B cell lymphoma - perirenal

Presentation

One week of fever, left flank pain and hematuria, being initially diagnosed as acute left pyelonephritis and discharged with oral antibiotics. Due to the persistence of symptoms, an ultrasound was performed in another center describing findings of a possible left peri-renal abscess.

Patient Data

Age: 50 years
Gender: Male
CT

Ill-defined medial left perirenal mass with thickening of the left anterior pararenal fascia. It shows heterogeneous enhancement with a hypodense center. 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.

MRI

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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Case information

rID: 69107
Published: 28th Jun 2019
Last edited: 1st Dec 2019
Inclusion in quiz mode: Included
Institution: Fundacio Puigvert

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