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Magn Reson Imaging Clin N Am 2019 May;27(2):279-290

Department of Radiology, Seattle Children's, University of Washington, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.

Pediatric renal tumors may be malignant or benign. Wilms tumor, the most common malignant pediatric renal tumor, arises sporadically or with various syndromes. Renal cell carcinoma typically presents in older children. Read More

Diagn Pathol 2018 Oct 27;13(1):84. Epub 2018 Oct 27.

Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan.

Background: Nephroblastoma (NB) is a malignant embryonal neoplasm derived from nephrogenic blastemal cells. NB usually forms a solid mass, but in extremely rare cases, it may show cystic changes.

Case Presentation: A six-month-old girl with persistent high fevers was found to have pyuria and bacteriuria. Read More

Clin Radiol 2019 Feb 9;74(2):83-94. Epub 2018 Oct 9.

Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada. Electronic address:

This article presents an updated review of cystic renal mass imaging. Most cystic renal masses encountered incidentally are benign and can be diagnosed confidently on imaging and require no follow-up. Hyperattenuating masses discovered at unenhanced or single-phase enhanced computed tomography (CT) measuring between 20-70 HU are indeterminate and can be further investigated first by using ultrasound and, then with multi-phase CT or magnetic resonance imaging (MRI); as the majority represent haemorrhagic/proteinaceous cysts (HPCs). Read More

J Chin Med Assoc 2018 Dec 13;81(12):1017-1026. Epub 2018 Jul 13.

Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC; Yee Zen Hospital, Taoyuan, Taiwan, ROC; Yuanpei University of Medical Technology, Hsinchu, Taiwan, ROC. Electronic address:

Renal cysts are common incidental findings in clinical practice. Most renal cysts detected in medical imaging are benign simple cysts. However, some are complicated by hemorrhage or infection or are associated with calcification. Read More

Abdom Radiol (NY) 2018 Jul;43(7):1540-1545

Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 7340037, Japan.

Tubulocystic renal cell carcinoma (TC-RCC) has been classified as an independent subtype according to the 2016 World Health Organization (WHO) classification. It is a rare subtype that predominantly affects men. Although few in number, radiological imaging reports have suggested that TC-RCC is characterized by multilocular cystic lesions, which are categorized as the Bosniak classification II-IV, with signature pathological characteristics comprising numerous small cysts or a tubular structure. Read More

Abdom Radiol (NY) 2018 Nov;43(11):3082-3100

Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

This article presents methods to improve MR imaging approach of disorders of the renal sinus which are relatively uncommon and can be technically challenging. Multi-planar Single-shot T2-weighted (T2W) Fast Spin-Echo sequences are recommended to optimally assess anatomic relations of disease. Multi-planar 3D-T1W Gradient Recalled Echo imaging before and after Gadolinium administration depicts the presence and type of enhancement and relation to arterial, venous, and collecting system structures. Read More

J Clin Diagn Res 2017 Jul 1;11(7):PD10-PD12. Epub 2017 Jul 1.

Lecturer, Department of Urology, LTMGH and LTMMC, Sion, Mumbai, Maharashtra, India.

Large renal tumours are not uncommon in developing countries. Enhancing renal tumours are considered to be malignant unless proved otherwise and radical surgical resection remains the mainstay of treatment of such tumours. A giant renal tumour, especially on right side, poses a big challenge for the operating team and requires a thoracoabdominal approach for successful excision. Read More

Case Rep Urol 2016 15;2016:5304324. Epub 2016 Dec 15.

Department of Urology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico.

The incidence of Multilocular cystic renal cell carcinoma (MCRCC) in literature is very low and confounding MCRCC with cystic nephroma (CN) is even more unusual. The aim of this report is to present a case of MCRCC and emphasize the importance of the preoperative radiologic evaluation and immunohistochemical staining confirmation to obtain an accurate diagnosis. A 73-year-old woman presented with a history of 4-month right flank pain. Read More

Urol Ann 2016 Oct-Dec;8(4):506-508

Department of Pathology, Hassan Institute of Medical Sciences, Hassan, Karnataka, India.

Multilocular cystic renal cell carcinoma (MCRCC) has been identified as a separate subtype of renal cell carcinoma (RCC) in the 2004 World Health Organization classification of adult renal tumors. MCRCC represents a rare variant of clear cell RCC. The common age group for this tumor is between 40 and 60 years. Read More

Arch Esp Urol 2016 Dec;69(10):711-715

Servicio de Anatomía Patológica. Hospital Universitario Vírgen Macarena. Sevilla. España.

Objective: Multicystic nephroma (multilocular cystic nephroma, multilocular cyst) is a relatively rare benign neoplasm of the kidney. Most patients are asymptomatic and tumours are usually discovered incidentally.

Methods: Between 2010 and 2015, 2 patients with cystic nephroma at our institution were diagnosed and treated. Read More

Urol Oncol 2017 01 23;35(1):35.e7-35.e14. Epub 2016 Sep 23.

Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China. Electronic address:

Purpose: To evaluate the clinical usefulness of neutrophil-lymphocyte ratio (NLR) in differentiating the ultrasound-indeterminate renal multilocular cystic masses (RMCM) in comparison with computed tomography (CT) and whether NLR has additional benefits to CT on sensitivity of detecting the malignant.

Materials And Methods: Overall, 93 patients who underwent normal ultrasound with a conclusion of indeterminate RMCM were examined by NLR and CT within 30 days before surgery or follow-up from March to September 2014 at PLA General Hospital and enrolled in this retrospective study. Logistic regression model was performed to find independent predictors for differentiating true nature of RMCM; differences in the validity parameters and diagnostic power of CT, NLR, and their combination were compared using McNemar tests and AUC model, respectively. Read More

J Indian Assoc Pediatr Surg 2016 Apr-Jun;21(2):61-5

Department of Paediatric Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.

Aims: Scrutiny over the clinical behaviors, management, and the final outcome of some rare renal neoplasm in order to find out some hidden facts about these tumors which are playing an important role in the disease course and its management.

Materials And Methods: Retrospective evaluation of uncommon (non-Wilms') renal neoplasm in the pediatric population in a tertiary care center. Fifteen cases of uncommon renal tumors were treated in our institution over the last 5 years (January 2008 to December 2012). Read More

Curr Probl Diagn Radiol 2018 Nov 28;47(6):417-427. Epub 2016 Jan 28.

Department of Radiology, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA.

Diseases of the kidney often have their names shortened, creating an arcane set of acronyms which can be confusing to both radiologists and clinicians. This review of renal pathology aims to explain some of the most commonly used acronyms within the field. For each entity, a summary of the clinical features, pathophysiology, and radiological findings is included to aid in the understanding and differentiation of these entities. Read More

Zhonghua Zhong Liu Za Zhi 2015 Nov;37(11):845-9

Email:

Objective: To study the CT findings of cystic nephroma (CN) and multilocular cystic renal cell carcinoma (MCRCC) and to improve the accuracy of preoperative diagnosis of these two diseases.

Methods: The CT findings of nine CN cases and 19 MCRCC cases confirmed by pathology were blindly reviewed and compared with their pathological results. Fisher's exact test and independent-samples T test were applied to statistically analyze some of the CT features of the CN and MCRCC lesions. Read More

Pediatr Dev Pathol 2015 Nov-Dec;18(6):504-11. Epub 2015 Dec 23.

1 International Pleuropulmonary Blastoma Registry, Children's Hospital and Clinics of Minnesota, Minneapolis, MN 55404, USA.

Pleuropulmonary blastoma (PPB) is the most common primary malignant neoplasm of the lung in children. Like other solid dysontogenic neoplasms, this tumor typically presents before 7 years of age. The earliest manifestation is the presence of a lung cyst(s), which is usually recognized in the first year of life and is difficult to differentiate on the basis of imaging studies from non-neoplastic cysts of early childhood. Read More

AJR Am J Roentgenol 2015 Dec;205(6):1188-93

1 All authors: Department of Radiology and Medical Imaging, Fundación Santa Fe de Bogotá University Hospital, Universidad de Los Andes, Cra. 7b #123-90, Bogotá 220246, Colombia.

Objective: The objective of our study was to systematically summarize the published evidence of demographic, clinical, diagnostic imaging, and therapeutic characteristics of patients with multilocular cystic nephroma (MLCN).

Conclusion: Cross-sectional imaging evaluation is important for suggesting the diagnosis of MLCN but has several limitations. The number of radical nephrectomies reported for MLCN encourages discussion concerning the utility of percutaneous presurgical biopsy and frozen-section intraoperative biopsy as a more conservative diagnostic approach. Read More

J Pediatr Urol 2015 Jun 31;11(3):149.e1-6. Epub 2015 Mar 31.

Department of Urology, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Room 4230, Indianapolis, IN 46202, USA. Electronic address:

Introduction: Solitary renal cysts are typically incidentally found in children who have undergone renal ultrasound (US). The main concern is a cystic tumor. There is no US-based grading system for children to guide management. Read More

Zhonghua Bing Li Xue Za Zhi 2014 Nov;43(11):723-7

Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao 266003, China. E-mail:

Objective: To investigate the clinicopathological characteristics and the diagnosis of multilocular cystic renal cell carcinoma (MCRCC).

Methods: The clinicopathological data of 19 MCRCC cases were collected and immunohistochemical staining assays were carried out. Forty-six cases of other cystic kidney lesions within the same period were collected as controls, including extensively cystic clear cell RCC (12 cases), clear cell tubulopapillary renal cell carcinoma (6 cases), tubulocystic carcinoma (2 cases), simple cortical cysts (22 cases), multilocular cystic nephroma (1 cases) and multicystic kidney (3 cases). Read More

Cesk Patol 2014 ;50(4):137-41

Kidney tumours form a broad spectrum of distinguished histopathological and molecular genetic entities. The last WHO classification is dated to 2004. Current classification has been published in October 2013 by ISUP (International Society of Urological Pathology). Read More

Am J Clin Exp Urol 2014 2;2(3):266-72. Epub 2014 Oct 2.

Department of Pathology, New York University Langone Medical Center New York, NY, USA.

Background: Tumors of the kidney are uncommon in children and young adults. Accurate classification is crucial for both prognostication and therapeutic intervention. However, majority of the tumors in this age group have unusual morphology that renders classification challenging. Read More

Can Urol Assoc J 2014 Jul;8(7-8):E545-7

Department of Urology, First Hospital of Jilin University, Jilin, China;

Multilocular cystic nephroma is a relatively rare benign tumour of the kidney, which usually presents as a unilateral multicystic renal mass without solid elements. The lesions typically have a bimodal age, with peak incidence in male children under 24 months and another one in women over 40 old. We present an unusual case report of multilocular cystic nephroma in the right kidney in a 30-year-old male. Read More

Abdom Imaging 2015 Mar;40(3):542-51

Radiology Department, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain,

Objective: The aim of this study was to assess the accuracy of Ultrasound (US) and contrast-enhanced ultrasound (CEUS) in the characterization of renal nodules indeterminate on CT by identifying benign cystic lesions not requiring further examination.

Methods: 72 patients with 83 indeterminate renal nodules on CT underwent baseline US and CEUS that classified lesions as benign (Bosniak I, II or IIF cysts) or potentially malignant (Bosniak III or IV cysts, solid nodules). The accuracy of US and CEUS in the differentiation between benign cysts and potentially malignant nodules was analyzed and compared with the final diagnosis obtained by histology or follow-up of at least 23 months with CEUS ± a conclusive CT/MR study. Read More

Int J Clin Exp Pathol 2014 15;7(8):5271-9. Epub 2014 Jul 15.

Department of Pathology, School of Medicine, Sifa University Izmir, Turkey.

Background: The multilocular cystic nephroma (MLCN) is a unilateral cystic neoplasm of the kidney exhibiting benign biological behavior. The etiology and histopathogenesis of the disease is controversial (dysplastic/hamartomous/neoplastic). MLCNs show bimodal age distribution, with peak incidence occurring at 2-4 years of age and between the fourth and sixth decades. Read More

Arch Esp Urol 2014 May;67(4):337-41

Department of Urology. Servicio Anatomia Patologica. Complejo Hospitalario Universitario de Albacete.Albacete.Spain.

Objective: To describe the clinical presentation, preoperative diagnostic possibilities, and treatment of cystic nephroma.

Methods: We describe a case of cystic nephroma in an adult male and show that, both in our patient and in the literature, a definitive diagnosis can only be obtained postoperatively, even when there is a reasonable clinical suspicion.

Conclusions: Cystic nephroma is rare, and some authors consider it a questionable entity. Read More

J Med Case Rep 2014 Apr 3;8:112. Epub 2014 Apr 3.

Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Introduction: Germ-line mutations in the micro-ribonucleic acid processing gene DICER1 have been shown to predispose to a subset of benign tumors susceptible to malignant transformation, including ovarian Sertoli-Leydig cell tumor, nontoxic multinodular goiter, multilocular cystic nephroma and pleuropulmonary blastoma, which can occur in children and young adults. This may be due to reduced Dcr-1 homolog expression in carriers of germline mutations, which causes impairment of micro-ribonucleic acid processing and deregulates the growth and differentiation of target cells, leading to an increased risk of tumorigenesis. Many carriers of germ-line DICER1 mutations remain unaffected, but development of tumors within carriers is associated with varying prognoses. Read More

J Lab Physicians 2014 Jan;6(1):50-2

Department of Pathology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.

Multilocular cystic renal cell carcinoma (MCRCC) represents a rare variant of clear cell renal cell carcinoma (RCC). MCRCC has been recognized as a separate subtype of RCC in the 2004 World Health Organization (WHO) classification of adult renal tumors. MCRCC is diagnosed on the basis of strict histological criteria according to 2004 WHO classification. Read More

Mod Pathol 2014 Sep 31;27(9):1267-80. Epub 2014 Jan 31.

1] Division of Pathology, and Children's National Medical Center, George Washington University School of Medicine & Health Sciences, Washington, DC, USA [2] Center for Genetic Medicine Research, Children's Research Institute, Minneapolis, MN, USA [3] International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA [4] Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, USA.

The pathogenesis of cystic nephroma of the kidney has interested pathologists for over 50 years. Emerging from its initial designation as a type of unilateral multilocular cyst, cystic nephroma has been considered as either a developmental abnormality or a neoplasm or both. Many have viewed cystic nephroma as the benign end of the pathologic spectrum with cystic partially differentiated nephroblastoma and Wilms tumor, whereas others have considered it a mixed epithelial and stromal tumor. Read More

Indian J Surg 2012 Dec 15;74(6):501-3. Epub 2011 May 15.

Jawaharlal Nehru Medical College, Wardha, Maharashtra India.

Cystic nephroma, also called multilocular cystic nephroma, is a relatively rare, nongenetic, benign, unilateral, renal multicystic lesion. The non-specific clinical findings and the poor contribution of imaging examinations make the preoperative diagnostic dilemma from other cystic renal neoplasia; thus nephrectomy seems to be the most preferable treatment. We report a case of cystic nephroma in 11 months old male child presented with asymptomatic lump in abdomen. Read More

Urol Ann 2013 Jan;5(1):13-7

Department of Radiology, Pinderfields General Hospital, Wakefield, West Yorkshire, UK.

Background: Cystic renal neoplasms of the kidney can be benign or malignant. Multicystic nephroma (MCN) represents a rare benign cystic lesion of the kidney, which usually presents as a unilateral multicystic renal mass without solid elements. According to the World Health Organization (WHO) classification of the renal neoplasms, it is grouped along with mixed epithelial-stromal tumor of the kidney. Read More

Virchows Arch 2013 May 24;462(5):575-81. Epub 2013 Mar 24.

Department of Pathology, University of Maryland Medical Center, NBW85, 22 S Greene Street, Baltimore, MD 21201, USA.

Tubulocystic carcinoma of the kidney (TCCK) is a tumor entity, which is not yet included in the WHO classification of renal tumors. The histogenesis of this neoplasm is uncertain. This study was undertaken to determine (1) the incidence of TCCK and (2) immunohistochemical and ultrastructural characteristics of those tumors that qualify as TCCK by the current definitions. Read More

J Clin Ultrasound 2013 Nov-Dec;41 Suppl 1:59-61. Epub 2012 Dec 27.

Department of Obstetrics and Gynecology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.

The authors report an unusual presentation of congenital mesoblastic nephroma as a multilocular cystic renal lesion. Prenatal sonography revealed a unilateral, encapsulated, multilocular cystic mass with solid components measuring 5.7 × 5. Read More

J Comput Assist Tomogr 2012 Nov-Dec;36(6):659-68

Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio TX 78229, USA.

Cystic renal neoplasms in adults are a heterogeneous group of tumors with characteristic histogenesis, pathological findings, and variable biological profiles. They include disparate entities that are either biologically benign (lymphangioma, cystic nephroma, and mixed epithelial and stromal tumor) or malignant (cystic renal cell carcinoma, multilocular cystic renal cell carcinoma, and primary renal synovial sarcoma). Renal cystic diseases are characterized by cystic changes of the kidneys due to hereditary, developmental, or acquired etiology. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2012 Oct;44(5):760-4

Department of Urology, Peking University Third Hospital, Beijing, China.

Objective: To evaluate the feasibility, efficacy and safety of laparoscopic partial nephrectomy for complex renal cystic lesions.

Methods: A retrospective cohort study was conducted on the clinical data of 27 patients with complex renal cystic lesions treated by laparoscopic partial nephrectomy from May 2008 to April 2011 in Peking University Third Hospital. According to the Bosniak classification, 7 cases were lesions of grade IIF, 11 of grade III, and 9 of grade IV. Read More

Indian J Pathol Microbiol 2012 Jul-Sep;55(3):420-2

Abdom Imaging 2012 Oct;37(5):873-84

Department of Radiology, Johns Hopkins University, JHOC 3251, 601 N. Caroline Street, Baltimore, MD 21287, USA.

The vast majority of primary renal masses represent clear cell or papillary renal cell carcinomas, angiomyolipomas, or transitional cell carcinomas. However, a number of more rare masses can also be encountered, many of which can be very difficult to differentiate from these more common entities based on their imaging features. These uncommon entities include metanephric adenoma, epithelioid angiomyolipoma, medullary renal cell carcinomas, multilocular cystic nephroma, hemangiopericytoma, hemangioma, leiomyoma, leiomyosarcoma, solitary fibrous tumor, renal plasmacytomas, and mixed epithelial and stromal tumors. Read More

Rom J Morphol Embryol 2011 ;52(1 Suppl):497-501

Department of Pathology, Emergency County Hospital, Constanta, Romania.

Primary tumors of the renal pelvis and ureter account for about 8% of all urinary tract tumors. More than 90% of them are urothelial carcinomas. On the other hand, unilateral multicystic renal disease is an uncommon pathologic condition that may be mistaken for unilateral autosomal dominant polycystic kidney disease, multilocular cystic nephroma or cystic neoplasm. Read More

J Formos Med Assoc 2011 Feb;110(2):125-8

Division of Plastic and Reconstructive Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Mixed epithelial and stromal tumor of the kidney is a newly categorized lesion, with few reported cases. We report a rare case of a 45-year-old woman with a palpable abdominal mass and elevated serum level of serum cancer antigen 125, who was not receiving hormones or contraceptive agents. Abdominal magnetic resonance imaging revealed a large multilocular cystic tumor that arose in the left central kidney. Read More

Actas Urol Esp 2010 Nov;34(10):921-3

J Med Genet 2010 Dec 29;47(12):863-6. Epub 2010 Oct 29.

Program in Cancer Genetics, Department of Oncology, McGill University, Montreal, Quebec, Canada.

Background: Multilocular cystic nephroma (CN) is a benign kidney tumour and is part of a family of kidney neoplasms including cystic partially differentiated nephroblastoma and Wilms tumour (WT). CN is rarely familial or bilateral, but it occurs in about 10% of families where pleuropulmonary blastoma (PPB) is present. Recently, germline mutations in DICER1 were found in familial PPB. Read More

Pathologe 2010 Oct;31 Suppl 2:239-43

Institut für Klinische Pathologie, UniversitätsSpital Zürich, Schmelzbergstr. 12, 8091, Zürich, Schweiz.

Renal neoplasms with dominant cysts represent a broad spectrum of known as well as novel renal tumor entities. Established renal tumors with dominant cysts include cystic nephroma, mixed epithelial and stromal tumor, synovial sarcoma and multilocular cystic renal cancer (WHO classification 2004). Novel tumor types have recently been reported, which are also characterized by marked cyst formation. Read More

Adv Anat Pathol 2010 May;17(3):209-14

Department Pathology, University Hospital Zurich, Switzerland.

Cystic renal neoplasms and renal epithelial stromal tumors are diagnostically challenging and represent some novel tumor entities. In this article, clinical and pathologic features of established and novel entities are discussed. Predominantly cystic renal tumors include cystic nephroma/mixed epithelial and stromal tumor, synovial sarcoma, and multilocular cystic renal cell carcinoma. Read More

BJU Int 2010 Apr 10;105(7):932-9. Epub 2009 Oct 10.

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Objective: To describe the features on ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) of mixed epithelial and stromal tumours of the kidney.

Patients And Methods: Five women with renal mixed epithelial and stromal tumours (mean age 55.6 years, range 49-59) who had preoperative imaging were retrospectively analysed. Read More

Arch Esp Urol 2009 Jan-Feb;62(1):62-6

Servicio de Urología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.

Objective: To analyze the presentation of multilocular cystic nephroma and its diagnostic-therapy scheme.

Methods: We report the three last new cases presenting in our department in a period of three years.

Results: Multilocular cystic nephroma is a benign lesion, rare that appears both in adult age, generally asymptomatic, and in children, frequently as a palpable mass. Read More

Tunis Med 2008 Jun;86(6):623-4

Ultraschall Med 2008 Dec 25;29 Suppl 5:264-7. Epub 2008 Nov 25.

Klinik für Kinder- und Jugendmedizin, Sozialstiftung Bamberg.

The following is a report of the unusual case of a multilocular cystic nephroma in an 8-year-old boy who was transferred to our unit with a palpable abdominal tumor. The patient suffered from thoracic pain and night sweating. The laboratory values were normal. Read More

Indian J Pathol Microbiol 2008 Oct-Dec;51(4):563-5

Cases J 2008 Oct 23;1(1):267. Epub 2008 Oct 23.

Department of Urology, Thriasio Hospital, Elefsina, Greece.

Background: The spectrum of cystic renal neoplasms includes both benign and malignant tumors and the order is as follows: benign multilocular cyst, multilocular cystic renal cell cancer and cystic renal cell cancer. Gross similarities among multicystic tumors of the kidney may cause conflict in the diagnosis and treatment of these lesions.

Results: We report a 53-year old male patient who presented with a mild persistent left flank pain and a painful left renal mass. Read More

Radiographics 2008 Jul-Aug;28(4):1221-5; discussion 1225-6

Department of Diagnostic Radiology, Kingston General Hospital, Queen's University, 76 Stuart St, Kingston, ON, Canada K7L 2V7.