|A simple renal cyst.|
|Classification and external resources|
A renal cyst or kidney cyst, is a fluid collection in or on the kidney. There are several types based on the Bosniak classification. The majority are benign, simple cysts that can be monitored and not intervened upon. However, some are cancerous or are suspicious for cancer and are commonly removed in a surgical procedure called nephrectomy.
Up to 27 percent of individuals greater than 50 years of age may have simple renal cysts that cause no symptoms.
Renal cysts are classified by malignant risk using the Bosniak Classification System. The system was created by Dr. Morton Bosniak, a faculty member at the New York University Langone Medical Center in New York City.
The Bosniak classification categorizes renal cysts into five groups.
- Benign simple cyst with thin wall without septa, calcifications, or solid components. It does not enhance with contrast, and has a density of 0–20 Hounsfield units (about equal to that of water).
- Benign cyst with a few thin septa, which may contain fine calcifications or a small segment of mildly thickened calcification. This includes homogenous, high-attenuation (60–70 Hounsfield units) lesions less than 3 cm with sharp margins but without enhancement. Hyperdense cysts must be exophytic with at least 75 percent of its wall outside the kidney to allow for appropriate assessment of margins, otherwise they are categorized as IIF.
This category includes renal cysts with multiple thin septa, a septum thicker than hairline, slightly thick wall, or with calcification, which may be thick. It also includes intrarenal cysts larger than 3 centimetres (1.2 inches) if there is no contrast enhancement.
- Indeterminate cystic masses with thickened irregular septa with enhancement. 50 percent of these lesions are ultimately found to be malignant.
- Malignant cystic masses with all the characteristics of category III lesions but also with enhancing soft tissue components independent of but adjacent to the septa. 100 percent of these lesions are malignant.
Peripelvic versus parapelvic cysts
Parapelvic cysts originate from around the kidney at the adjacent renal parenchyma, and plunge into the renal sinus. Peripelvic cysts are contained entirely within the renal sinus, possibly related to dilated lymphatic channels. When viewed on CT in absence of contrast, they can mimic hydronephrosis. If symptomatic, they can be laparoscopically decorticated - removal of the outer layer or cortex.
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- "Bosniak classification of renal cystic disease". GPnotebook. Retrieved 2017-05-17.
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