Renal Cysts
Publication date: September 5, 2012 | Updated on September 5, 2012
Report
Diagnosis
Renal Cysts
History
Bosniak I:
- Benign simple cyst with a hairline-thin wall that does not contain septa, calcifications, or solid components
- water attenuation
- does not enhance
- % malignant : ~ 0
- No intervention is needed
Bosniak II:
- Benign cystic lesion that may contain a few hairline-thin septa in which perceived (not measurable) enhancement may be appreciated
- Fine calcification or a short segment of slightly thickened calcification may bepresent in the wall or septa
- Uniformly high-attenuating lesions (< 3 cm) that are sharply marginated and do not enhance are included in this group.
- % malignant : ~ 0
- No intervention is needed
Bosniak IIF:
- Cysts may contain multiple hairline-thin septa
Perceived (not measurable) enhancement of a hairline-thin smooth septum or wall can be identified;
- Possible minimal thickening of wall or septa, which may contain calcification that may be thick and nodular, but no measurable contrast enhancement is present
- No enhancing soft-tissue components
- Totally intrarenal nonenhancing high-attenuating renal lesions (>3 cm) also included in this category(lesions generally well marginated)
- % malignant : ~ 5 %
- Thought to be benign but need follow-up to prove their benignity by showing stability
Bosniak III
- Cystic masses with thickened irregular or smooth walls or septa and in which measurable enhancement is present;
- % malignant : ~ 50%
- Need surgical intervention in most cases with histologic diagnosis, as neoplasm cannot be excluded
- This category includes complicated hemorrhagic or infected cysts, multilocular cystic nephroma, and cystic neoplasms
Bosniak IV
- Clearly malignant cystic masses that can have all of the criteria of category III but
also contain distinct enhancing soft-tissue components independent of the wall
or septa
- % malignant : ~ 100%
- Need to be removed