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Forum Name: Miscellaneous Nephrology Topics

Question: With renal cysts since 2001, should I see a nephrologist?


 cassielo - Thu May 28, 2009 11:29 pm

I recently had an ultrasound during which a renal cyst was found in the same place as was found a year ago. Both times, the cyst was found incidentally. Not remembering hearing that they'd found one last year, I recalled one was found previously--looking back over my records which are outlined below, it seems to me that considering I've had renal cysts since at least 2001, should I see a nephrologist (should I HAVE seen a nephrologist previously?). This did not seem to be cause for alarm, but it seems odd I've had a cyst on the same kidney for 8 years:
12/2001--"a lesion on the left kidney which could be infectious or inflammatory; also 1-cm hypechoic mass on left kidney.
11/2002--1 cm hypoechoic mass mid pole of the left kidney.
From examination report: "Evaluation of the kidneys demonstrates that both kidneys excrete contrast without evidence of hydronephrosis. With the medial and anterior aspect of the left mid-kidney, is a focus diminished attentuation measuring approximately 9 mm. This is not clearly a cyst, aloth this could be due to the lesion's small size. ...cannot exclude a focal infectious or inflammatory process involving the left kidney such as a focal nephronia. The appearance is not typical for a discrete abscess collection."
10/2006--silmple left renal cysts, no renal mass seen (from a pelvic us).
From radiology report: 1 cm fluid density lesion in the interpolar region of the left kidney. Unfortunately, no precontract imaging was performed due to a techincal error, however the Hounsfield units are low on this study suggesting a simple cyst; probable additional tiny bilaterial renal cysts; bilateral partially duplicated collecting systems..."
 Dr. A Hesham Said - Wed Jul 08, 2009 3:26 am

Hi Cassielo
I accidentally found your question. It may be somewhat late to answer a consultation after 40 days, but .. ok, lets go the question
...
I could understand from your post that:
1. you had a single lesion (mass) in the left kidney
2. it was 1st discovered on 2001
3. it didn't change is size till now (i.e. it is not a growing tissue)
4. on ultrasound (US) is looks cystic (i.e. purely fluidy)
5. on contrast CT it still showed low density (i.e. it didn't take or retain the dye). This means it is not a living tissue that gets blood supply.
--
These findings should make you comfortable. These are the typical classical criteria of simple renal cysts. Simple renal cysts usually don't produce symptoms. So, you don't need to see a nephrologist (if you didn't already through these 40 days .. !!!), unless you have other kidney symptoms (e.g. blood in urine, pain in the loin,, etc.). Other nephrologists can discuss kidney symptoms better than me.
--
Simple renal cysts are not tumours. They are not well understood. One possible mechanism is that they are a closed nephron (single functional unit of kidney). Urine can't get out into the ureter, so it collects. Over years they may enlarge to reach large size (10cm or more), and then they may press on the nearby structures causing some problems (easy to resolve .. just give it a prick and aspirate the fluid). That may explain why they are commoner in old people.
A fairly confident diagnosis is [url]usually[/url]by US only.
--
Hoping this is helpful to you. Please don't hesitate to contact me if you still have other inquiries

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