Implications of a Kidney Lesion

It can be alarming to be told that you or someone you love has a kidney lesion. It is a good idea to educate yourself on all there is to understand about this before pursuing treatment. A general understanding of the problem will make for a less stressed out patient.

First of all, a lesion refers to any abnormal tissue that can be found in or on any given organism; the lesion is usually the result of a disease or other trauma to the tissue. In fact, the root word for lesion in Latin is “laesio” meaning injury. A lesion is defined so broadly that any damage is covered by this word. A kidney lesion can be a reference to a tissue damaged by some malignant growth or it may refer to tissue damage caused by being near some other impacted organ. Metabolic processes such as an ulcer, trauma such as chemical burns and electrocution or a skin disease such as chicken pox are all likely to cause lesions.

Medical professionals differentiate lesions according to their features to distinguish between the broad varieties of lesions that exist. Often lesions are classified by their shape and so we have the bull’s-eye or target lesion. The cause of a lesion is sometimes used to define it and so a cancer-induced lesion is called a malignant lesion as opposed to a non-cancerous one is benign. The size is the defining characteristic when a lesion is referred to as gross because it can be seen by the human eye. A smaller lesion is referred to as histological as a microscope is needed to see it. The shape occupied by a lesion is another kind of classification – a space occupying lesion may intrude on the space of nearby organ tissues while a non space occupying lesion is embedded within the affected tissue as perhaps a hole. Some tissues of the brain become fluid following a stroke and this will also be seen as a non space occupying lesion.

What does this mean in terms of a kidney lesion? When a lesion is discovered during an imaging, doctors evaluate it to decide whether it requires further investigation. One of systems that they may follow is called “ Bosniak's Classification of Cystic Renal Masses.” According to this system introduced by Bosniak in 1986 to deal with cysts discovered in CT scans, round or oval lesions which are found to have water-like uniform density with no clear walls and show no impact after the patient is given a contrasting medium can be classified as simple benign cysts.  The next level is the minimally complicated simple cystic lesion which covers cysts with minimal calcification, septated or infected cysts and cysts which show a high density.

A greater level of complication emerges when the lesions show signs of malignancy which is apparent in thicker and irregular calcifications, inconsistent density and borders that are irregular. Uniformly thick walls and non-enhancing nodules may also be signs of malignancy. Class IV in Bosniak’s model addresses the possibility of clearly malignant lesions and tumor-induced liquefaction and necrosis are direct evidence of renal cell carcinoma or RCC. RCC lesions have what is called a “shaggy appearance” and these identifiable by their thickened walls and enhancing nodules.

This last classification is the one that a patient needs to be most concerned about. And when it is not immediately apparent from an imaging of a kidney lesion, doctors order further tests and investigation to determine the possible cause of a lesion.  Ultrasound, MRIs and CT scans are all used by doctors to get a comprehensive idea about a lesion in the kidney.

A lesion may often not have any accompanying symptom and may be discovered only by some other investigation and this is especially true for a cyst. Some times there may be a pain in the abdominal area and this along with other evidence may point to a growth that needs investigation. There may be inflammatory kidney lesions which emerge because of other problems such a urinary tract infection or fever. So, the symptoms associated with that disease may be part of the clinical history that the doctor will factor in while diagnosing.

A kidney lesion in and of itself is not a cause for alarm and early medical intervention can help in a quick diagnosis in most cases.


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