Genitourinary Imaging

Mesenchymal Neoplasms of the Kidney in Adults: Imaging Spectrum with Radiologic-Pathologic Correlation

Published Online:Oct 6 2010https://doi.org/10.1148/rg.306105517

Abstract

The spectrum of renal mesenchymal neoplasms is reviewed, with emphasis on their cross-sectional imaging features and histopathologic correlation.

Mesenchymal neoplasms of the kidney in adults cover a wide spectrum with characteristic ontogeny and histologic findings and variable biologic profiles and imaging findings. Benign mesenchymal renal tumors include angiomyolipoma, leiomyoma, hemangioma, lymphangioma, juxtaglomerular cell tumor, renomedullary interstitial cell tumor (medullary fibroma), lipoma, solitary fibrous tumor, and schwannoma. Malignant renal tumors of mesenchymal origin include leiomyosarcoma, rhabdomyosarcoma, angiosarcoma, osteosarcoma, synovial sarcoma, fibrosarcoma, malignant fibrous histiocytoma, and solitary fibrous tumor. Cross-sectional imaging findings for mesenchymal renal tumors in adults are varied. Although angiomyolipomas and lipomas show macroscopic fat, lymphangiomas are cystic in appearance. Renal hemangioma may show phleboliths and a characteristic enhancement pattern. Leiomyoma typically arises from the capsule and causes buckling of the renal cortex. Although osteosarcoma may demonstrate characteristic dense ossification, most renal sarcomas demonstrate imaging features that are indistinguishable from the more common renal cell carcinoma. Although some renal mesenchymal tumors have typical imaging findings, biopsy is warranted to establish a definitive diagnosis. Awareness of the various mesenchymal renal tumors and familiarity with their imaging findings permit optimal patient management.

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Article History

Received: Feb 11 2010
Revision requested: Mar 17 2010
Revision received: Apr 9 2010
Accepted: Apr 9 2010
Published online: Oct 6 2010
Published in print: Oct 2010

Vol. 30, No. 6

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