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Neuroblastoma

KEY FACTS Terminology Malignant tumor of sympathetic chain primitive neural crest cells Increasing degrees of cellular differentiation/benignity along spectrum: Neuroblastoma (malignant) → ganglioneuroblastoma → ganglioneuroma (benign) Imaging Location Adrenal (35-48%) Extraadrenal retroperitoneum (25-35%) Posterior mediastinum (16-20%) Small round solitary mass vs. large multilobulated lesion Aggressive tumor with tendency to invade adjacent tissues Frequently engulfs & displaces adjacent vascular structures (rather than just displacing) Ca²⁺ in up…

Renal Stones

KEY FACTS Terminology Definition: Concretion in urinary system Imaging Most stones seen in kidneys & upper urinary tract Range in size from 1-2 mm to > 1 cm NECT most sensitive modality to detect stones Calcified density in urinary system Ultrasound shows hyperechoic urinary tract focus with posterior acoustic shadowing &/or twinkle artifact Signs of obstruction (US/CT/MR) Hydroureteronephrosis Nephromegaly Perinephric/periureteral edema Lack of ureteral jet in…

Pyelonephritis

KEY FACTS Terminology Acute infection of renal parenchyma; often difficult to clinically distinguish from lower UTI Imaging Imaging work-up of UTI controversial See professional society guidelines With pyelonephritis, marked inflammatory response to renal parenchymal infection causes swelling that alters normal tissue properties & effectively ↓ radiologic contrast agent delivery to site, which results in ↓ uptake on nuclear cortical scan ↓ perfusion on Doppler imaging with…

Wilms Tumor

KEY FACTS Imaging Ultrasound frequently 1st study performed; CECT & MR better characterize tumor & local extent Large, heterogeneous but predominantly solid hypoechoic (US)/hypoenhancing (CT/MR) renal mass Must carefully evaluate – Adjacent soft tissues for tumor rupture, adenopathy – Renal vein & inferior vena cava for tumor thrombus – Contralateral kidney for synchronous tumor or nephrogenic rests Chest radiograph or CT: Lung metastases in 10-20% Top…