What is the role of CT scanning in transitional cell carcinoma (TCC) imaging?

Updated: Mar 18, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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The workup of patients in whom TCC is suspected includes ultrasonography and IVU. However, CT scanning enables the detection and staging of TCC, usually without the need for additional imaging. (See the images below). [3, 4, 15, 21, 22, 23]

Nonenhanced (top) and enhanced (bottom) CT scans t Nonenhanced (top) and enhanced (bottom) CT scans through the kidneys show a mass in the right renal pelvis. The histologic diagnosis was a right renal pelvis neurofibroma and a bladder transitional cell carcinoma.
Nonenhanced (top) and enhanced (bottom) CT scans o Nonenhanced (top) and enhanced (bottom) CT scans obtained through the kidneys in a 73-year-old woman show a mass in the left renal pelvis is a transitional cell carcinoma.

The commonly recognized presentations of TCC on CT scans include the following: irregular filling defects of the pelvocaliceal system and ureters, which tend to be associated with obstruction and dilatation of the ureter and pelvis proximal to the lesion; ureteral wall thickening; frondlike growths projecting into the bladder from a fixed mural site; and surface calcification of bladder TCC.

On nonenhanced CT scans, the TCC is hypoattenuated or isoattenuated relative to the normal renal parenchyma, and it is hyperattenuated relative to urine. TCCs demonstrate mild to moderate enhancement after the administration of contrast material, and they are hypoattenuated relative to opacified urine.

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