Recently, Ms. Liu, who lives in Changsha, conducted a physical examination, B ultrasound prompted the right kidney cystic mass, which frightened Ms. Liu, and rushed to the Second People's Hospital of Hunan Province (Hunan Provincial Brain Hospital) for treatment, under the advice of the doctor, Ms. Liu underwent an ABDOMINAL MRI flat scan + enhancement and diffusion examination, and the image report suggested that Bosniak type III cystic mass.
For this sudden renal cystic mass, Ms. Liu is full of confusion, what is a kidney cystic mass? Is it malignant? What is a Bosniak typing? What's next? In this article, we will make a brief answer to Ms. Liu's related questions.
First: What is a kidney cystic mass?
Renal cystic mass refers to the growth mode of the mass on the image that is mainly liquid, the strengthened solid component does not exceed 1/4 of the lesion, and the overall prognosis of the cystic mass is good. Cystic renal masses make up about 15% of renal masses, and both benign and malignant renal lesions can present as cystic masses.
Mr. Liu's magnetic resonance image
Second: What is a Bosniak typing?
Bosniak typing is a method of imaging assessment of cystic masses in the kidneys, which assists in the development of clinical treatment and surgical protocols. The latest 2019 edition is divided into: type I, type II, type IIF, type III, type IV, the higher the level, the greater the possibility of malignancy.
Bosniak type I is seen mainly in simple cysts;
Bosniak type II is common in hemorrhagic cysts, cysts containing protein components, and cysts formed after trauma;
89% of Bosniak IIF types are seen in benign lesions and 11% are seen in malignant lesions, such as cystic kidney carcinoma, including clear cell carcinoma, papillary kidney cancer, low-grade malignant potential multi-cystic renal tumor, tubular cystic kidney cancer, acquired cystic kidney disease-related kidney cancer, etc.;
Benign and malignant lesions of Bosniak type III each account for 50%.
Malignant lesions of Bosniak type IV > 80% to 90%.
Third: What's next?
For Bosniak renal cystic masses of types I and II, simple or benign renal cysts are considered and follow-up is not required;
For IIF cystic masses, follow-up of 6 months is recommended, with no change, the follow-up period can be extended to 1 year;
For Bosniak type III and type IV cystic masses, a visit to the urology department is required for surgical evaluation and protocol development.
Under the patient explanation of the doctor, Ms. Liu finally underwent surgical treatment after careful consideration, the operation went smoothly, the postoperative recovery was good, the postoperative pathology showed a low-grade malignant potential multi-atrial cystic kidney tumor of the right kidney, the doctor informed Ms. Liu that the tumor was originally named multi-room transparent cell kidney cell carcinoma, who changed its name in 2016, it belongs to a subtype of translucent cell carcinoma, but the surgery prognosis is good, previous reports show that 200 cases > 5 years of follow-up, none of which recurred, Therefore, the doctor suggested that Ms. Liu conduct regular ultrasound review and observation, and Ms. Liu's hanging heart was finally put down.
Contributed by: Jiang Xili, Department of Radiology, Second People's Hospital of Hunan Province (Hunan Brain Hospital).
Editor: Liu Yuchen
Image: From the Internet, intrusion and deletion