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What does loss of differentiation of cortex and medullae in a kidney mean ?

ID NO : 96/387653 Date: 22-03-11 Patient s Name: Mrs. Nuzrat Tasmin I Age: 27 Years Sex: Female Refd.By : Prof. Dr. A BM Abdullah. Part Scan : ULTRASONOGRAPHYOF ABDOMINOPELVIC ORGANS SUMMARYOF FINDINGS HBS LIVER: • Is normal in size (12.7 cm). in right mid clavicular line • Uniform in parenchymal echotexture. • No focal or diffuse lesion is seen. • Intra hepatic veins and portal veins appear normal. • Intrahepatic biliary trees are not dilated. GALL BLADDER: • Is normal in size (5.8 x 2.6) cm. • Wall thickness is within normal limit (2.2mm). • No evidence of echogenic structure or biliary sludge is seen within the lumen .. CBD: • Is not dilated (4.0mm). , • No evidence of echogenic structure or biliary sludge is seen within the lumen. PANCREAS: • Normal in size. • Parenchymalechotexture is homogeneous. • Pancreatic duct is not dilated. . SPLEEN: • Normal in size (8.5 cm). • Parenchymal echotexture is uniform. • No focal lesion is seen. KUB: RIGHT KIDNEY : • Is enlarged in size in TD and in bipolar diameter. measuring about 14.0 cm. normal in shape and position. • Loss of-differentiation of cortex and medullae. • Pelvi-calyceal system could not be evaluated properly. • There are multiple anechoic lesions seen allthrough the parenchyma. the largest one is measuring about 5.7x4.8cm which contains internal echoes. LEFT KIDNEY : • Is enlarged in size in bipolar diameter, measuring about 13.5 cm, normal in shape and position • Well-differentiated cortex and medullae. • Pelvi-calycealsystem is not dilated. • There are multiple tiny an anechoic lesions seen allthrough the parenchyma. • Perinephric space appears normal. URETERS: No evidence of any obstructive feature seen in any Ureteric region. URINARY BLADDER: • Is partially filled and normal in outline. • Wall thickness is within normal limit • No intravesical lesion or calculus is seen. UTERUS AND ADNEXAE: Uterus: • Is bulky in size (8.0x4.8x5.6)cm, anteverted in position • Uniform parenchymal echotexture of myometrium. • Endometrial thickness is 9.0 mm, which is within normal limit. Right Ovary • Is normal in size, shape and position and has follicular activities. • The ovary is measuring about (3.1x1.9) cm. Left Ovary • Is normal in size, shape and position and has follicular activities . • The ovary is measuring about (3.4x1.6) cm. CUL-DE-SAC: • No free fluid is seen in cul-d~-sQc. OTHERS: NO EVIDENCE OF ANY ABNORMAL FREE OR ORGANIZED FLUID IS SEEN IN PERITONEAL CAVITY . NO EVIDENCE OF ANY PLEURAL EFFUSION IS SEEN. NO EVIDENCE OF ANY ENLARGED LYMPH NODES IN PRE OR PARA AORTIC REGION. IMPRESSION: - FEATURES ARE CONSISTENT WITH 1. BILATERAL ENLARGED KIDNEYS. 2. SUSPECTED BILATERAL POLYCYSTIC KIDNEY DISEASES . 3. BULKY UTERUS. Dr. Shahnaz Bithi MBBS, DMUD.
Asked On : Tue, 22 Mar 2011
Answers:  2 Views:  112
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General Surgeon 's  Response
Hello and welcome to healthcare forum.
Your usg report is suggestive that you are suffering from adult polycystic kidney disease.
As such there is no specific treatment to eradicate this condition and only option is kidney transplant. You will require renal function test every 3 months to know present status of kidney function and according to that decision of transplant will be taken.
So, consult a nephrologist for further management.
Answered: Tue, 26 Jul 2011
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Nephrologist Dr. Avinash Ignatius's  Response
The description is suggestive of polycycstic kidneys. Is there a family history of kidney problems. Polycystic may not cause any problems even till old age in some, while in others they may develop renal failure even in their 40s. what is the present creatinine, is there protein in the urine, is blood pressure high. All these will decide how well the kidneys will function.
Answered: Wed, 3 Aug 2011
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