Presentation
Right flank pain.
Patient Data
Age: 75 years
Gender: Female
From the case:
Renal sinus lipomatosis
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Scanogram shows A calcular shadow at right side of the abdomen below the level of inferior hepatic border opposite L2 vertebra body.
CT shows enlarged right kidney with prominent renal sinus fat, reflecting renal sinus lipomatosis. The right renal pelvis is contracted over an oval-shaped stone.
Left kidney is average in size with mild pelvicalyceal dilatation and extrarenal pelvis.
No ureteric stones or dilatation.
Case Discussion
In renal sinus lipomatosis, there is excessive renal sinus fat with preserved parenchymal thickness and no signs of significant granulomatous inflammatory process. This is one of the reported changes due to renal stone disease.
Differential diagnoses are
- renal replacement lipomatosis; the advanced variant of this appearance in which there is renal parenchymal atrophy - compare with case (rID: 45867)
- xanthogranulomatous pyelonephritis: one of the complications of renal stone disease in which there is complete obstruction of renal pelvis and dilated calyces with signs of chronic pyelonephritis
- renal fibro-fatty proliferation in and around the kidney, as in obesity or Cushing's disease and excessive corticosteroid therapy
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