Renal lymphoma

Case contributed by Dr Chris O'Donnell

Presentation

Known chronic lymphocytic leukemia, now presenting with dull left loin pain.

Patient Data

Age: 70 years
Gender: Male
CT

Infiltrative mass centered in the left renal sinus extending around the upper left ureter (encasing the calyces, renal pelvis, and ureter). Right kidney contains multiple cysts, but is otherwise normal. On the delayed scan, left kidney excretes contrast. Note splenomegaly and minimally enlarged para-aortic lymph nodes.

Fluoroscopy

Surprisingly the pyelogram is normal without obvious extrinsic compression or filling defect.

Ultrasound

Non-discrete mass in the left renal sinus targeted at core biopsy under ultrasound control

Pathology

Core biopsy confirms a neoplasm of small lymphocytes - in the spectrum of lymphoma/chronic lymphatic leukemia

Case Discussion

This case is one of the typical manifestations of renal lymphoma i.e. an infiltrative process rather than discrete parenchymal mass without involvement of the lumen of the collecting system (excluding the diagnosis of TCC).

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