Letter to the editor: Proper imaging method for evaluation of solidary renal parapelvic neurofibroma

Abstract

Free AccessCorrespondenceLetter to the editor: Proper imaging method for evaluation of solidary renal parapelvic neurofibromaW-G Liu and W-J LiangW-G LiuSearch for more papers by this author and W-J LiangSearch for more papers by this authorPublished Online:28 Jan 2014https://doi.org/10.1259/bjr/24172380SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail AboutThe Editor,We read with great interest the article by Dr Eljack and colleagues [1] in the June 2010 issue of the British Journal of Radiology. In their article, they described the radiological changes of this rare kidney tumor [1]. Until now, radiological characteristics of solitary renal parapelvic neurofibroma have been considered non-specific, and difficult to differentiate from malignant tumors [1-5]. In some cases, radical surgical operations have been performed on these patients because of radiological similarities between solitary renal parapelvic neurofibroma and malignant tumors [1,3,5]. Therefore, pre-operative identification of the benign nature of the tumour is important for the choice of surgical operation. Here, we suggest possible methods of identification of the nature of the tumour.The theory of Folkman's tumour angiogenesis factor provided a theoretical basis for (CT and MRI) perfusion imaging [6]. Perfusion experiments were executed on a large number of patients with nodules of the lung and breast, which demonstrated that time-signal intensity curves obtained by perfusion parameters were reliable for the diagnosis of benign and malignant lesions [7-9]. In a prior study, benign lesions of the breast demonstrated a curve of increasing enhancement or plateau of signal intensity, which was different from the type of washout of signal intensity obtained by malignant lesions [8]. In another study, by analysis of histology, vascular density and vascular permeability in benign and malignant lesions of the breast, they concluded that vascular permeability was the main factor in determining the curve pattern [9]. Furthermore, malignant nodules had high vascular permeability, but benign had low vascular permeability, both of which were related to the expression of the degree of vascular endothelial growth factor [9].Renal parapelvic neurofibroma is a benign lesion confirmed by pathological histology [1]. Therefore, we believe that there may be a curve of increasing enhancement or plateau of signal intensity based on low vascular permeability. Further more, we suggest that perfusion imaging may be of help in differentiating renal parapelvic neurofibroma from malignant lesions of the kidney.Yours etc.,References1 Eljack S , Rosenkrantz AB , Das K . CT and MRI appearance of solitary parapelvic neurofibroma of the kidney. Br J Radiol 2010;83:e108–10. Link ISI, Google Scholar2 Freund ME , Crocker DW , Harrison JH . Neurofibroma arising in a solitary kidney. J Urol 1967;98:318–21. Crossref Medline ISI, Google Scholar3 Borrego J , Cuesta C , Allona A , Navio S , Escudero A . Myxoid neurofibroma of the renal sinus. Actas Urol Esp 1995;19:415–18. Medline, Google Scholar4 Nishiyama T , Ikarashi T , Terunuma H . Parapelvic neurofibroma of the kidney. Int J Urol 2000;7:470–1. Crossref Medline ISI, Google Scholar5 Kostakopoulos A , Chorti M , Protogerou V , Kokkinou S . Solitary neurofibroma of kidney: clinical, histological and chromosomal appearance. Int Urol Nephrol 2003;35:11–3. Crossref Medline, Google Scholar6 Folkman J . Tumor angiogenesis: therapeutic implications. N Engl J Med 1971;285:1182–6. Crossref Medline ISI, Google Scholar7 Yamashita K , Matsunobe S , Tsuda T , Nemoto T , Matsumoto K , Miki H . Solitary pulmonary nodule: preliminary study of evaluation with incremental dynamic CT. Radiology 1995;194:399–401. Crossref Medline ISI, Google Scholar8 Kuhl CK , Mielcareck P , Klaschik S , Leutner C , Wardelmann E , Gieseke J . Dynamic breast MR imaging: are signal time course data useful for differential diagnosis of enhancing lesions? Radiology 1999;211:101–10. Crossref Medline ISI, Google Scholar9 Knopp MV , Weiss E , Sinn HP , Mattern J , Junkermann H , Radeleff J . Pathophysiologic basis of contrast enhancement in breast tumors. J Magn Reson Imaging 1999;10:260–6. Crossref Medline ISI, Google Scholar Previous article Next article FiguresReferencesRelatedDetailsCited byParapelvic solitary neurofibroma of the kidney10 June 2015 | Case Reports, Vol. 2015, No. jun10 1 Volume 84, Issue 1004August 2011Pages: 677-e168 2011 The British Institute of Radiology History ReceivedJanuary 11,2011AcceptedFebruary 01,2011Published onlineJanuary 28,2014 Metrics Download PDF