Faces of Hemorrhage Spontaneous Subcapsular HemorrhagePatient has acquired cystic disease of chronic failure and presents wit spontaneous subcapsular hemorrhage of the left kidney. A hemorrhage from a malignancy known to occur as a complication of this entity was suspected. At the inferior aspect of the hemorrhage there is extension of the process into the retroperitoneum giving the appearance of the “spider web sign” or “cobweb sign”Ashley Davidoff MD TheCommonVein.net RnD Spontaneous Subcapsular HemorrhagePatient has acquired cystic disease of chronic failure and presents wit spontaneous subcapsular hemorrhage of the left kidney. A hemorrhage from a malignancy known to occur as a complication of this entity was suspected. At the inferior aspect of the hemorrhage there is extension of the process into the retroperitoneum giving the appearance of the “spider web sign” or “cobweb sign”Ashley Davidoff MD TheCommonVein.net RnD Polycystic Kidney DiseaseCT scan with contrast of a 54 year old male with polycystic kidney disease. In this case, the cysts are distributed in a relatively orderly and homogeneous fashion in the periphery of the both kidneys with an unusual symmetry. There is a reasonable amount of functioning parenchyma. One of the cysts in the periphery of the right kidney has a higher density and high density sediment suggesting hemorrhageAshley Davidoff MD TheCommonVein.net Polycystic Kidney DiseaseCT scan with contrast of a 54 year old male with polycystic kidney disease. In this case, the cysts are distributed in a relatively orderly and homogeneous fashion in the periphery of the both kidneys with an unusual symmetry. There is a reasonable amount of functioning parenchyma. One of the cysts in the periphery of the right kidney (yellow arrowhead) has a higher density and high density sediment (red arrowhead lower image suggesting hemorrhageAshley Davidoff MD TheCommonVein.net Hemorrhagic or Proteinaceous Cysts CT Non Contrast CT High Density Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left KidneyNon-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 systemAshley Davidoff MD TheCommonVein.net TCV 24K 135915c Hemorrhagic or Proteinaceous Cysts CT with Contrast CT with Contrast 6minute Delay in Pyelographic PhaseHigh Density Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left KidneyCT 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 diagnosisThe 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 systemAshley Davidoff MD TheCommonVein.net TCV 24K 135920c T1 Bright Hemorrhagic or Proteinaceous Cyst Pre Contrast T1 Weighted MRI – T1 Bright Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left KidneyT1 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 cystAshley Davidoff MD TheCommonVein.net TCV 24K 135921c In and Out of Phase Pre-Contrast T1-Weighted MRI – T1 Bright Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left KidneyT1 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 cystAshley Davidoff MD TheCommonVein.net TCV 24K 135923c T2 Dark Hemorrhagic or Proteinaceous Cyst T2-Weighted MRI – T2 Dark Hemorrhagic or Proteinaceous Cyst of the Upper Pole of the Left KidneyT2 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 cystAshley Davidoff MD TheCommonVein.net TCV 24K 135925cL