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Parapelvic Cysts of the Kidney: Symptoms, Diagnosis and Treatment

Definition of Renal Parapelvic Cysts

Parapelvic cysts of the kidneys are simple renal cysts adjacent to the renal pelvis or the renal sinus.

Bilateral parapelvic cysts (abdominal CT scan left and center figure, ultrasound imaging of the same patient right): multiple cysts in the renal sinus with elongation of the renal calyces without obstruction. Parapelvic cysts may be misinterpreted in ultrasound imaging as hydronephrosis. CT scans with kind permission, Prof. Dr. K. Bohndorf, Augsburg.

Etiology of Parapelvic Cysts

Typical parapelvic cysts are multiple and probably derive from lymphatic vessels, often associated with nephrolithiasis or urinary obstruction. Parapelvic cysts may also derive from the renal parenchyma adjacent to the renal pelvis.

Signs and Symptoms

Usually, there are no complaints. Parapelvic cysts can compress the pyelocalyceal system or ureter, cause flank pain, or lead to other symptoms of urinary obstruction.

Diagnostic Workup of Parapelvin Cysts

Renal ultrasound should be sufficient in most cases for the diagnosis. In doubtful ultrasound findings, perform an intravenous pyelography, abdominal CT, or renal scintigraphy to rule out a urinary obstruction.

Differential Diagnosis of Parapelvic Cysts

Hydronephrosis (upper urinary tract obstruction).

Treatment of Parapelvic Cysts

Treatment of parapelvic cysts is rarely necessary; see section simple renal cyst.

References

Israel, G. M. & Bosniak, M. A.
An update of the Bosniak renal cyst classification system.
Urology, 2005, 66, 484-488

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