Unusual presentation of perirenal lung metastases

D'Souza, DL; Heinze, SB; Dowling, Richard

doi:10.1111/j.1440-1673.2006.01570.x

Cited by 6 publications

(6 citation statements)

References 3 publications

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“…Therefore, it may not be appropriate to just predict operative complexity on the basis of imaging finding of perinephric infiltration because it could not represent "sticky fat". Another problem in assessing perinephric fat stranding is its low reproducibility (24), and our study also showed substantial agreement between the two reviewers for perinephric fat stranding.…”

Section: Discussionsupporting

confidence: 75%

“…Perinephric fat stranding has been reported as the determinant for predicting operative complexity in the MAP score along with PPFT (8), and the underlying pathophysiology of perinephric "sticky fat" has been thought to be inflammation, desmoplasia, idiopathic fibrosis, or autoimmune response (20). However, from a radiological perspective, the cause of perinephric fat stranding varies from acute to chronic, with a wide spectrum of conditions including acute ureteral obstruction, pyelonephritis, bladder outlet obstruction, postoperative change, acute pancreatitis, and metastasis (21)(22)(23)(24). Moreover, in a histopathologic comparison of patients with or without APF, Dariane et al (17) demonstrated no significant difference in inflammatory infiltration or fibrosis in the perinephric tissue but only significantly larger adipocytes in patients with APF and concluded that the histology of adhesive perinephric fat was unclear.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Patient-Related Operative Complexity During Partial Nephrectomy: Comparison of Two Tailored Methods for Measurement of Posterior Perinephric Fat Thickness on Preoperative CT

et al. 2021

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Background: Adherent perinephric fat affects operative complexity during partial nephrectomy (PN) and it could be predicted using computed tomography (CT) based on the Mayo adhesive probability (MAP) score. Objectives: To investigate reproducible measurement methods of perinephric fat with comparison of two tailored methods for measurement of posterior perinephric fat thickness (PPFT) on preoperative CT and examine the association between the methods and operative complexity in PN. Patients and Methods: This cross-sectional study included 72 consecutive patients who underwent robotic-assisted or open PN. The data on operative time, ischemia time, and pathologic results were obtained. Two radiologists independently assessed PPFT based on the MAP system in the first session, and subsequently by using two tailored methods in the second session and scored for perinephric fat stranding. The nephrometry scoring system was used for stratifying the complexity of renal masses. Multiple linear regression was used to evaluate the determinants of operative time and ischemia time. Results: For measurement of PPFT, intraclass correlation coefficients between the reviewers using two detailed methods showed no statistical difference (P = 0.173) but were significantly higher than the coefficients scored in the first session (P < 0.001). Nephrometry score was a determinant of ischemia time (P < 0.001 and 0.001 for two reviewers) and PPFT was identified as a determinant of operative time (P ≤ 0.023 in all the analysis using two different methods for both the reviewers) in robotic-assisted PN. Nephrometry score was identified as a determinant of ischemia time in open PN as per one of the reviewers (P = 0.006). Conclusion: The tailored methods presented herein were more reproducible than the MAP score and demonstrated that increased PPFT was related to longer operative time in robotic-assisted, and not in open PN.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Assessment of Patient-Related Operative Complexity During Partial Nephrectomy: Comparison of Two Tailored Methods for Measurement of Posterior Perinephric Fat Thickness on Preoperative CT

et al. 2021

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“…CT findings in this case were similar to that in our case. As in our case, there were linear heterogeneous densities at the perirenal site (1). To the best our knowledge, our case is the second case of diffuse perirenal fat tissue infiltration.…”

Section: Radiology Pagementioning

confidence: 55%

“…In the differential diagnosis of perirenal heterogeneity, linear and millimetric nodular densities and enhancement secondary to perinephric fatty tissue infection acute/subacute retroperitoneal haemorrhage, perirenal lymphoma and liposarcoma can be thought (1).…”

Section: Radiology Pagementioning

confidence: 99%

Unusual Perirenal Metastasis from Lung Adenocarcinoma

Başara¹,

Altay²,

Seçil³

2015

jus

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“…PFS is associated with a wide spectrum of conditions including acute ureteral obstruction, pyelonephritis, postoperative change, acute pancreatitis and metastasis. 5,6,12 There are two possible explanations for PFS in cases of acute ureteral obstruction. When the ureter becomes obstructed, the increased intrapelvic pressure results in a microscopic rupture at the calyceal fornix, which is the area of least resistance, and pyelosinus backflow of urine may occur.…”

Section: Discussionmentioning

confidence: 99%

Perirenal fat stranding on CT: is there an association with bladder outlet obstruction?

Han¹,

Sung²,

Kim³

et al. 2016

BJR

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Objective: To determine the association between perirenal fat stranding (PFS) on CT and bladder outlet obstruction (BOO). Methods: CT scans from 122 patients who had undergone urodynamic study for lower urinary tract symptoms (LUTS) were registered after exclusion of patients with renal or retroperitoneal disease. Images were independently reviewed by two radiologists and compared with those of 244 age-and sex-matched control patients without LUTS. The PFS severity was scored on a fourpoint scale, and the interobserver agreement was assessed with kappa statistics. The severity score and incidence was compared between the groups, and the association with baseline characteristics was analyzed. For the LUTS group, an association between PFS severity and urodynamic and laboratory data was evaluated.Results: PFS was more frequent and more severe in the LUTS group than in the control group (p-value , 0.001); its presence was significantly associated with male gender and older age (p-value , 0.001). PFS was predominantly bilateral in both groups (80.1-93.2%). In the LUTS group, PFS severity scores were significantly correlated with the maximum flow rate, maximum detrusor pressure and estimated glomerular filtration rate (p-value , 0.001). Interobserver agreements were excellent for PFS presence (k 5 0.883) and severity (k 5 0.816). Conclusion: Severe PFS was observed in older, male patients with LUTS. PFS severity was associated with the degree of BOO and impaired renal function. Advances in knowledge: Recognition of PFS on the CT scan may warrant further evaluation of BOO and appropriate management to prevent renal impairment. INTRODUCTIONBladder outlet obstruction (BOO) is a common cause of lower urinary tract symptoms (LUTS) in males, and benign prostatic hyperplasia (BPH) is mainly attributable to BOO in male patients. Multiple mechanisms leading to increased pressure in the urinary bladder and the renal collecting system have been proposed to explain the association between chronic BOO and renal function impairment.1 Renal function impairment secondary to BOO is preventable if cases are recognized early, but it is often difficult to identify patients at risk of renal failure. Urodynamic study is the gold standard for the diagnosis of BOO.2 However, because of its invasiveness, its use for screening purposes is inappropriate.

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Unusual presentation of perirenal lung metastases

Abstract: Lung cancer is not commonly known to metastasize to the perirenal space, with only five such cases previously published. We present an unusual case of perirenal lung metastases manifesting as diffuse perinephric stranding which to our knowledge has not been described before.

Cited by 6 publications

References 3 publications

Assessment of Patient-Related Operative Complexity During Partial Nephrectomy: Comparison of Two Tailored Methods for Measurement of Posterior Perinephric Fat Thickness on Preoperative CT

Assessment of Patient-Related Operative Complexity During Partial Nephrectomy: Comparison of Two Tailored Methods for Measurement of Posterior Perinephric Fat Thickness on Preoperative CT

Unusual Perirenal Metastasis from Lung Adenocarcinoma

Perirenal fat stranding on CT: is there an association with bladder outlet obstruction?

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