Computed Tomography of Renal Tuberculosis and Its Pathological Correlates

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Abstract
Computed tomographic [CT] studies of 8 patients with proven renal tuberculosis demonstrated a spectrum of findings related to the extent and the severity of kidney involvement. In early or focal disease, obstruction of a single major calyx or a group of minor calyces was noted (4 cases) with no excretion of contrast material into the affected calyces (3 cases) and cortical thinning. Tuberculosis of the renal pelvis (5 cases) was manifested by either pelvic dilatation secondary to ureteropelvic junction obstruction (3 patients) or diffuse pelvic contraction (2 patients). In far advanced disease (4 cases) the kidneys were small and exhibited atrophy with replacement of parenchyma by 1 or more low density areas. Calcifications (37.5%) were identified in the parenchyma and within the calyces. CT may provide the 1st clue in suggesting the inflammatory nature of a renal mass and excluding a neoplastic process. CT is also of value in determining the full extent of extrarenal involvement and the amount of residual functioning parenchyma, both of which are critical in proper treatment planning.