Pyelocalyceal diverticula containing milk of calcium--CT diagnosis.
OBJECTIVE
To present the computed tomography (CT) findings of pyelocalyceal diverticula containing milk of calcium in seven patients.


METHODS
Three patients were examined because of flank pain, one because a malignant lesion was suspected and the three others were examined for unrelated symptoms. Three repeated scans to the kidney area were performed in every patient: an unenhanced scan, post-contrast scan and a delayed scan.


RESULTS
Unenhanced scans demonstrated an intraparenchymal round lesion with calcific material localized either at the inferior border or filling almost the entire cavity. On post-contrast scans a contrast-fluid level appeared, with some enhancement of the clear fluid in the upper part of the cyst. A further rise in the contrast-fluid level or total opacification with a density identical to that of the collecting system was obtained on delayed scans.


CONCLUSIONS
Pyelocalyceal diverticula containing milk of calcium present on CT as a partially calcified renal mass. Slight opacification soon after injection may be mistaken for enhancement arousing suspicion of a tumour. However, a delayed scan will demonstrate a densely opacified cyst filled with contrast from the collecting system which is virtually pathognomonic of the lesion.
Gayer
G
G
Department of Diagnostic Imaging, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Apter
S
S
Heyman
Z
Z
Morag
B
B
D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging*; D002119:Calcium Carbonate; D003287:Contrast Media; D004240:Diverticulum / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D002119:Calcium Carbonate