Presentation
One week of fever, left flank pain and haematuria, being initially diagnosed as acute left pyelonephritis and discharged with oral antibiotics. Due to the persistence of symptoms, an ultrasound was performed in another centre describing findings of a possible left peri-renal abscess.
Patient Data
Ill-defined medial left perirenal mass with thickening of the left anterior pararenal fascia. It shows heterogeneous enhancement with a hypodense centre. The left renal vessels are surrounded by the mass and there is no entrapment of the left ureter. Also, some enlarged nodes can be seen in the mesentery.
T2 weighted images show a heterogenenous soft-tissue mass with peripheral enhancement after the administration of Gadolinium.
Case Discussion
Because of the findings the diagnosis of a lymphoproliferative disease was suggested (among other perirrenal diseases) and a chest CT scan was performed, which was unremarkable. A percutaneous ultrasound guided biopsy of the lesion was also performed, with non-diagnostic results.
A surgical biopsy was obtained with a pathology report of a high grade B cell lymphoma.
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