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Bladder Carcinoma
Cancer that most commonly originates in the epithelium (Wall) of the bladder
Urothelial carcinoma (previously known as transitional cell carcinoma)
Appears as: punctuate, coarse, or linear calcifications that are usually encrusted on the surface of the tumour - can be within it
Frequently on the trigone where they are difficult to visualize
Calculi
most commonly form in the kidney and are asymptomatic until they cause obstruction and pain (kidney to groin, flank pain)
Can be caused by underlying metabolic abnormality, or increase in calcium excretion in urine, urinary stasis, infection
About 80% can be seen on radiographs due to calcium, but x-ray misses 34% due to size, location, or obstruction by bowel or bone
Most commonly lodge in lower portion of the ureter, at ureterovesical junction and pelvic brim
Stone formation in bladder most occurs in older men
Can be most shapes: circular or oval, amorphous, layered, speculation; jack stone (hard burr)
Cysts
most common univocal mass of the kidneys
Fluid filled land usually unilocular
Septa sometimes divide cyst into chambers
Vary in size; can be single or multiple; one or both kidneys
Appears as: beak sign, slowly increasing in size and elevating the adjacent edges of the cortex
Duplication
common anomaly that may vary from a simple bifid pelvis to a completely double pelvis ureter and ureterovesical orifice
Ureter draining upper renal segment enters bladder below the ureter draining the lower renal segment
Vesicoureteral reflex normally affects lower pole; obstruction affects upper pole
Ectopic Kidney
abnormally located kidneys
Pelvic kidney (in true pelvis) to above the diaphragm (intrathoracic kidney)
Usually functional
Crossed ectopia = ectopic kidney on same side as the normal kidney; frequently fused
Horseshoe Kidney
most common type of fusion anomaly
Both kidneys are malrotated and lower poles joined by a band of normal renal parenchyma/connective tissue
Ureters arise anteriorly instead of medially
Lower pole calyces point medially instead of laterally
Large flabby pelves, may simulate obstruction
Ureteropelvic junction may occur because of the anterior position of the ureters
Hydronephrosis
dilation of the pelvicalyceal system caused by urinary tract obstruction
Hydroureter
dilation of the ureter caused by urinary tract obstruction
Acute Renal Failure
rapid deterioration in kidney function sufficient to result in the accumulation of nitrogen-containing wastes in the blood
Caused by: low blood volume, cardiac failure, renal artery obstruction, obstruction to urine outflow, nephrotoxic agents, etc
Ultrasound best
IVU would show bilateral renal enlargement with delayed and prolonged nephrogram
Chronic Renal Failure
caused by: bilateral renal artery stenosis, bilateral ureteral obstruction, intrinsic renal disorders
Failure to clear nitrogen containing waste leads to uraemia - eventual coma
Decreased ability of the kidney to synthesize erythropoietin which helps the red blood cells produce, leads to anemia
Appears as: bilateral renal calcifications or obstructions, or stones
Kidneys can be small and smooth, small and irregular (chronic pyelonephrosis), or large (poly cystic, obstructive disease)
Ureterocele
cystic dilation of the distal ureter near its insertion into the bladder
Frequently, stenosis of distal ureter leads to prolapse into bladder and dilation of proximal ureter
With contrast, appears as round/oval density surrounded by radiolucent halo (cobra head sign)
Without contrast, appears as radiolucent mass within opacified bladder
