Pediatric Cystic Nephroma

Etiology: Part of spectrum of nephroblastoma with two histologically distinct but radiographically identical entities – cystic partially differentiated nephroblastoma and cystic nephroma
Imaging:
— Encapsulated with bulging bosselated surface
— 5-10 centimeters in size
— Composed entirely of cysts and septations of variable thickness
— No gross nodularity of septa and only wall and septations enhance
— Cysts contain clear fluid and may herniate into collecting system
DDX:
— Solid tumor with cystic change – Look for solid nodular elements
— Multicystic dysplastic kidney – Has no function and usually in neonate and usually entire kidney is replaced
— Echinococcal cyst
Complications:
Treatment: Surgical
Clinical:

Radiology Cases of Cystic Nephroma

MRI of multilocular cystic nephroma — Sagittal US of the left kidney (above) shows a multicystic renal mass involving most of the left kidney. Coronal (lower left) and axial (lower right) T1 MRI with contrast of the abdomen shows the left renal mass to contain multiple thin septations and to have no solid component.

CT and US of pediatric cystic nephroma — Axial (above left) and sagittal (above right) CT with contrast of the abdomen show two multiseptated low density lesions in the superior and middle poles of the right kidney. Sagittal US of the right kidney (below) show the two lesions are anechoic and filled with multiple thin septations without any nodularity.

Gross Pathology Cases of Pediatric Cystic Nephroma

Pathological image of pediatric cystic nephroma — Gross pathological image (left) and sectioned gross pathological image (right) shows a mass composed of multiple cysts separated by thin septae.