What’s causing this characteristic appearance on CT?

April 25, 2018
Figure 1 Quiz of the Week

Figure 1 Quiz of the Week

A 37-year-old female presents to her family physician with recurring abdominal and flank pain. She mentions her mother suffered from kidney problems but doesn’t know many details. Examination reveals a blood pressure of 170/110 mmHg and proteinuria is present on dipstick. Laboratory tests show an elevated hematocrit, microalbuminuria, and microscopic hematuria. A CT scan later reveals the findings seen here.

Which of the following conditions is most commonly associated with this patient’s likely diagnosis?

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Figure 1 Quiz of the Week

Image credit: @JCJones905


Answer: Cerebral aneurysm

This patient’s presentation and imaging findings are indicative of autosomal dominant polycystic kidney disease (ADPKD)—a multisystemic genetic disorder characterized by the formation and enlargement of cysts in the kidney and other organs. Approximately 20% of older adults with the condition are at risk for a cerebral aneurysm, one of the major extrarenal manifestations of polycystic kidney disease and the most serious complication. Those at greatest risk have a family history of intracranial aneurysm or subarachnoid hemorrhage, and therefore screening may be recommended in these patients.

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