Faces of Calcifications

Nephrolithiasis Pre-lithotripsy

Antegrade Pyelogram Filling Defects in the Right Renal Pelvis
37year-old male presents with back pain Antegrade pyelogram shows 2 filling defects in the renal pelvis with the larger occupying almost the entire downstream pelvis. There is mild hydronephrosis. Contrast is seen in the ureter
Ashley Davidoff MD TheCommonVein.net 135460
Coronal CT – Kidney Stones
37year-old male presents with back pain Non contrast CT shows 2 calcifications. The larger stone is in the renal pelvis and the smaller in a lower pole calyx.
Ashley Davidoff MD TheCommonVein.net 135461

Cancer

Large Renal Cell Carcinoma Extending beyond the Renal Capsule
On CT there is dystrophic calcification. On angiography there is hypervascularity, neovascularity, AV shunting. Excretory phase after angiography shows distorted calyces
Ashley Davidoff MD

Polycystic Kidney Disease PCKD

CT with Contrast– Polycystic Kidney Disease PCKD
56-year-old male in chronic renal failure presents with flank pain. CT with contrast shows diffuse cystic changes of near normal sized kidneys with total replacement of the renal parenchyma by small uniformly sized cysts. Multiple calcifications are scattered throughout the parenchyma.
Ashley Davidoff MD TheCommonVein.net 135723c

 

Cystic Renal Cell Carcinoma (RCC) with Clear Cell Histology
Cystic renal cell carcinoma with dystrophic calcification in the mid portion of the left kidney. Pathology reveals cystic renal cell carcinoma with clear cell histopathology
Ashley Davidoff MD
Exophytic Renal cell Carcinoma (RCC) with Dystrophic Calcification
Ashley Davidoff MD
Exophytic Renal cell Carcinoma (RCC) with Dystrophic Calcification
Ashley Davidoff MD
Exophytic Renal cell Carcinoma (RCC) with Dystrophic Calcification
Ashley Davidoff MD
Exophytic Renal cell Carcinoma (RCC) with Dystrophic Calcification
Ashley Davidoff MD
Large Renal Cell Carcinoma (RCC) with calcification and thrombus in the inferior vena cava (IVC)
Ashley Davidoff MD

Metabolic Causes

Lithium

51 year old female with bipolar disorder on Lithium
CT shows numerous punctate calcifications in the cortex
and medulla bilaterally. Given history of lithium usage, CT appearance can be
seen with lithium-induced renal disease.
Ashley Davidoff The CommonVein.net
51 year old female with bipolar disorder on Lithium
CT shows numerous punctate calcifications in the cortex
and medulla bilaterally. Given history of lithium usage, CT appearance can be
seen with lithium-induced renal disease.
Ashley Davidoff The CommonVein.net
Echogenic kidneys with numerous punctate echogenic foci in the cortex
and medulla. CT showed multiple punctate calcifications Given history of lithium usage, sonographic appearance can be
seen with lithium-induced renal disease.
Ashley Davidoff The CommonVein.net

72 year old Asian female with multiple microcysts or nodular calcifications in a capsular or subcapsular location.
Consequence of lithium therapy is the most likely diagnosis
Ashley Davidoff MD
018 72F Asian renal capsular calcification
72 year old Asian female with multiple microcysts or nodular calcifications in a capsular or subcapsular location.  Arterial calcifications are also present.
Consequence of lithium therapy is the most likely diagnosis
Ashley Davidoff MD
019 72F Asian renal capsular calcification
72 year old Asian female with multiple microcysts or nodular calcifications in a capsular or subcapsular location.
Consequence of lithium therapy is the most likely diagnosis
Ashley Davidoff MD
020 72F Asian renal capsular calcification
Magnetic resonance image in a 68-year-old patient shows abundant microcysts in the cortical and medullary regions of both kidneys. Source: Farres MT, et al. Chronic lithium nephropathy: MR imaging for diagnosis. Radiology 2003; 229: 570-574