Good evening,
Images are from a 15 m/o male boxer that presented for acute onsent incontinence. He is bright and alert and a bouncing, happy boy. No past history of illness.
Labs: Crea 2.2, BUN 80, USG 1.018, ALT 190.
Urine culture negative. UPC 1.5
Lepto TITERS neg
I sent this study into a radiologist and the scan was normal except for the kidneys. Those comments are below:
Good evening,
Images are from a 15 m/o male boxer that presented for acute onsent incontinence. He is bright and alert and a bouncing, happy boy. No past history of illness.
Labs: Crea 2.2, BUN 80, USG 1.018, ALT 190.
Urine culture negative. UPC 1.5
Lepto TITERS neg
I sent this study into a radiologist and the scan was normal except for the kidneys. Those comments are below:
“The left kidney measures 7.4 cm long which is considered normal for patient of this size. No abnormal renal pelvic dilation is present. The cortical medullary distinction slightly decreased in the cortex is hyperechoic (isoechoic compared to the adjacent spleen). There are a few small anechoic structures, consistent with cysts, along the periphery of the kidney.
The right kidney also measures 7.4 cm long. Similar to the left be cortical medullary distinction appears decreased and there are are several rounded anechoic structures along the periphery. No abnormal pelvic dilation is seen.”
“There are bilateral chronic changes of the kidneys. These changes are nonspecific and may be secondary to previous or chronic infectious, inflammatory, or previous toxic insult. Although this patient is young, renal dysplasia is considered unlikely given the preservation of renal architecture. There are numerous cortical cysts in both kidneys which may be degenerative or congenital; the peripheral (subcapsular?) location is unusual. “
1.) Is there any significance to the subcapsular region for the cyst formation?
2.) Is there any way to narrow the differential list? Also, I’m wondering if anyone may have a difference of opinion regarding dysplasia?
Thank you for your time!
Laura
Comments
IMO Reanl dysplasia till
IMO Reanl dysplasia till proven otherwise. Biopsy to confirm.
The world according to “GARP”
Word randy! Boxers are the
Word randy! Boxers are the poster breed for renal dysplasia in my opinioon but golden retrievers chase them as well.
These kidneys have disrupted pelvic and cortical architecture with thickened irregular cortices and contour. When the pelvis is out of place displaced to the right or left or dorsally within the kidney it either started that way, as likely in this case given the young patient in renal failure, or there is a mass effect moving the pelvis internally such as in HSA or carcinoma or lsa. Core Bx to confirm
Thank you so much!
Thank you so much!