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Moreover, Pedrosa et al[53] found that findings such as large size, intralesional necrosis, retroperitoneal vascular collaterals, and renal vein thrombosis predicted ABT-737 mouse a high grade clear cell subtype (P 4 cm can show internal heterogeneity due to cystic change and necrosis[55]. Cystic papillary RCCs may show hemorrhagic fluid content and internal mural nodules or papillary projections while cystic clear cell RCCs typically show clear fluid content and irregular walls and septations[11,53,55]. Chromophobe RCC tends to appear well-circumscribed and homogeneous Hesperadin (cystic change and necrosis are uncommon) even when large (Figure ?(Figure3),3), and perinephric infiltration and vascular involvement ( 25% signal loss was predictive Torin 1 mouse for clear cell RCC. The use of a simple two-point Dixon fat-water separation technique derived from a dual-echo chemical shift T1 sequence is often helpful in aiding the radiologist in identifying small quantities of microscopic fat in a renal mass. Calcifications were significantly more frequent in papillary RCCs (32%) and chromophobe RCCs (38%) than clear cell RCCs (11%)[25,56]. Bilaterality and multifocality is also more common in papillary RCC (4% and 22.5% respectively) than clear cell RCC (