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    Differential Diagnosis of A Renal Mass

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    mdjohari
    This document provides an overview of the differential diagnosis of a renal mass. It discusses various potential causes including congenital (e.g. polycystic kidney disease), traumatic, inflammatory (e.g. abscess), and neoplastic (e.g. renal cell carcinoma) etiologies. It describes approaches to reaching a diagnosis through obtaining a history, physical examination, and investigations like urine analysis, blood tests, ultrasound, CT, MRI, and isotopic scans to characterize the mass and assess kidney function. The differential diagnosis of a renal mass can provide clues to the underlying cause, whether congenital, inflammatory, traumatic, or neoplastic in nature.

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    Differential Diagnosis of A Renal Mass

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    mdjohari
    101 views23 pages
    This document provides an overview of the differential diagnosis of a renal mass. It discusses various potential causes including congenital (e.g. polycystic kidney disease), traumatic, inflammatory (e.g. abscess), and neoplastic (e.g. renal cell carcinoma) etiologies. It describes approaches to reaching a diagnosis through obtaining a history, physical examination, and investigations like urine analysis, blood tests, ultrasound, CT, MRI, and isotopic scans to characterize the mass and assess kidney function. The differential diagnosis of a renal mass can provide clues to the underlying cause, whether congenital, inflammatory, traumatic, or neoplastic in nature.

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    Original Title

    Renal Mass

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    This document provides an overview of the differential diagnosis of a renal mass. It discusses various potential causes including congenital (e.g. polycystic kidney disease), traumatic, inflammatory (e.g. abscess), and neoplastic (e.g. renal cell carcinoma) etiologies. It describes approaches to reaching a diagnosis through obtaining a history, physical examination, and investigations like urine analysis, blood tests, ultrasound, CT, MRI, and isotopic scans to characterize the mass and assess kidney function. The differential diagnosis of a renal mass can provide clues to the underlying cause, whether congenital, inflammatory, traumatic, or neoplastic in nature.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    101 views23 pages

    Differential Diagnosis of A Renal Mass

    Uploaded by

    mdjohari
    This document provides an overview of the differential diagnosis of a renal mass. It discusses various potential causes including congenital (e.g. polycystic kidney disease), traumatic, inflammatory (e.g. abscess), and neoplastic (e.g. renal cell carcinoma) etiologies. It describes approaches to reaching a diagnosis through obtaining a history, physical examination, and investigations like urine analysis, blood tests, ultrasound, CT, MRI, and isotopic scans to characterize the mass and assess kidney function. The differential diagnosis of a renal mass can provide clues to the underlying cause, whether congenital, inflammatory, traumatic, or neoplastic in nature.

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    of 23

    DIFFERENTIAL DIAGNOSIS

    OF A RENAL MASS

    BY
    Nasr El-Tabey
    Assistant professor of Urology
    Urology and Nephrology Center
    Mansoura-Egypt
    Differential Diagnosis

    Congenital
    Traumatic
    Inflammatory
    Neoplastic
    Others
    Congenital

    Polycystic kidney
    Pelviureteric junction obstruction
    Multicystic dysplastic kidney
    PUV causing hydronephrosis
    Traumatic
    Perirenal urinoma
    Perirenal hematoma
    Inflammatory
    Perinephric abscess

    Intrarenal abscess

    TB pyelonephritis
    Neoplastic

    Benign :Renal cyst


    Angiomyolipoma
    Oncocytoma
    Malignant :RCC
    Sarcoma
    Lymphoma
    Other causes
    Hydronephrosis :Ureteric stone
    Ureteric stricture
    Ureteric tumor
    Reflux
    Chronic retention
    How to reach the diagnosis

    History

    Examination

    Investigations
    History

    Age :
    Children :congenital causes,Tumor,hydronephrosis
    Adults : Hydronephrosis due to stones.
    Old age : Tumors

    Sex :
    Renal tumors and stones are more common in male
    Angiomyolipoma more in female
    History
    History of trauma

    Associated symptoms :
    Fever in perinepric abscess
    Hematuria in renal tumors and trauma
    Renal colic in hydronephrosis and stones
    Examination
    General examination :
    Fever : eg. inflammatory cases
    Pallor : eg. Trauma and tumors

    Abdominal Examination :
    Inspection
    Palpation
    Percution
    Auscultation
    Inspection
    Echymosis and abrasions: in cases of trauma

    Redness and pointing : in abscess

    Diffuse bulge : in hydronephrosis and polycystic kidney.

    Localized bulge : in renal tumor


    Palpation
    Bimanual examination
    Palpation
    Site : in the renal angle
    Size : variable
    Shape : variable
    Surface : regular in hydronehrosis and tumors
    irregular in polycystic kidneys
    Consistency : solid in tumors
    cystic in hydronephrosis and pck
    Tenderness : in perinephric abscess
    Investigations
    Urine analysis : hematuria in tumors
    Pus cells in abscess
    crystals in stones

    Blood picture : leucocytosis in abscess


    Anaemia in tumors and trauma
    metabolic abnormalities in stones
    uremia if affected kidney function
    Investigations
    Radiological : KUB
    IVP
    US
    CT
    MRI
    Isotopic study
    KUB
    Soft tissue mass

    Obliteration of the psoas shadow

    Ureteric stones

    Tumor calcification
    IVP
    Soft tissue mass
    Hydronephrosis and stones
    Polycystic kidneys
    PUJO
    Assess the kidney function
    US
    Site
    Size
    Cystic or solid
    Stones
    CT
    The most accurate
    All criteria of the mass
    The possible aetiology
    Assess the kidney function
    MRI
    No additional advantages over CT

    Indicated in high serum creatinine


    ISOTOPIC SCAN
    OF little value

    Assess the kidney function


    THANK YOU

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