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Case of the Week 322 
What's the most likely diagnosis?
- 28 year-old with flank pain
Contrast-enhanced CT Urogram with inset of right kidney
- Renal cell carcinoma
- Pyelopnephritis
- Transitional cell carcinoma
- Medullary sponge kidneys
- Renal laceration
Additional Images - Unenhnaced CT of both kidneys
Additional Images
Unenhanced axial CT images of both kidneys
Answer:
4. Medullary sponge kidneys
More (Click Discussion Tab)
Medullary Sponge Kidneys
General Considerations
- Developmental dilatation of the collecting tubules in the medullary pyramids of kidneys
- Usually in people 10-30 years old
- Pathogenesis is not known
- Multiple cysts connect the collecting tubule with the papillary ducts or calyces
- The cysts may contain calcifications
- Stones are usually calcium apatite and calcium oxalate or calcium apatite alone
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