1- PART OF IVU shows good excretory
function of Rt kidney with space occupying
lesion in the upper pole making distortion
of the calyces.
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2- Cystogram shows largeirregular filling
defect,in the left lateral wall of the
bladderfor DD the most probable diagnosis
is bladder tumor
Stone Renal pelvis tumor -Necrotic
papilae-Mass
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5- U/S picture showing 2 soft tissue masses
in the base of the bladder for D.D. most
propably basal bladder mass.
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6- This KUB Showing what?
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3- IVP film --> showing horse-shoe kidney
which is :
-low in position -medially directed lower
calyces
-logitudial axis meet caudally
shoe kidney
- horse
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4- IVP film --> showing filling defect in the
upper calyx for D.D:
- Fungal ball
-Blood clots- Radiolucent
KUB showing bilateral radio opaque shadow
mostly bilateral renal staghorn kidney
staghorne stone : about infection stone, struvite
stone, as infection with urease producing
organisms leads to formation of ammoniam and
alkaline media.. precipitation of phosphate, mg,
and ammoniam and formation of stuvite stone.
7- Male patient 60 years old complaining
of difficulty of micturation and
hematuria, the cystogram of the patient
is shown
1) Describe and write D.D. of this
cystogram.
2) What further investigations help to
settle diagnosis?
Cystogram film - showing basal smooth
outlined filling defect most propably prostatic
enlargement
DD BPH, BLADDER CA, BLOOD CLOT,
RADIOLUCENT STONE,.....
smooth and elevated above the symphsis pubis
investigations:
TRUS
PSA>>>4-10ng/ml in BPH ,,,,more than 10ng/ml
>>>>suspect malignancy
uroflowmetry>>>>max.flow rate less than
15ml/sec>>>obstruction
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8- Male patient 45 years old presented to
urology clinic by hematuria and RT. loin
pain
This is his CT scan
1)- describe CT
2)-most likely diagnosis and DD
3)- what are the likely management
lines.
* CT scan with contrast with enhancement
showing heterogenous density in rt kidney
propably renal mass for d.d
and showing affection of left renal vein by
metastasis.
* management by: 1.radical nephrectomy of rt
kidney. 2.hormonal therapy. 3.radiotherapy after
the nephrectomy and for the metastasis.
4.immunotherapy as interferon and I.L.
5.recently T.K.I.
* yes nephron sparing surgery is the best option
for the rt renal mass