Diagnostic Imaging Pathways - Renal Mass

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Population Covered By The Guidance

This pathway provides guidance on the further imaging investigation of adult patients with a renal mass that is clinically palpable or incidentally found on previous imaging.

Date reviewed: December 2015

Date of next review: 2017/2018

Published: August 2016

Quick User Guide

Move the mouse cursor over the PINK text boxes inside the flow chart to bring up a pop up box with salient points.
Clicking on the PINK text box will bring up the full text.
The relative radiation level (RRL) of each imaging investigation is displayed in the pop up box.

SYMBOL RRL EFFECTIVE DOSE RANGE
No radiation None 0
Minimal radiation Minimal < 1 millisieverts
Low radiation Low 1-5 mSv
Medium radiation Medium 5-10 mSv
High radiation High > 10 mSv

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Pathway Diagram

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Image Gallery


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1 Click to view full size image

Simple Renal Cyst

Image 1 (Ultrasound): Small simple benign cyst (arrow) in the upper pole of the right kidney with foci of calcification in or adjacent to the wall.

2 Click to view full size image

Renal Cell Carcinoma

Image 2 (Computed Tomography): Large right kidney mass with central necrosis consistent with renal cell carcinoma. There is tumour extension into the right renal vein (arrow).

3a Click to view full size image Renal Cell Carcinoma

Image 3a: Nephrectomy showing a circumscribed and encapsulated renal cell carcinoma arising from the lower pole of the kidney. The cut surface shows a heterogenous appearance typical of malignancy with patchy areas of necrosis (blue arrow) and haemorrhage (red arrow).

3b Click to view full size image Image 3b (H&E, x10): Histological section of a conventional clear cell renal cell carcinoma showing sheets and nests of malignant cells with intervening thin-walled vessels. The cells demonstrate irregular and hyperchromatic nuclei surrounded by abundant clear cytoplasm (clear cells).

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Teaching Points