Diffuse large B cell lymphoma - renal involvement
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At the time the case was submitted for publication Aiyapa Aruna Ajjikuttira had no recorded disclosures.View Aiyapa Aruna Ajjikuttira's current disclosures
Presentation to the general practitioner with nocturnal back pain worsening over a few weeks.
CT abdomen and pelvis
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Major findings include:
- large, infiltrating left renal lesion centered around the lower pole
- fixation of the lesion to the left psoas major muscle with dilation of the left-sided collecting system
- left-sided retroperitoneal lymphadenopathy with the largest lymph node abutting the left renal vein
Other findings include:
- large bowel diverticulosis
- gallbladder calculi without evidence of acute cholecystitis
- no evidence of lytic or sclerotic metastatic disease within the imaged field
This gentleman was urgently referred to the urology outpatient service with a history of worsening abdominal and back pain. Imaging shows extensive left-sided retroperitoneal lymphadenopathy and a large, left-sided renal mass centered around the lower pole. Given the CT appearance of the lesion in question, it was felt to be reflective of an infiltrating process such as a lymphoma rather than a primary renal cell carcinoma during the discussion at our genito-urinary MDT meeting.
The patient underwent a CT-guided biopsy of the renal mass. Final histopathology confirmed the diagnosis of diffuse large B cell lymphoma. The patient is currently undergoing treatment via R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone).