OBJECTIVE: To evaluate progression rate of Bosniak category IIF complex renal cysts and the malignancy rate among surgically resected cysts. MATERIALS AND METHODS: We performed a database search for complex renal cysts classified as Bosniak category IIF on computed tomography or magnetic resonance imaging between January 2008 and April 2016. Follow-up examinations (computed tomography or magnetic resonance imaging) were used in order to evaluate progression (Bosniak category reclassification) and stability, the latter being defined as remaining stable for a minimum of six months. Pathology reports were used as the reference to assess the malignancy rate of surgically resected cysts. RESULTS: A total of 152 cysts in 143 patients were included in the final analysis. Seven cysts (4.6%) were reclassified on follow-up studies, and mean time to progression was 20 months (range, 1 month to 4 years). Three cysts were surgically resected. All three were diagnosed as low-grade malignant renal cell carcinomas (RCCs): one clear cell RCC and two papillary RCCs. The remaining 145 cysts remained unchanged after a mean follow-up period of 28 months (range, 6 to 118 months). CONCLUSION: The progression rate in Bosniak category IIF cysts was low. Even lesions that were upgraded on follow-up remained stable, indicating an indolent behavior. Our data support the idea of conservative management of Bosniak IIF renal cyst.

Keywords: Tomography, X-ray computed; Magnetic resonance imaging; Cysts/classification; Carcinoma, renal cell; Kidney/diagnostic imaging.

Acute penile conditions, which typically have a traumatic, vascular, or infectious etiology, are rather uncommon and often require prompt medical evaluation. Penile emergencies can be treated conservatively or surgically, and their management often relies on the results of imaging examinations. Because of its high spatial resolution and wide availability, as well as the fact that it does not involve the use of ionizing radiation, ultrasound is the imaging modality of choice in the initial evaluation of penile emergencies. Inconclusive cases can be further evaluated with magnetic resonance imaging. The main purpose of this pictorial essay is to review the main penile emergencies, by presenting illustrative cases, focusing on radiologic findings, and discussing the roles played by the various imaging methods.

Keywords: Penile diseases/pathology; Penile diseases/etiology; Emergencies; Emergency medicine; Urology; Radiology.

OBJECTIVE: To evaluate the correlation of morphological criteria of the cecal appendix using computed tomography (CT) and the possible risk of developing acute appendicitis. MATERIALS AND METHODS: Cases were defined as patients with surgically confirmed acute appendicitis who had undergone CT at least twice: at diagnosis and at least one month prior. Controls were defined as emergency patients with abdominal pain who had undergone abdominal CT that excluded acute appendicitis and had also undergone CT at least one month before. RESULTS: 100 cases and 100 controls were selected for inclusion in the final analysis. Comparisons between the cases and controls revealed the following: mean transverse diameter of 0.6 cm (range, 0.4–1.0 cm) versus 0.6 cm (range, 0.6–0.8 cm; p = 0.37); mean length of 6.6 cm (range, 3.5–9.7 cm) versus 6.6 cm (range, 4.5–8.3 cm; p = 0.87); mean angle of 100º (range, 23–178º) versus 86º (range, 43–160º; p = 0.01); vertical descending orientation in 56% versus 45% (p = 0.2); absence of gas in 69% versus 77% (p = 0.34); and presence of an appendicolith in 17% versus 8% (p = 0.08). CONCLUSION: Hypothetical risk factors for obstruction of the vermiform appendix detected on CT were not associated with acute appendicitis. That suggests that factors other than those related to mechanical obstruction are implicated in the pathogenesis of acute appendicitis.

Keywords: Appendicitis; Appendix; Multidetector computed tomography; Emergency medicine.

More than half of patients over 50 years of age have had at least one focal renal lesion detected as an incidental finding during an ultrasound, computed tomography, or magnetic resonance imaging examination. Although the majority of such lesions can be easily detected and correctly characterized, misdiagnoses may occur and are often related to methodological limitations, inappropriate imaging protocols, or misinterpretation. This pictorial essay provides recommendations on how to recognize benign and malignant renal processes that can be potentially missed or mischaracterized in imaging studies.

Keywords: Kidney neoplasms/diagnostic imaging; Magnetic resonance imaging; Ultrasonography; Computed tomography.