Presentation
Possible mass left kidney on ultrasound examination (outside institution)
Patient Data
No true mass identified on CT. There was a prominent area of normal renal tissue in the upper pole of the left kidney with maintained cortico-medullary differentiation on the cortico-medually phase imaging (best seen on coronals). The findings are consistent with a benign prominent column of Bertin (normal parenchyma).
Case Discussion
Abnormally shaped normal renal parenchyma can be hard to differentiate from renal masses on ultrasound alone and require further imaging to characterize.
CT renal mass protocol, particularly the corticomedullary phase, is extremely useful to exclude a mass and diagnose with certainty a pseudotumor. Review of coronal reformats are particularly useful.
In this case the pseudotumor was a prominent column of Bertin (aka junctional parenchyma).
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