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Multiple perirenal masses with ill-defined, strandy borders. Several masses likely invade or arise from renal cortex.
Moderate hydronephrosis due to strandy mass obstructing proximal pelvoureteral junction.
Patient with several year history of lymphoma on and off chemotherapy. Fairly characteristic appearance of renal/perirenal disease with multiple ill defined masses and involvement of the cortex.
Given moderate hydronephrosis, urology consult would be appropriate. If tissue diagnosis were needed, ultrasound-guided biopsy would be feasible.
The differential diagnosis for perirenal infiltrative soft tissue involves several unusual diagnoses, and is worth trying to remember:
- retroperitoneal fibrosis
- igG4 sclerosing disease
- Erdheim-Chester disease
- extramedullary hematopoiesis