011 May;52 Suppl 6:S437-51. https://doi.org/10.1093/cid/cir110.

    Article  PubMed  Google Scholar 

  29. Moore NJ, Leef JL 3rd, Pang Y. Systemic candidiasis. Radiographics. 2003;23(5):1287–90. https://doi.org/10.1148/rg.235025162.

  30. Eggimann P, Garbino J, Pittet D. Epidemiology of Candida species infections in critically ill non-immunosuppressed patients. Lancet Infect Dis. 2003 Nov;3(11):685-702. https://doi.org/10.1016/s1473-3099(03)00801-6.

    Article  PubMed  Google Scholar 

  31. Dimopoulos G, Karabinis A, Samonis G, Falagas ME. Candidemia in immunocompromised and immunocompetent critically ill patients: a prospective comparative study. Eur J Clin Microbiol Infect Dis. 2007 Jun;26(6):377-84. https://doi.org/10.1007/s10096-007-0316-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Oh JW, Rha SE, Choi MH, Oh SN, Youn SY, Choi JI. Immunoglobulin G4-related Disease of the Genitourinary System: Spectrum of Imaging Findings and Clinical-Pathologic Features. Radiographics. 2020 Sep-Oct;40(5):1265-1283. https://doi.org/10.1148/rg.2020200043.

    Article  PubMed  Google Scholar 

  33. Lanzillotta M, Mancuso G, Della-Torre E. Advances in the diagnosis and management of IgG4 related disease. BMJ. 2020 Jun 16;369:m1067. https://doi.org/10.1136/bmj.m1067.

    Article  Google Scholar 

  34. Salvadori M, Tsalouchos A. Immunoglobulin G4-related kidney diseases: An updated review. World J Nephrol. 2018 Jan 6;7(1):29-40. https://doi.org/10.5527/wjn.v7.i1.29.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Vlachou PA, Khalili K, Jang HJ, Fischer S, Hirschfield GM, Kim TK. IgG4-related sclerosing disease: autoimmune pancreatitis and extrapancreatic manifestations. Radiographics. 2011 Sep-Oct;31(5):1379-402. https://doi.org/10.1148/rg.315105735.

    Article  PubMed  Google Scholar 

  36. Takahashi N, Kawashima A, Fletcher JG, Chari ST. Renal involvement in patients with autoimmune pancreatitis: CT and MR imaging findings. Radiology. 2007 Mar;242(3):791-801. https://doi.org/10.1148/radiol.2423060003.

    Article  PubMed  Google Scholar 

  37. Seo N, Kim JH, Byun JH, Lee SS, Kim HJ, Lee MG. Immunoglobulin G4-Related Kidney Disease: A Comprehensive Pictorial Review of the Imaging Spectrum, Mimickers, and Clinicopathological Characteristics. Korean J Radiol. 2015 Sep-Oct;16(5):1056-67. https://doi.org/10.3348/kjr.2015.16.5.1056.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Sah RP, Chari ST. Serologic issues in IgG4-related systemic disease and autoimmune pancreatitis. Curr Opin Rheumatol. 2011 Jan;23(1):108-13. https://doi.org/10.1097/BOR.0b013e3283413469.

    Article  CAS  PubMed  Google Scholar 

  39. Kim B, Kim JH, Byun JH, Kim HJ, Lee SS, Kim SY, Lee MG. IgG4-related kidney disease: MRI findings with emphasis on the usefulness of diffusion-weighted imaging. Eur J Radiol. 2014 Jul;83(7):1057-1062. https://doi.org/10.1016/j.ejrad.2014.03.033.

    Article  PubMed  Google Scholar 

  40. Wallace ZS, Naden RP, Chari S, Choi H, Della-Torre E, Dicaire JF, Hart PA, Inoue D, Kawano M, Khosroshahi A, Kubota K, Lanzillotta M, Okazaki K, Perugino CA, Sharma A, Saeki T, Sekiguchi H, Schleinitz N, Stone JR, Takahashi N, Umehara H, Webster G, Zen Y, Stone JH; American College of Rheumatology/European League Against Rheumatism IgG4-Related Disease Classification Criteria Working Group. The 2019 American College of Rheumatology/European League Against Rheumatism Classification Criteria for IgG4-Related Disease. Arthritis Rheumatol. 2020 Jan;72(1):7–19. https://doi.org/10.1002/art.41120.

  41. Saeki T, Nagasawa T, Ubara Y, Taniguchi Y, Yanagita M, Nishi S, Nagata M, Yamaguchi Y, Saito T, Nakashima H, Kawano M. Validation of the 2019 ACR/EULAR criteria for IgG4-related disease in a Japanese kidney disease cohort: a multicentre retrospective study by the IgG4-related kidney disease working group of the Japanese Society of Nephrology. Ann Rheum Dis. 2021 Jul;80(7):956-957. https://doi.org/10.1136/annrheumdis-2020-219510.

    Article  PubMed  Google Scholar 

  42. Wu H, Huang J. Drug-Induced Nephrotoxicity: Pathogenic Mechanisms, Biomarkers and Prevention Strategies. Curr Drug Metab. 2018;19(7):559-567. https://doi.org/10.2174/1389200218666171108154419.

    Article  CAS  PubMed  Google Scholar 

  43. Sales GTM, Foresto RD. Drug-induced nephrotoxicity. Rev Assoc Med Bras (1992). 2020 Jan 13;66Suppl 1(Suppl 1):s82–s90. https://doi.org/10.1590/1806-9282.66.S1.82.

  44. Yousif ZK, Koola JD, Macedo E, Cerda J, Goldstein SL, Chakravarthi R, Lewington A, Selewski D, Zappitelli M, Cruz D, Tolwani A, Joy MS, Jha V, Ramachandran R, Ostermann M, Pandya B, Acharya A, Brophy P, Ponce D, Steinke J, Bouchard J, Irarrazabal CE, Irarrazabal R, Boltansky A, Askenazi D, Kolhe N, Claure-Del Granado R, Benador N, Castledine C, Davenport A, Barratt J, Bhandari S, Riley AA, Davis TK, Farmer C, Hogarth M, Thomas M, Murray PT, Robinson-Cohen C, Nicoletti P, Vaingankar S, Mehta R, Awdishu L. Clinical Characteristics and Outcomes of Drug-Induced Acute Kidney Injury Cases. Kidney Int Rep. 2023 Aug 14;8(11):2333-2344. https://doi.org/10.1016/j.ekir.2023.07.037.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Liu C, Yan S, Wang Y, Wang J, Fu X, Song H, Tong R, Dong M, Ge W, Wang J, Yang H, Wang C, **a P, Zhao L, Shen S, **e J, Xu Y, Ma P, Li H, Lu S, Ding Y, Jiang L, Lin Y, Wang M, Qiu F, Feng W, Yang L. Drug-Induced Hospital-Acquired Acute Kidney Injury in China: A Multicenter Cross-Sectional Survey. Kidney Dis (Basel). 2021 Mar;7(2):143-155. https://doi.org/10.1159/000510455.

    Article  PubMed  Google Scholar 

  46. Naughton CA. Drug-induced nephrotoxicity. Am Fam Physician. 2008 Sep 15;78(6):743-50.

    PubMed  Google Scholar 

  47. Kwiatkowska E, Domański L, Dziedziejko V, Kajdy A, Stefańska K, Kwiatkowski S. The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage. Int J Mol Sci. 2021 Jun 6;22(11):6109. https://doi.org/10.3390/ijms22116109.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. McDonald JS, McDonald RJ. Risk of Acute Kidney Injury Following IV Iodinated Contrast Media Exposure: 2023 Update, From the AJR Special Series on Contrast Media. AJR Am J Roentgenol. 2023 Oct 4. https://doi.org/10.2214/AJR.23.30037.

    Article  PubMed  Google Scholar 

  49. Krishnan N, Perazella MA. Drug-induced acute interstitial nephritis: pathology, pathogenesis, and treatment. Iran J Kidney Dis. 2015 Jan;9(1):3-13. PMID: 25599729.

    PubMed  Google Scholar 

  50. Gérard AO, Merino D, Laurain A, Cremoni M, Andreani M, Rocher F, Destere A, Esnault VLM, Sicard A, Drici MD. Drug-Induced Tubulointerstitial Nephritis: Insights From the World Health Organization Safety Database. Kidney Int Rep. 2022 May 5;7(7):1699-1702. https://doi.org/10.1016/j.ekir.2022.04.090.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Sato T, Kawasaki Y, Ito A, Izumi H, Kawamorita N, Yamashita S, Mitsuzuka K, Matsuura T, Watanabe M, Arai Y. Infliximab-Induced Tubulointerstitial Nephritis with Image Findings of Striated Nephrogram in Crohn's Disease. Tohoku J Exp Med. 2018 Jul;245(3):149-152. https://doi.org/10.1620/tjem.245.149.

    Article  PubMed  Google Scholar 

  52. Davis J, Desmond M, Berk M. Lithium and nephrotoxicity: a literature review of approaches to clinical management and risk stratification. BMC Nephrol. 2018 Nov 3;19(1):305. https://doi.org/10.1186/s12882-018-1101-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Farres MT, Ronco P, Saadoun D, Remy P, Vincent F, Khalil A, Le Blanche AF. Chronic lithium nephropathy: MR imaging for diagnosis. Radiology. 2003 Nov;229(2):570-4. https://doi.org/10.1148/radiol.2292020758.

    Article  PubMed  Google Scholar 

  54. Cai Y, Shi Z, Bai Y. Review of Rosai-Dorfman Disease: New Insights into the Pathogenesis of This Rare Disorder. Acta Haematol. 2017;138(1):14-23. https://doi.org/10.1159/000475588.

    Article  CAS  PubMed  Google Scholar 

  55. Abla O, Jacobsen E, Picarsic J, Krenova Z, Jaffe R, Emile JF, Durham BH, Braier J, Charlotte F, Donadieu J, Cohen-Aubart F, Rodriguez-Galindo C, Allen C, Whitlock JA, Weitzman S, McClain KL, Haroche J, Diamond EL. Consensus recommendations for the diagnosis and clinical management of Rosai-Dorfman-Destombes disease. Blood. 2018 Jun 28;131(26):2877-2890. https://doi.org/10.1182/blood-2018-03-839753.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Goyal G, Ravindran A, Young JR, Shah MV, Bennani NN, Patnaik MM, Nowakowski GS, Thanarajasingam G, Habermann TM, Vassallo R, Sher T, Parikh SA, Rech KL, Go RS; Mayo Clinic Histiocytosis Working Group. Clinicopathological features, treatment approaches, and outcomes in Rosai-Dorfman disease. Haematologica. 2020;105(2):348–357. https://doi.org/10.3324/haematol.2019.219626.

  57. Abrishami A, Ziaeefar P, Ebrahimi S, Khalili N, Nouralizadeh A, Farjad R. Rosai-Dorfman disease: A case report of asymptomatic isolated renal involvement. Clin Case Rep. 2021 Jul 10;9(7):e04132. https://doi.org/10.1002/ccr3.4132.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Gumeler E, Onur MR, Karaosmanoglu AD, Ozmen M, Akata D, Karcaaltincaba M. Computed tomography and magnetic resonance imaging of peripelvic and periureteric pathologies. Abdom Radiol (NY). 2018 Sep;43(9):2400-2411. https://doi.org/10.1007/s00261-017-1444-5.

    Article  PubMed  Google Scholar 

  59. Brown WE, Coakley FV, Heaney M. Renal involvement by Rosai-Dorfman disease: CT findings. Abdom Imaging. 2002 Mar-Apr;27(2):214–6. https://doi.org/10.1007/s00261-001-0061-4.

  60. Lai FM, To KF, Szeto CC, Wang AY, Ahuja AT, Choi PC, Leung CB, Kew J, Li PK. Acute renal failure in a patient with Rosai-Dorfman disease. Am J Kidney Dis. 1999 Sep;34(3):e12. https://doi.org/10.1016/s0272-6386(99)70098-3.

    Article  CAS  PubMed  Google Scholar 

  61. Huynh KN, Nguyen BD. Histiocytosis and Neoplasms of Macrophage-Dendritic Cell Lineages: Multimodality Imaging with Emphasis on PET/CT. Radiographics. 2021 Mar-Apr;41(2):576-594. https://doi.org/10.1148/rg.2021200096.

    Article  PubMed  Google Scholar 

  62. Pegoraro F, Papo M, Maniscalco V, Charlotte F, Haroche J, Vaglio A. Erdheim-Chester disease: a rapidly evolving disease model. Leukemia. 2020 Nov;34(11):2840-2857. https://doi.org/10.1038/s41375-020-0944-4.

    Article  CAS  PubMed  Google Scholar 

  63. Goyal G, Heaney ML, Collin M, Cohen-Aubart F, Vaglio A, Durham BH, Hershkovitz-Rokah O, Girschikofsky M, Jacobsen ED, Toyama K, Goodman AM, Hendrie P, Cao XX, Estrada-Veras JI, Shpilberg O, Abdo A, Kurokawa M, Dagna L, McClain KL, Mazor RD, Picarsic J, Janku F, Go RS, Haroche J, Diamond EL. Erdheim-Chester disease: consensus recommendations for evaluation, diagnosis, and treatment in the molecular era. Blood. 2020 May 28;135(22):1929-1945. https://doi.org/10.1182/blood.2019003507.

    Article  CAS  PubMed  Google Scholar 

  64. Chazal T, Pegoraro F, Manari G, Bettiol A, Maniscalco V, Gelain E, Charlotte F, Mazor RD, Renard-Penna R, Amoura Z, Cohen-Aubart F, Haroche J, Izzedine H, Vaglio A. Clinical phenotypes and long-term outcome of kidney involvement in Erdheim-Chester histiocytosis. Kidney Int. 2023 Jan;103(1):177-186. https://doi.org/10.1016/j.kint.2022.09.027.

    Article  PubMed  Google Scholar 

  65. Purysko AS, Westphalen AC, Remer EM, Coppa CP, Leão Filho HM, Herts BR. Imaging Manifestations of Hematologic Diseases with Renal and Perinephric Involvement. Radiographics. 2016 Jul-Aug;36(4):1038-54. https://doi.org/10.1148/rg.2016150213.

    Article  PubMed  Google Scholar 

  66. Suzer O, Shirkhoda A, Jafri SZ, Madrazo BL, Bis KG, Mastromatteo JF. CT features of renal infarction. Eur J Radiol. 2002 Oct;44(1):59-64. https://doi.org/10.1016/s0720-048x(01)00476-4.

    Article  PubMed  Google Scholar 

  67. Antopolsky M, Simanovsky N, Stalnikowicz R, Salameh S, Hiller N. Renal infarction in the ED: 10-year experience and review of the literature. Am J Emerg Med. 2012 Sep;30(7):1055-60. https://doi.org/10.1016/j.ajem.2011.06.041.

    Article  PubMed  Google Scholar 

  68. Woo S, Seo D, Cho YS, Lee JW, Moon J, Nah S, Han S. Clinical factors distinguishing renal infarction from acute pyelonephritis: A randomly matched retrospective case-control study. Am J Emerg Med. 2023 Oct;72:88-94. https://doi.org/10.1016/j.ajem.2023.07.036.

    Article  PubMed  Google Scholar 

  69. Saeed K. Renal infarction. Int J Nephrol Renovasc Dis. 2012;5:119-23. https://doi.org/10.2147/IJNRD.S33768.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Bourgault M, Grimbert P, Verret C, Pourrat J, Herody M, Halimi JM, Karras A, Amoura Z, Jourde-Chiche N, Izzedine H, François H, Boffa JJ, Hummel A, Bernadet-Monrozies P, Fouque D, Canouï-Poitrine F, Lang P, Daugas E, Audard V. Acute renal infarction: a case series. Clin J Am Soc Nephrol. 2013 Mar;8(3):392-8. https://doi.org/10.2215/CJN.05570612.

    Article  PubMed  Google Scholar 

  71. Scolari F, Ravani P. Atheroembolic renal disease. Lancet. 2010 May 8;375(9726):1650-60. https://doi.org/10.1016/S0140-6736(09)62073-0.

    Article  PubMed  Google Scholar 

  72. Ambesh P, Lal H. Renal cortical rim sign. Abdom Imaging. 2015 Oct;40(7):2914-5. https://doi.org/10.1007/s00261-015-0483-z.

    Article  PubMed  Google Scholar 

  73. Piccoli GB, Priola AM, Vigotti FN, Guzzo G, Veltri A. Renal infarction versus pyelonephritis in a woman presenting with fever and flank pain. Am J Kidney Dis. 2014 Aug;64(2):311-4. https://doi.org/10.1053/j.ajkd.2014.02.027.

    Article  PubMed  Google Scholar 

  74. Leto C, Giambelluca D, Bruno A, Midiri M, Salvaggio G. "Flip-flop enhancement" in renal infarction. Abdom Radiol (NY). 2019 Apr;44(4):1625-1626. https://doi.org/10.1007/s00261-018-1843-2.

    Article  PubMed  Google Scholar 

  75. Shiekh Y, Ilyas M. Reverse rim sign: acute renal cortical necrosis. Abdom Radiol (NY). 2018 Dec;43(12):3507-3508. https://doi.org/10.1007/s00261-018-1607-z.

    Article  PubMed  Google Scholar 

  76. Wolff L, Horisberger A, Moi L, Karampetsou MP, Comte D. Polyarteritis Nodosa: Old Disease, New Etiologies. Int J Mol Sci. 2023 Nov 23;24(23):16668. https://doi.org/10.3390/ijms242316668.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Hočevar A, Tomšič M, Perdan Pirkmajer K. Clinical Approach to Diagnosis and Therapy of Polyarteritis Nodosa. Curr Rheumatol Rep. 2021 Feb 10;23(3):14. https://doi.org/10.1007/s11926-021-00983-2.

    Article  PubMed  Google Scholar 

  78. De Virgilio A, Greco A, Magliulo G, Gallo A, Ruoppolo G, Conte M, Martellucci S, de Vincentiis M. Polyarteritis nodosa: A contemporary overview. Autoimmun Rev. 2016 Jun;15(6):564-70. https://doi.org/10.1016/j.autrev.2016.02.015.

    Article  PubMed  Google Scholar 

  79. Maritati F, Iannuzzella F, Pavia MP, Pasquali S, Vaglio A. Kidney involvement in medium- and large-vessel vasculitis. J Nephrol. 2016 Aug;29(4):495-505. https://doi.org/10.1007/s40620-016-0303-8.

    Article  CAS  PubMed  Google Scholar 

  80. Ozaki K, Miyayama S, Ushiogi Y, Matsui O. Renal involvement of polyarteritis nodosa: CT and MR findings. Abdom Imaging. 2009 Mar-Apr;34(2):265-70. https://doi.org/10.1007/s00261-008-9377-7.

    Article  PubMed  Google Scholar 

  81. Venkatanarasimha N, Irani F. Polyarteritis Nodosa. Radiology. 2023 Mar;306(3):e221255. https://doi.org/10.1148/radiol.221255.

    Article  PubMed  Google Scholar 

  82. Chung SA, Gorelik M, Langford CA, Maz M, Abril A, Guyatt G, Archer AM, Conn DL, Full KA, Grayson PC, Ibarra MF, Imundo LF, Kim S, Merkel PA, Rhee RL, Seo P, Stone JH, Sule S, Sundel RP, Vitobaldi OI, Warner A, Byram K, Dua AB, Husainat N, James KE, Kalot M, Lin YC, Springer JM, Turgunbaev M, Villa-Forte A, Turner AS, Mustafa RA. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Polyarteritis Nodosa. Arthritis Rheumatol. 2021 Aug;73(8):1384-1393. https://doi.org/10.1002/art.41776.

    Article  PubMed  Google Scholar 

  83. Stanson AW, Friese JL, Johnson CM, McKusick MA, Breen JF, Sabater EA, Andrews JC. Polyarteritis nodosa: spectrum of angiographic findings. Radiographics. 2001 Jan-Feb;21(1):151-9. https://doi.org/10.1148/radiographics.21.1.g01ja16151.

    Article  CAS  PubMed  Google Scholar 

  84. Lopes Vendrami C, Parada Villavicencio C, DeJulio TJ, Chatterjee A, Casalino DD, Horowitz JM, Oberlin DT, Yang GY, Nikolaidis P, Miller FH. Differentiation of Solid Renal Tumors with Multiparametric MR Imaging. Radiographics. 2017 Nov-Dec;37(7):2026-2042. https://doi.org/10.1148/rg.2017170039.

    Article  PubMed  Google Scholar 

  85. Bracken RB, Chica G, Johnson DE, Luna M. Secondary renal neoplasms: an autopsy study. South Med J. 1979 Jul;72(7):806-7. https://doi.org/10.1097/00007611-197907000-00013.

    Article  CAS  PubMed  Google Scholar 

  86. Abrams HL, Spiro R, Goldstein N. Metastases in carcinoma; analysis of 1000 autopsied cases. Cancer. 1950 Jan;3(1):74-85. https://doi.org/10.1002/1097-0142.

    Article  CAS  PubMed  Google Scholar 

  87. Zhou C, Urbauer DL, Fellman BM, Tamboli P, Zhang M, Matin SF, Wood CG, Karam JA. Metastases to the kidney: a comprehensive analysis of 151 patients from a tertiary referral centre. BJU Int. 2016 May;117(5):775-82. https://doi.org/10.1111/bju.13194.

    Article  PubMed  Google Scholar 

  88. Choyke PL, White EM, Zeman RK, Jaffe MH, Clark LR. Renal metastases: clinicopathologic and radiologic correlation. Radiology. 1987 Feb;162(2):359-63. https://doi.org/10.1148/radiology.162.2.3797648.

    Article  CAS  PubMed  Google Scholar 

  89. Prasad SR, Dalrymple NC, Surabhi VR. Cross-sectional imaging evaluation of renal masses. Radiol Clin North Am. 2008;46(1):95–111, vi–vii. https://doi.org/10.1016/j.rcl.2008.01.008.

  90. Honda H, Coffman CE, Berbaum KS, Barloon TJ, Masuda K. CT analysis of metastatic neoplasms of the kidney. Comparison with primary renal cell carcinoma. Acta Radiol. 1992 Jan;33(1):39–44.

  91. Miyake O, Namiki M, Sonoda T, Kitamura H. Secondary involvement of genitourinary organs in malignant lymphoma. Urol Int. 1987;42(5):360-2. https://doi.org/10.1159/000281993.

    Article  CAS  PubMed  Google Scholar 

  92. Chepuri NB, Strouse PJ, Yanik GA. CT of renal lymphoma in children. AJR Am J Roentgenol. 2003 Feb;180(2):429-31. https://doi.org/10.2214/ajr.180.2.1800429.

    Article  PubMed  Google Scholar 

  93. Reznek RH, Mootoosamy I, Webb JA, Richards MA. CT in renal and perirenal lymphoma: a further look. Clin Radiol. 1990 Oct;42(4):233-8. https://doi.org/10.1016/s0009-9260(05)82109-9. Erratum in: Clin Radiol 1991 Apr;43(4):289.

    Article  CAS  PubMed  Google Scholar 

  94. Sheth S, Ali S, Fishman E. Imaging of renal lymphoma: patterns of disease with pathologic correlation. Radiographics. 2006 Jul-Aug;26(4):1151-68. https://doi.org/10.1148/rg.264055125.

    Article  PubMed  Google Scholar 

  95. Chen J, Peng J, Zheng Y, Li S, Yang P, Wu X, Tian H, Liu H, Yang S, Wang W, Wu B. Primary renal lymphoma: a population-based study in the United States, 1980-2013. Sci Rep. 2019 Oct 22;9(1):15125. https://doi.org/10.1038/s41598-019-51635-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Nguyen T, Gupta A, Bhatt S. Multimodality imaging of renal lymphoma and its mimics. Insights Imaging. 2022 Aug 13;13(1):131. https://doi.org/10.1186/s13244-022-01260-1.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Heiken JP, Gold RP, Schnur MJ, King DL, Bashist B, Glazer HS. Computed tomography of renal lymphoma with ultrasound correlation. J Comput Assist Tomogr. 1983 Apr;7(2):245-50. https://doi.org/10.1097/00004728-198304000-00007.

    Article  CAS  PubMed  Google Scholar 

  98. El-Galaly TC, Villa D, Gormsen LC, Baech J, Lo A, Cheah CY. FDG-PET/CT in the management of lymphomas: current status and future directions. J Intern Med. 2018 Oct;284(4):358-376. https://doi.org/10.1111/joim.12813.

    Article  CAS  PubMed  Google Scholar 

  99. Cohan RH, Dunnick NR, Leder RA, Baker ME. Computed tomography of renal lymphoma. J Comput Assist Tomogr. 1990 Nov-Dec;14(6):933-8. https://doi.org/10.1097/00004728-199011000-00013.

    Article  CAS  PubMed  Google Scholar 

  100. Chennamadhavuni A, Lyengar V, Mukkamalla SKR, et al. Leukemia. [Updated 2023 Jan 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560490/

  101. Luciano RL, Brewster UC. Kidney involvement in leukemia and lymphoma. Adv Chronic Kidney Dis. 2014 Jan;21(1):27-35. https://doi.org/10.1053/j.ackd.2013.07.004.

    Article  PubMed  Google Scholar 

  102. Northrup BE, Jokerst CE, Grubb RL 3rd, Menias CO, Khanna G, Siegel CL. Hereditary renal tumor syndromes: imaging findings and management strategies. AJR Am J Roentgenol. 2012 Dec;199(6):1294-304. https://doi.org/10.2214/AJR.12.9079.

    Article  PubMed  Google Scholar 

  103. Choyke PL, Glenn GM, Walther MM, Zbar B, Linehan WM. Hereditary renal cancers. Radiology. 2003 Jan;226(1):33-46. https://doi.org/10.1148/radiol.2261011296.

    Article  PubMed  Google Scholar 

  104. Carlo MI. Hereditary Renal Cell Carcinoma Syndromes. Hematol Oncol Clin North Am. 2023 Oct;37(5):841-848. https://doi.org/10.1016/j.hoc.2023.04.013.

    Article  PubMed  Google Scholar 

  105. Haas NB, Nathanson KL. Hereditary kidney cancer syndromes. Adv Chronic Kidney Dis. 2014 Jan;21(1):81-90. https://doi.org/10.1053/j.ackd.2013.10.001.

    Article  PubMed  Google Scholar 

  106. Gaur S, Turkbey B, Choyke P. Hereditary Renal Tumor Syndromes: Update on Diagnosis and Management. Semin Ultrasound CT MR. 2017 Feb;38(1):59-71. https://doi.org/10.1053/j.sult.2016.10.002. Epub 2016 Oct 14.

    Article  PubMed  Google Scholar 

  107. Leung RS, Biswas SV, Duncan M, Rankin S. Imaging features of von Hippel–Lindau disease. Radiographics. 2008;28(1):65–79; quiz 323. https://doi.org/10.1148/rg.281075052.

  108. Shanbhogue KP, Hoch M, Fatterpaker G, Chandarana H. von Hippel-Lindau Disease: Review of Genetics and Imaging. Radiol Clin North Am. 2016 May; 54(3):409-22. https://doi.org/10.1016/j.rcl.2015.12.004.

    Article  PubMed  Google Scholar 

  109. Jonasch E, Donskov F, Iliopoulos O, Rathmell WK, Narayan VK, Maughan BL, Oudard S, Else T, Maranchie JK, Welsh SJ, Thamake S, Park EK, Perini RF, Linehan WM, Srinivasan R; MK-6482–004 Investigators. Belzutifan for Renal Cell Carcinoma in von Hippel-Lindau Disease. N Engl J Med. 2021;385(22):2036–2046. https://doi.org/10.1056/NEJMoa2103425.

  110. Wolters WPG, Dreijerink KMA, Giles RH, van der Horst-Schrivers ANA, van Nesselrooij B, Zandee WT, Timmers HJLM, Seute T, de Herder WW, Verrijn Stuart AA, Kilic E, Brinkman WM, Zondervan PJ, Vandertop WP, Daniels AB, Wolbers T, Links TP, van Leeuwaarde RS. Multidisciplinary integrated care pathway for von Hippel-Lindau disease. Cancer. 2022 Aug 1;128(15):2871-2879. https://doi.org/10.1002/cncr.34265.

    Article  CAS  PubMed  Google Scholar 

  111. Wang MX, Segaran N, Bhalla S, Pickhardt PJ, Lubner MG, Katabathina VS, Ganeshan D. Tuberous Sclerosis: Current Update. Radiographics. 2021 Nov-Dec;41(7):1992-2010. https://doi.org/10.1148/rg.2021210103.

    Article  PubMed  Google Scholar 

  112. Kingswood JC, d'Augères GB, Belousova E, Ferreira JC, Carter T, Castellana R, Cottin V, Curatolo P, Dahlin M, de Vries PJ, Feucht M, Fladrowski C, Gislimberti G, Hertzberg C, Jozwiak S, Lawson JA, Macaya A, Nabbout R, O'Callaghan F, Benedik MP, Qin J, Marques R, Sander V, Sauter M, Takahashi Y, Touraine R, Youroukos S, Zonnenberg B, Jansen AC; TOSCA consortium and TOSCA investigators. TuberOus SClerosis registry to increase disease Awareness (TOSCA) - baseline data on 2093 patients. Orphanet J Rare Dis. 2017;12(1):2. https://doi.org/10.1186/s13023-016-0553-5.

  113. Nair N, Chakraborty R, Mahajan Z, Sharma A, Sethi SK, Raina R. Renal Manifestations of Tuberous Sclerosis Complex. J Kidney Cancer VHL. 2020;7(3):5–19. https://doi.org/10.15586/jkcvhl.2020.131.

  114. Uysal SP, Şahin M. Tuberous sclerosis: a review of the past, present, and future. Turk J Med Sci. 2020;50(SI-2):1665–1676. https://doi.org/10.3906/sag-2002-133.

  115. Manoukian SB, Kowal DJ. Comprehensive imaging manifestations of tuberous sclerosis. AJR Am J Roentgenol. 2015 May;204(5):933-43. https://doi.org/10.2214/AJR.13.12235. PMID: 25905927.

    Article  PubMed  Google Scholar 

  116. Menko FH, van Steensel MA, Giraud S, Friis-Hansen L, Richard S, Ungari S, Nordenskjöld M, Hansen TV, Solly J, Maher ER; European BHD Consortium. Birt–Hogg–Dubé syndrome: diagnosis and management. Lancet Oncol. 2009;10(12):1199–206. https://doi.org/10.1016/S1470-2045(09)70188-3.

  117. Steinlein OK, Ertl-Wagner B, Ruzicka T, Sattler EC. Birt-Hogg-Dubé syndrome: an underdiagnosed genetic tumor syndrome. J Dtsch Dermatol Ges. 2018 Mar;16(3):278-283. https://doi.org/10.1111/ddg.13457.

    Article  PubMed  Google Scholar 

  118. Dal Sasso AA, Belém LC, Zanetti G, Souza CA, Escuissato DL, Irion KL, Guimarães MD, Marchiori E. Birt-Hogg-Dubé syndrome. State-of-the-art review with emphasis on pulmonary involvement. Respir Med. 2015;109(3):289–96. https://doi.org/10.1016/j.rmed.2014.11.008. Epub 2014 Dec 9.

  119. Ishigami K, Jones AR, Dahmoush L, Leite LV, Pakalniskis MG, Barloon TJ. Imaging spectrum of renal oncocytomas: a pictorial review with pathologic correlation. Insights Imaging. 2015 Feb;6(1):53-64. https://doi.org/10.1007/s13244-014-0373-x.

    Article  PubMed  Google Scholar 

  120. Adamy A, Lowrance WT, Yee DS, Chong KT, Bernstein M, Tickoo SK, Coleman JA, Russo P. Renal oncocytosis: management and clinical outcomes. J Urol. 2011 Mar;185(3):795-801. https://doi.org/10.1016/j.juro.2010.10.068.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiology Department, Hospital Naval Almirante Nef, Subida Alesandri S/N., Viña del Mar, Provincia de Valparaíso, Chile

    Mario G. Santamarina & Javier A. Necochea Raffo

  2. Radiology Department, Hospital Dr. Eduardo Pereira, Valparaiso, Chile

    Mario G. Santamarina

  3. Internal Medicine, Hospital Naval Almirante Nef, Viña del Mar, Chile

    Giuliana Lavagnino Contreras

  4. Departamento de Radiología, Escuela de Medicina, Universidad de Valparaíso, Valparaiso, Chile

    Jaime Recasens Thomas

  5. Radiology Department, Centro de Diagnóstico Dr. Enrique Rossi, Buenos Aires, Argentina

    Mariano Volpacchio

Authors
  1. Mario G. Santamarina
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Javier A. Necochea Raffo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuliana Lavagnino Contreras
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jaime Recasens Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mariano Volpacchio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mario G. Santamarina.

Ethics declarations

Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Santamarina, M.G., Necochea Raffo, J.A., Lavagnino Contreras, G. et al. Predominantly multiple focal non-cystic renal lesions: an imaging approach. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04440-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00261-024-04440-3

Keywords

Search

Navigation