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"apellidos" => "Reis" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480619301366" "doi" => "10.1016/j.acuro.2019.06.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480619301366?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578619301234?idApp=UINPBA00004N" "url" => "/21735786/0000004300000010/v1_201912120813/S2173578619301234/v1_201912120813/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "The current nosology on renal cysts: Bosniak III or IV?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "519" "paginaFinal" => "520" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. González Enguita, C. Simón Rodríguez, R. Vela Navarrete" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "González Enguita" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Simón Rodríguez" ] 2 => array:4 [ "nombre" => "R." "apellidos" => "Vela Navarrete" "email" => array:1 [ 0 => "RVela@fjd.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Fundacion Jimenez Diaz, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El Debate del Bosniak 3 o 4 y La vigente nosología quística" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">During the last 30 years the classification system of renal cystic processes proposed by Bosniak has been a common resource to define any renal cyst evaluated by computed tomography (CT).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The Bosniak classification is based on the detailed semiotics provided by CT; contour and contents, presence of septations and/or calcifications, enhancement after contrast agent injection and Hounsfield units.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Cystic processes with tumor suspicion are rated Bosniak III or IV and simple renal cysts are I or II. The assessment is strictly radiological, and the terminology is exclusively numerical. In the presence of disease, the final diagnosis is reduced to 2 options: clear cell renal cell carcinoma (CCRCC) or simple/benign renal cyst.</p><p id="par0015" class="elsevierStylePara elsevierViewall">CT has facilitated the diagnosis of many renal cystic processes, thus, avoiding unnecessary exploratory surgeries. The Bosniak classification has been, and still is, extraordinarily valid. However, numerical classification has limitations: it is not inerrable, it is incomplete and confusing due to the exclusion of conventional anatomo-clinical terminology. A recent publication<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> paradigmatically confirms these limitations: the classification of categories III and IV did not improve when the cystic volume assessment was added, still obtaining similar results for both categories of CCRCC. The second limitation is related to the answer to this question: What diseases that present renal cysts, benign or malignant, have been included in this series? There is not one single reference to common urology terms in the text, but the authors present 6 images; one is typical of multicystic kidney; another one shows polycystic disease of the renal sinus but described as a “subtype of benign cyst.”</p><p id="par0020" class="elsevierStylePara elsevierViewall">This extensive study confirms that the population included, of unknown nosological identity, is very heterogeneous. Despite multiple publications, other cystic diseases (parapelvic cysts, polycystic disease of the renal sinus) remain unknown in the literature.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> It also acknowledges that the unavoidable and more rigorous implementation to Bosniak, is provided by the clinician, in this case the urologist, positioning, not only the cyst, but the patient as well, in the correct anatomo-clinical definition. Actually, the CCRCC can correspond to different processes such as the multicystic dysplastic kidney (anomaly of the kidney of reduced recognizable malignancy in childhood) or the von Hippel-Lindau (systemic inherited disorder of extreme recognizable gravity in adulthood), and a benign cyst can be cortical or parapelvic, with different (renal or lymphatic) origin and clinical consequences.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In our clinical practice, the radiological identity proposed by Bosniak needs to add the nosological, anatomo-clinical surname from the conventional terminology, which is being ignored or avoided in the current radiological literature.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-06-07" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: González Enguita C, et al. El debate del Bosniak 3 o 4 y la vigente nosología quística. Actas Urol Esp. 2019;43:519–520.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The current radiological approach to renal cysts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.A. Bosniak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiology.158.1.3510019" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "1986" "volumen" => "158" "paginaInicial" => "1" "paginaFinal" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3510019" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and management of patients with complicated cystic lesions of the kidney" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.A. Bosniak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Roentgenol" "fecha" => "1997" "volumen" => "169" "paginaInicial" => "819" "paginaFinal" => "821" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cystic renal cell carcinoma: a report on outcomes of surgery and active surveillance in patients retrospectively identified on pretreatment imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. 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García Robledo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0022-5347(17)52319-8" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1983" "volumen" => "129" "paginaInicial" => "700" "paginaFinal" => "703" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6842686" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Poliquistosis del seno renal o hilioquistosis. Controversias, retos e historia de un descubrimiento compartido" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Simón Rodríguez" 1 => "C. Gonzalez Enguita" 2 => "R. 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