Difference between revisions of "Bosniak classification of renal cysts"

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!Percent malignant
!Percent malignant
!Management
!Management
!Radiological Characteristics
|-
|-
| Bosniak I
| Bosniak I
| 0%  
| 0%  
| no follow-up necessary
| no follow-up necessary
| Simple cyst
|-
|-
| Bosniak II
| Bosniak II
| 0%  
| 0%  
| no follow-up necessary
| no follow-up necessary
| Minimally complex (septa <1mm or thin calcification; non-enhancing attenuation due to proteinaceous or haemorrhagic contents)
|-
|-
| Bosniak IIF
| Bosniak IIF
| 5%
| 5%
| follow-up for 4 years required<ref name=pmid24766033>{{Cite journal  | last1 = Hindman | first1 = NM. | last2 = Hecht | first2 = EM. | last3 = Bosniak | first3 = MA. | title = Follow-up for Bosniak category 2F cystic renal lesions. | journal = Radiology | volume = 272 | issue = 3 | pages = 757-66 | month = Sep | year = 2014 | doi = 10.1148/radiol.14122908 | PMID = 24766033 }}</ref>
| follow-up (4 years<ref name=pmid24766033>{{Cite journal  | last1 = Hindman | first1 = NM. | last2 = Hecht | first2 = EM. | last3 = Bosniak | first3 = MA. | title = Follow-up for Bosniak category 2F cystic renal lesions. | journal = Radiology | volume = 272 | issue = 3 | pages = 757-66 | month = Sep | year = 2014 | doi = 10.1148/radiol.14122908 | PMID = 24766033 }}</ref>)
| Minimally complex (increased septa, but minimally thicknened/nodular; perceived, but not measurable enhancement)
|-
|-
| Bosniak III
| Bosniak III
| 50%
| 50%
| excise to r/o malignancy
| excise to r/o malignancy
| Indeterminate (thick or nodular septa with measurable CT enhancement)
|-
|-
| Bosniak IV
| Bosniak IV
| 100%  
| 100%  
| almost certainly malignant
| almost certainly malignant
| Clearly malignant (solid mass +/- cystic/necrotic component)
|}
|}



Latest revision as of 16:31, 12 May 2018

Bosniak classification of renal cysts is a radiologic classification system for kidney cysts. It originally consisted of four categories (I, II, III, IV).[1][2]

A subsequent modification turned it into a five category system:

Category Percent malignant Management Radiological Characteristics
Bosniak I 0% no follow-up necessary Simple cyst
Bosniak II 0% no follow-up necessary Minimally complex (septa <1mm or thin calcification; non-enhancing attenuation due to proteinaceous or haemorrhagic contents)
Bosniak IIF 5% follow-up (4 years[3]) Minimally complex (increased septa, but minimally thicknened/nodular; perceived, but not measurable enhancement)
Bosniak III 50% excise to r/o malignancy Indeterminate (thick or nodular septa with measurable CT enhancement)
Bosniak IV 100% almost certainly malignant Clearly malignant (solid mass +/- cystic/necrotic component)

Note:

  • The "F" in IIF have minimally suspicious features and should get follow-up imaging.[4]

Schematic

See also

References

  1. Bosniak, MA. (Jan 1986). "The current radiological approach to renal cysts.". Radiology 158 (1): 1-10. doi:10.1148/radiology.158.1.3510019. PMID 3510019.
  2. Curry, NS.; Cochran, ST.; Bissada, NK. (Aug 2000). "Cystic renal masses: accurate Bosniak classification requires adequate renal CT.". AJR Am J Roentgenol 175 (2): 339-42. doi:10.2214/ajr.175.2.1750339. PMID 10915671.
  3. Hindman, NM.; Hecht, EM.; Bosniak, MA. (Sep 2014). "Follow-up for Bosniak category 2F cystic renal lesions.". Radiology 272 (3): 757-66. doi:10.1148/radiol.14122908. PMID 24766033.
  4. Ding, Y.; Chen, L.; Deng, FM.; Melamed, J.; Fan, R.; Bonsib, S.; Zhou, M. (Apr 2013). "Localized cystic disease of the kidney: distinction from cystic neoplasms and hereditary polycystic diseases.". Am J Surg Pathol 37 (4): 506-13. doi:10.1097/PAS.0b013e318271eff9. PMID 23211292.
  5. Muglia, VF.; Westphalen, AC.. "Bosniak classification for complex renal cysts: history and critical analysis.". Radiol Bras 47 (6): 368-73. doi:10.1590/0100-3984.2013.1797. PMID 25741120.