kidney

I got my ct scan results of my kidney to take to urologist and it says on impression that I have - Heterogeneous opacification of right renal pelvis on delayed images is concerning for an intra-luminal filling defect. Differential conciderations include transitional cell carcinoma versus hemorrhagic or infectious debris. Correlation with retrograde urography or ureteroscopy is recommended. does anyone know what this means?

[Fernando Roque, MD]

Hi.  The renal pelvis is a funnel-like area inside the kidney where all the urine produced by the nephrons (kidney tissue) come together.  Basically, what the "heterogenous opacification" and "intraluminal filling defect"  means is that there seems to be a mass inside your right renal pelvis. The radiologist reading the CT scan is not sure what that mass is, but he has enumerated three possibilities (his "educated guess"):

1.  The mass is cancer (transitional cell carcinoma)
2.  It's a blood clot.
3.  Your kidney is infected and that mass is actually a collection of pus and probably necrotic material from the infection.

To determine what that "mass" really is, the radiologist is suggesting further testing to be done. Retrograde urography is a procedure wherein a dye is introduced to the urinary tract via the urethra and bladder.  X-rays are taken as the dye spreads upwards to the kidneys.  Ureteroscopy involves inserting a scope into the urinary tract to directly visualize it.