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IMAGES IN NEPHROLOGY
Year : 2010  |  Volume : 20  |  Issue : 2  |  Page : 116-117
 

Unilateral renal cystic disease


Department of Radiodiagnosis, Govt Medical College, Srinagar, India

Date of Web Publication9-Jul-2010

Correspondence Address:
N A Choh
Department of Radiodiagnosis, Govt Medical College, Srinagar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.65310

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How to cite this article:
Choh N A, Rashid M. Unilateral renal cystic disease. Indian J Nephrol 2010;20:116-7

How to cite this URL:
Choh N A, Rashid M. Unilateral renal cystic disease. Indian J Nephrol [serial online] 2010 [cited 2021 Dec 6];20:116-7. Available from: https://www.indianjnephrol.org/text.asp?2010/20/2/116/65310


Unilateral renal cystic disease of kidney is a non-familial and non-progressive disorder, characterized by replacement of the renal parenchyma by a cluster of multiple cysts with a normal contralateral kidney. This rare condition is not related to autosomal dominant polycystic kidney disease; as such, hepatic and pancreatic cysts are not seen. We report a case of unilateral renal cystic disease in an elderly male documented by CT and serial ultrasound examinations.

An elderly asymptomatic male (with normal renal function tests and urine examination) was found to have multiple cysts in left kidney during a routine ultrasound examination with thinned out intervening parenchyma; the right renal parenchyma was normal in size and echotexture. There was no evidence of hepatic or pancreatic cysts. Screening of family members did not reveal any evidence of autosomal dominant polycystic kidney disease. Contrast enhanced CT revealed multiple clustered cysts in left kidney, with normal enhancement of the intervening parenchyma [Figure 1]. The right kidney was normal without any cyst. Unilateral renal cystic disease was presumed, and patient put on follow-up. Serial ultrasounds over two years have documented the stability of the left renal cystic lesions, confirming the diagnosis.

Unilateral renal cystic disease, also called unilateral polycystic kidney disease, localized cystic disease of kidney, and segmental polycystic kidney, is characterized by replacement of renal parenchyma, either total or localized to a portion of kidney, by multiple cysts. [1],[2],[3],[4] This is distinct from ADPKD, which is bilateral with involvement of both cortex and medulla. In children, ADPKD can have asymmetric onset; in these cases long term follow-up and screening of family members can make the distinction from unilateral cystic disease. The extrarenal manifestations of ADPKD (hepatic and pancreatic cysts, cerebral aneurysms) are not seen in unilateral renal cystic disease. Nephrolithiasis and hyperattenuating cysts are also generally seen in ADPKD. [4],[5]

When unilateral cystic disease of kidney is focal, it may be confused with a cystic neoplasm like multilocular cystic nephroma or cystic RCC. Careful analysis of multiple sequential images reveal a continuum of cysts in localized cystic disease of kidney with normal intervening parenchyma as compared to focal encapsulated mass in case of cystic neoplasms with compression of adjacent renal parenchyma. [1],[4]

The renal function is preserved with near normal concentration of contrast by the affected kidney. This allows distinction from multicystic dysplastic kidney (an entity seen in infants and children) in which the intercystic parenchyma is dysplastic and non functional; the dysplastic core in MCDK may show some enhancement, but has a different appearance from the normal renal tissue. [1],[2],[3],[4],[5]

 
  References Top

1.Kohno A, Yunoki M. Unilateral renal cystic disease. Radiat Med 1999;17:423-6.   Back to cited text no. 1  [PUBMED]    
2.Curry NS, Chung CJ, Gordon B. Unilateral renal cystic disease in an adult. Abdom Imaging 1994;19:366-8.  Back to cited text no. 2  [PUBMED]    
3.Hwang DY, Ahn C, Lee JG, Kim SH, Oh HY, Kim YY, et al. Unilateral renal cystic disease in adults. Nephrol Dial Transplant 1999;14:1999-2003.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  
4.Slywotzky CM, Bosniak MA. Localised cystic disease of kidney. AJR 2001;176:843-9.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]  
5.Fick-Brosnahan G, Johnson AM, Strain JD, Gabow PA. Renal asymmetry in children with autosomal dominant polycystic kidney disease. Am J Kidney Dis 1999;34:639-64.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]  


    Figures

  [Figure 1]

This article has been cited by
1 Case report: Atypical polycystic kidney disease
Christopher Shin, Leonard Berliner
Radiology Case Reports. 2021; 16(7): 1643
[Pubmed] | [DOI]
2 Localized cystic disease of the kidney: A rare entity
Neyaz, Z. and Kumar, S. and Lal, H. and Kapoor, R.
Journal of Radiology Case Reports. 2012; 6(7): 29-35
[Pubmed]



 

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