Renal imaging: angiomyolipoma: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Renal imaging: angiomyolipoma

Sample item

A CT shows a well-defined renal mass containing areas of density -80 HU. Which tumour is it, and in which genetic syndrome is it frequently bilateral and multiple?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Angiomyolipoma, tuberous sclerosis

Macroscopic fat (-20 HU or less) in a renal mass is diagnostic of angiomyolipoma. Tuberous sclerosis is associated with bilateral multiple lesions, and lesions over 4 cm carry a risk of haemorrhage (Wunderlich syndrome). Embolisation or mTOR inhibitors are used in selected cases.

Option by option

  • A. Renal oncocytoma, von Hippel-Lindau

    Oncocytoma has a central scar and VHL is associated with clear cell RCC.

  • B. Wilms tumour, WAGR syndrome

    Wilms tumour presents in children and rarely contains fat.

  • C. Angiomyolipoma, tuberous sclerosis (correct)

    Correct. Fat within the mass is diagnostic of AML, linked to tuberous sclerosis.

  • D. Transitional cell carcinoma, Lynch

    Transitional cell carcinoma arises in the collecting system.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Angiomyolipoma, tuberous sclerosis. Macroscopic fat (-20 HU or less) in a renal mass is diagnostic of angiomyolipoma.

Why is "Renal oncocytoma, von Hippel-Lindau" not the answer?

Oncocytoma has a central scar and VHL is associated with clear cell RCC.

Why is "Wilms tumour, WAGR syndrome" not the answer?

Wilms tumour presents in children and rarely contains fat.

Why is "Transitional cell carcinoma, Lynch" not the answer?

Transitional cell carcinoma arises in the collecting system.

What concept does this question test?

It tests Renal imaging: angiomyolipoma in Radiology. Tuberous sclerosis is associated with bilateral multiple lesions, and lesions over 4 cm carry a risk of haemorrhage (Wunderlich syndrome). Embolisation or mTOR inhibitors are used in selected cases.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Renal imaging: angiomyolipoma?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.