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Persistent fetal renal lobulation

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Incidental finding on CT abdomen for abdominal pain. No urinary symptoms.

Patient Data

Age: 40
Gender: Female

Bilateral, lobulated renal cortices corresponding to a each renal pyramid.  No hydronephrosis.

Case Discussion

In the fetus, renal lobes (consisting of a pyramid of collecting tubles and overlying cortex) are separate, eventually fusing to form the typical reniform shape with a smooth surface.  These lobes can persist to produce a lobulated cortical surface, each representing a pyramid and overlying cortex with a valley in between as compared to renal scarring due to vesico-ureteric reflux, where there are cortical defects overlying the pyramids especailly at the upper and lower poles.

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