Nierenzysten-Klassifikation

Bosniak
classification system of renal cystic masses • Bosniak classification of renal cysts (illustrations) - Ganzer Fall bei Radiopaedia
Skalski, M. Bosniak classification of renal cysts (illustrations). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-20989 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Renal cell carcinoma on a background of autosomal dominant polycystic kidney disease - Ganzer Fall bei Radiopaedia
Knipe, H. Renal cell carcinoma on a background of autosomal dominant polycystic kidney disease. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-55759 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Renal complex cyst (Bosniak category III) - Ganzer Fall bei Radiopaedia
Niknejad, M. Renal complex cyst (Bosniak category III). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-86522 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Renal complex cyst (Bosniak category III) - Ganzer Fall bei Radiopaedia
Niknejad, M. Renal complex cyst (Bosniak category III). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-86408 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Renal complex cyst (Bosniak category III) - Ganzer Fall bei Radiopaedia
Niknejad, M. Renal complex cyst (Bosniak category III). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-86180 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Renal complex cyst (Bosniak category IV) - Ganzer Fall bei Radiopaedia
Niknejad, M. Renal complex cyst (Bosniak category IV). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-82606 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Renal cyst - Bosniak type IIF (CEUS) - Ganzer Fall bei Radiopaedia
Botz, B. Renal cyst - Bosniak type IIF (CEUS). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-72117 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Renal cyst - Bosniak type II (CEUS) - Ganzer Fall bei Radiopaedia
Botz, B. Renal cyst - Bosniak type II (CEUS). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-68346 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Complex renal cyst - Bosniak type IV - Ganzer Fall bei Radiopaedia
Niknejad, M. Complex renal cyst - Bosniak type IV. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-61987 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Bosniak renal cyst - type IV - Ganzer Fall bei Radiopaedia
Dixon, A. Bosniak renal cyst - type IV. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-23402 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Simple renal cyst - Ganzer Fall bei Radiopaedia
Radswiki, T. Simple renal cyst. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-11931 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Bosniak renal cyst - type IV - Ganzer Fall bei Radiopaedia
Cuete, D. Bosniak renal cyst - type IV. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-22929 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Bosniak cyst - type IV - Ganzer Fall bei Radiopaedia
Bickle, I. Bosniak cyst - type IV. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-23525 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Atypical renal cyst - Ganzer Fall bei Radiopaedia
Schubert, R. Atypical renal cyst. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-17536 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Bosniak renal cyst - type IIF - Ganzer Fall bei Radiopaedia
Gaillard, F. Bosniak renal cyst - type IIF. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-23385 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Bosniak renal cyst (type II) - Ganzer Fall bei Radiopaedia
Di Muzio, B. Bosniak renal cyst (type II). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-19634 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Bosniak renal cyst - type II - Ganzer Fall bei Radiopaedia
Dixon, A. Bosniak renal cyst - type II. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-23404 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Bosniak renal cyst (hemorrhagic cyst) - type II - Ganzer Fall bei Radiopaedia
Bashir, U. Bosniak renal cyst (hemorrhagic cyst) - type II. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-18823 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Bosniak renal cyst - type I - Ganzer Fall bei Radiopaedia
Cuete, D. Bosniak renal cyst - type I. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-27479 • CC by-nc-sa 3.0 (modified)
Bosniak
classification system of renal cystic masses • Renal complex cyst (Bosniak category IV) - Ganzer Fall bei Radiopaedia
Niknejad, M. Renal complex cyst (Bosniak category IV). Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-93636 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

The Bosniak classification system of renal cystic masses divides renal cystic masses into five categories based on imaging characteristics on contrast-enhanced CT. It is helpful in predicting a risk of malignancy and suggesting either follow up or treatment.

There has been a recent proposal (2019) in Radiology  for updating the current classification which does not yet have validation. This update incorporates MRI in addition to CT, establishes definitions for previously vague imaging terms, and enables a greater proportion of masses to enter lower risk classes.

Classification

Bosniak I
  • simple cyst
    • imperceptible wall, rounded
    • work-up: none
    • percentage malignant: ~0%
Bosniak II
  • minimally complex
    • a few thin <1 mm septa or thin calcifications (thickness not measurable); 
    • non-enhancing high-attenuation (due to proteinaceous or hemorrhagic contents) renal lesions <3 cm
    • these lesions are generally well marginated
    • work-up: none
    • percentage malignant: ~0%
Bosniak IIF
  • minimally complex
    • increased number of septa, minimally thickened with nodular or thick calcifications
    • there may be perceived (but not measurable) enhancement of hairline-thin smooth septa
    • minimal thickening of the wall with perceivable enhancement
    • hyperdense cyst >3 cm diameter, mostly intrarenal (less than 25% of wall visible); no enhancement
    • requiring follow-up (the 'F' in 2F is for 'follow'): needs ultrasound/CT/MRI follow up - no strict rules on the time frame but reasonable at 6 months
    • percentage malignant: ~5% 
Bosniak III
  • indeterminate
    • thick, nodular multiple septa or wall with measurable enhancement
    • treatment/work-up: partial nephrectomy or radiofrequency ablation in elderly or poor surgical candidates
    • percentage malignant: ~55% 
Bosniak IV
  • clearly malignant
    • solid mass with a large cystic or a necrotic component
    • treatment: partial or total nephrectomy
    • percentage malignant: ~100%

History and etymology

It is named after Morton A Bosniak (1929-2016), who was professor emeritus in radiology at New York University (NYU) Langone School of Medicine .

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Bosniak-Klassifikation:
renal cysts
 
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