Presentation
Pain in the left lumbar region with recurrent episodes of fever and chills. Incidental finding.
Patient Data
The unenhanced CT phase showed an oval hypodense exophytic lesion in the upper pole of the left kidney, in the corticomedullary zone. After contrast injection examination revealed contrast filling of the cyst with fluid level within the cyst, confirming communication between the renal cyst and the collecting system and patency of the diverticular infundibulum. Two small calyceal diverticula are also visible on the right in the thickness of the cortex; there are no kidney stones or hydronephrosis. Few bilateral peripelvic cysts are noted.
Case Discussion
A calyceal diverticulum is a cystic cavity within the kidney that is lined by transitional epithelium and communicates with a calyx or less commonly with the renal pelvis through a narrow isthmus. Pyelocalyceal diverticula are usually asymptomatic but may present with symptoms of urinary tract obstruction when complicated by calculi or of infection. Opacification of the diverticulum on delayed imaging also serves to see patency of the diverticular infundibulum for aiding treatment planning and avoiding the need for retrograde pyelography sometimes. The diverticulum may be congenital, secondary to trauma or a complication of previous surgery such as percutaneous nephrolithotomy.
Radiographer: TSRM Fabio Imola
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