24K Hemorrhagic Cyst or Proteinaceous Cyst

38 year-old female with Incidental Finding of a Hyperdense Cyst

CT High Density Hemorrhagic or Proteinaceous Cyst

CT High Density Hemorrhagic or Proteinaceous Cyst
Non-Contrast CT in the axial plane shows an 8mm homogeneous hyperdense lesion, exophytic off the upper pole of the left kidney. A hyperdense cyst as a result of hemorrhage or accumulation of proteinaceous material are most likely
Ashley Davidoff MD TheCommonVein.net TCV 24K 135914c
CT High Density hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left Kidney
Non-Contrast CT in the coronal plane shows an 8mm homogeneous hyperdense lesion, exophytic off the upper pole of the left kidney. A hyperdense cyst as a result of hemorrhage or accumulation of proteinaceous material are most likely. The right kidney has a deformity of the upper pole secondary to atrophy of the upper pole moiety of a duplicated collecting system
Ashley Davidoff MD TheCommonVein.net TCV 24K 135915c

CT with Contrast
High Density Hemorrhagic or Proteinaceous Cyst of the
Upper Pole of the Left Kidney

CT with Contrast  70 Second Delay in Late Corticomedullary Phase – High Density Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left Kidney
CT in the axial plane shows an 8mm homogeneous that has now become relatively hypodense, exophytic off the upper pole of the left kidney. It does not appear to enhance, though it does appear to have a hyper-enhancing wall, which more likely relates to normal surrounding parenchyma. .
A hemorrhagic or proteinaceous cyst is most likely. MRI subsequently confirmed the diagnosis
Ashley Davidoff MD TheCommonVein.net TCV 24K 135918c
CT with Contrast  70 Second Delay in Late Corticomedullary Phase – High Density Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left Kidney
CT in the coronal plane shows an 8mm homogeneous that has now become relatively hypodense, exophytic off the upper pole of the left kidney. It does not appear to enhance.
A hemorrhagic or proteinaceous cyst is most likely. MRI subsequently confirmed the diagnosis
Ashley Davidoff MD TheCommonVein.net TCV 24K 135919c

CT with Contrast 6minute Delay in Pyelographic Phase

CT with Contrast 6minute Delay in Pyelographic Phase
High Density Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left Kidney
CT in the coronal plane shows an 8mm homogeneous that remains relatively hypodense, exophytic off the upper pole of the left kidney. .A hemorrhagic or proteinaceous cyst is most likely. MRI subsequently confirmed the diagnosis
The right kidney shows contrast in a mildly dilated collecting system in an upper pole moiety with secondary atrophy of the upper pole moiety of a duplicated collecting system
Ashley Davidoff MD TheCommonVein.net TCV 24K 135920c

In and Out of Phase Pre-Contrast T1-Weighted MRI –
T1 Bright Hemorrhagic or Proteinaceous Cyst of the
Upper Pole of the Left Kidney

In and Out of Phase Pre-Contrast T1-Weighted MRI – T1 Bright Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left Kidney
T1 weighted MRI in the axial plane shows a T1 bright 8mm homogeneous lesion, exophytic off the upper pole of the left kidney.
This finding is compatible with a hemorrhagic or proteinaceous cyst
Ashley Davidoff MD TheCommonVein.net TCV 24K 135923c

T2-Weighted MRI – T2 Dark Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left Kidney

T2-Weighted MRI – T2 Dark Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left Kidney
T2 weighted MRI in the axial plane shows a T1 dark 8mm homogeneous lesion, (yellow arrowheads lower image) exophytic off the upper pole of the left kidney confirming that the cyst contains protein or blood.
This finding is compatible with a hemorrhagic or proteinaceous cyst
Ashley Davidoff MD TheCommonVein.net TCV 24K 135925cL

Pre Contrast T1 Weighted MRI –
T1 Bright Hemorrhagic or Proteinaceous Cyst of the
Upper Pole of the Left Kidney

Pre Contrast T1 Weighted MRI – T1 Bright Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left Kidney
T1 weighted MRI in the axial plane shows a T1 bright 8mm homogeneous lesion, exophytic off the upper pole of the left kidney.
This finding is compatible with a hemorrhagic or proteinaceous cyst
Ashley Davidoff MD TheCommonVein.net TCV 24K 135921c

Contrast Enhanced T1 Weighted Image in the
Arterial Phase-
No Internal Enhancement –

Contrast Enhanced T1 Weighted Image in the Arterial Phase-No Internal Enhancement – Proteinaceous Cyst of the Upper Pole of the Left Kidney
Contrast enhance MRI in the axial plane at 20seconds shows no enhancement of the matrix of the cyst. The wall does enhance but is thin.
This finding is compatible with a hemorrhagic or proteinaceous cyst
Ashley Davidoff MD TheCommonVein.net TCV 24K 135926c

 

Subtraction of a Contrast Enhanced T1 Weighted Image in the Arterial Phase-No Internal Enhancement –

Subtraction of a Contrast Enhanced T1 Weighted Image in the Arterial Phase-No Internal Enhancement – Proteinaceous Cyst of the Upper Pole of the Left Kidney
Subtraction technique in the axial plane at 20seconds shows no enhancement of the matrix of the cyst. The wall does enhance minimally but is thin and smooth.
This finding is compatible with a hemorrhagic or proteinaceous cyst
Ashley Davidoff MD TheCommonVein.net TCV 24K 135927c