Renal cell carcinoma accounts for approximately 3% of adult cancers, and papillary renal cell carcinoma is thought to account for between 10 and 15 percent of renal cell carcinomas. Clear cell RCC by far the more predominant type (approximately 70%). There is a male to female predominance in papillary RCC of 5:1.
Papillary renal cell cancer is a solid mass. Its key characteristic in distinction to its more common colleagues is its relative avascularity. This manifests most often on ultrasound as hypoechogenicity. CT demonstrates an enhancing lesion, but generally with less enhancement than surrounding renal parenchyma. Noncontrasted images show iso, hypo, or even hyper density of the lesion. Papillary RCC also often manifests with amorphous calcifications (approximately 30%). MRI most often demonstrates T1 and T2 isointensity, but hyper intensity on T2 is also common. The MRI enhancement pattern is similar to that of CT.
Key points:
Papillary renal cell cancer is a solid mass. Its key characteristic in distinction to its more common colleagues is its relative avascularity. This manifests most often on ultrasound as hypoechogenicity. CT demonstrates an enhancing lesion, but generally with less enhancement than surrounding renal parenchyma. Noncontrasted images show iso, hypo, or even hyper density of the lesion. Papillary RCC also often manifests with amorphous calcifications (approximately 30%). MRI most often demonstrates T1 and T2 isointensity, but hyper intensity on T2 is also common. The MRI enhancement pattern is similar to that of CT.
Key points:
- Papillary RCC represents about 10-15% of RCCs.
- Papillary RCC is a solid hypo vascular mass, causing a typical hypoechogenic appearance on ultrasound.
- The lesions tend to enhance, but less avidly than surrounding renal parenchyma on both CT and MR.
- Calcifications are common.
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