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Background: The infiltrative renal growth pattern is either characteristic of certain prototype transitional cell carcinomas (TCCs) or other mimickers. Specific computed tomography (CT) features may be used to differentiate TCCs from other overlap findings. Accurate early diagnosis is important to improve treatment outcome and prevent morbidity and mortality from delayed specific treatment.
Objective: To determine the multidetector computed tomography (MDCT) features that discriminate infiltrative TCCs from other infiltrative renal lesions.
Methods: A retrospective review was performed on patients with infiltrative, proven renal lesions on CT from January 2008 to July 2014. Individual CT sequences were analyzed for lesion number, location, size, and density on unenhanced and nephrographic phase scans. Final diagnoses were confirmed by histopathology or clinical or imaging follow-up after treatment. The CT findings of intrarenal TCCs and mimics were compared by using logistic regression analysis.
Results: In 73 patients, there were 18 (24.6%) TCCs, 2 (2.7%) renal cell carcinomas (RCCs), 11 (15.1%) lymphomas, 15 (20.5%) renal parenchymal metastases, 17 (23.3%) infections, and 10 (13.7%) other diagnosis. Compared to non-TCCs, intrarenal TCCs were more likely to be solitary lesion, lack intralesional calcification, less avidly enhance in nephrographic phase and infiltrate pelvicalyceal and perinephric tissue (P < .05).
Conclusions: Five MDCT features including solitary lesion, absence of calcification and poor absolute, relative enhancement, pelvicalyceal system involvement, and perinephric tissue invasion were significantly associated with intrarenal and infiltrative TCCs.
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