What is the role of CT scans in renal lymphoma imaging?

Updated: Mar 22, 2019
  • Author: Ali Shirkhoda, MD; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

CT scans demonstrate a wide variety of appearances in renal lymphoma; the study patterns depend on the technique of CT scanning. Multidetector and spiral/helical CT scanning are universally accepted as the techniques of choice in patients with renal involvement, and they have a high degree of sensitivity in the detection of renal lymphoma. [22, 33, 27, 18, 19, 28, 26]

Breath-hold images can be quickly obtained during the multiple phases of renal enhancement after the intravenous injection of contrast medium. The nephrographic phase is the most important phase for renal parenchymal assessment. These images are essentially free of motion artifact and respiratory misregistration. This approach helps in accurately detecting and characterizing most renal masses, including smaller lesions that may involve the renal parenchyma in lymphoma.

In addition, the vascular phase of contrast enhancement enables characterization of the renal vasculature, which may be involved in renal cell carcinoma but uncommonly in renal lymphoma. Without intravenously administered contrast material, infiltrative forms of renal lymphoma can be entirely missed on CT scan studies. Also, CT scanning should not be limited to the cortical medullary phase of contrast enhancement because the lesions can be missed in this phase.


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