Alveolar architecture of clear cell renal carcinomas (<= 5.0 cm) show highattenuation on dynamic CT scanning

Background: To establish the correlation between tumor appearance on CT and tumor histology in renal cell carcinomas. Methods: The density and attenuation patterns of 96 renal cell carcinomas, each less than or equal to 5 cm in greatest diameter, were studied by non-e nhanced CT and early and late after bolus injection of contrast medium usin g dynamic CT. The density and attenuation patterns and pathological maps of each tumor were individually correlated. Results: High attenuated areas were present in 72 of the 96 tumors on early enhanced dynamic CT scanning. All 72 high attenuated areas were of the cle ar cell renal cell carcinoma and had alveolar architecture. The remaining 2 4 tumors that did not demonstrate high attenuated foci on early enhanced sc anning included three clear cell, nine granular cell, six papillary, five c hromophobe and one collecting duct type. With respect to tumor architecture , all clear cell tumors of alveolar architecture demonstrated high attenuat ion on early enhanced scanning. Conclusion: Clear cell renal cell carcinomas of alveolar architecture show high attenuation on early enhanced dynamic CT scanning. A larger number of patients are indispensable to obtaining clear results. However, these findi ngs seem to be an important clue to the diagnosis of renal cell carcinomas as having an alveolar structure.