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Background <p>To compare the CT and MRI features of renal inflammatory myofibroblastic tumor (IMT) with those of clear cell renal cell carcinoma (ccRCC) and chromophobe renal cell carcinoma (ChRCC).</p> Methods <p>Clinical and imaging data of 13 patients with pathologically confirmed renal IMT, along with 52 patients with ccRCC and 52 with ChRCC treated at two centers between January 2013 and February 2025 were retrospectively obtained, and the lesions’ location, shape, margin, size, secondary changes, density or signal characteristics, and enhancement degree with pattern were analyzed. The clear cell likelihood score (ccLS) was used for the evaluation of MRI characteristics.</p> Results <p>The renal IMT cohort comprised 9 males and 4 females (mean age, 54.2 ± 8.61 years). All lesions were solitary, measuring 1.7–14.4&#xa0;cm. Notably, ill-defined margins were detected in 9/13 (69.2%), perirenal fascia thickening in 8/13 (61.5%), and non-enhancing region in 3/13 (23.1%). There was no hemorrhage, central scar or calcification. Unenhanced CT showed a mean attenuation of 43.7 HU. On contrast-enhanced CT, 77.8% (7/9) exhibited mild-moderate enhancement, with 55.6% (5/9) showing progressive enhancement and 33.3% (3/9) demonstrating a “slow-in and slow-out” pattern. MRI revealed hypointense or isointense signal on T1WI and T2WI, while 87.5% (7/8) showed restricted diffusion on DWI and arterial-to-delayed enhancement ratio &lt; 1.5. No lesions exhibited microscopic fat or segmental enhancement inversion. The ccLS for renal IMTs were predominantly 1–2. Compared to ccRCCs and ChRCCs, renal IMTs more commonly exhibited ill-defined margins (<i>P</i>1 = 0.037, <i>P</i>2 &lt; 0.001), perirenal fascia thickening (<i>P</i>1 = 0.014, <i>P</i>2 &lt; 0.001) and higher unenhanced CT attenuation (<i>P</i>1 = 0.016, <i>P</i>2 = 0.030). Two renal IMT cases showed suspected postoperative recurrence or metastasis.</p> Conclusions <p>CT and MRI imaging features can facilitate the diagnosis of renal IMT and differentiate it from ccRCC and ChRCC.</p>

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CT and MRI features of renal inflammatory myofibroblastic tumor and its differential diagnosis from clear cell renal cell carcinoma and chromophobe renal cell carcinoma: a study of 13 cases from two centers

  • 期刊论文

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  • 发表日期：

    2026年5月28日

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  • Hongyang Du,
  • Jingyun Wu,
  • Qi Shen,
  • Chang Rong,
  • Kexin Wang,
  • Jing Liu,
  • Jianxing Qiu,
  • He Wang,
  • Naishan Qin

摘要

Background

To compare the CT and MRI features of renal inflammatory myofibroblastic tumor (IMT) with those of clear cell renal cell carcinoma (ccRCC) and chromophobe renal cell carcinoma (ChRCC).

Methods

Clinical and imaging data of 13 patients with pathologically confirmed renal IMT, along with 52 patients with ccRCC and 52 with ChRCC treated at two centers between January 2013 and February 2025 were retrospectively obtained, and the lesions’ location, shape, margin, size, secondary changes, density or signal characteristics, and enhancement degree with pattern were analyzed. The clear cell likelihood score (ccLS) was used for the evaluation of MRI characteristics.

Results

The renal IMT cohort comprised 9 males and 4 females (mean age, 54.2 ± 8.61 years). All lesions were solitary, measuring 1.7–14.4 cm. Notably, ill-defined margins were detected in 9/13 (69.2%), perirenal fascia thickening in 8/13 (61.5%), and non-enhancing region in 3/13 (23.1%). There was no hemorrhage, central scar or calcification. Unenhanced CT showed a mean attenuation of 43.7 HU. On contrast-enhanced CT, 77.8% (7/9) exhibited mild-moderate enhancement, with 55.6% (5/9) showing progressive enhancement and 33.3% (3/9) demonstrating a “slow-in and slow-out” pattern. MRI revealed hypointense or isointense signal on T1WI and T2WI, while 87.5% (7/8) showed restricted diffusion on DWI and arterial-to-delayed enhancement ratio < 1.5. No lesions exhibited microscopic fat or segmental enhancement inversion. The ccLS for renal IMTs were predominantly 1–2. Compared to ccRCCs and ChRCCs, renal IMTs more commonly exhibited ill-defined margins (P1 = 0.037, P2 < 0.001), perirenal fascia thickening (P1 = 0.014, P2 < 0.001) and higher unenhanced CT attenuation (P1 = 0.016, P2 = 0.030). Two renal IMT cases showed suspected postoperative recurrence or metastasis.

Conclusions

CT and MRI imaging features can facilitate the diagnosis of renal IMT and differentiate it from ccRCC and ChRCC.