Presentation
Left lumbar pain and weight loss. 1 month history of phlegm.
Patient Data
CT CHEST: Multiple nodules upto 1.6cm in both lungs. No mediastinal lymphadenopathy.
CT ABDOMEN: Chronic severe left sided hydronephrosis due to a pelvis stone. Renal cortex thinned to 2mm. Soft tissue thickening of the left renal pelvis at the site of the stone. Left renal hilum nodes up to 2cm
The remainder of the solid organs are normal.
The sequence of performing a CT guided FNAC of one of the pulmonary nodules.
This was deemed a safer and easier way of achieving a histological diagnosis than accessing the soft tissue at the renal hilum.
The FNAC from one of the lung nodules is concordant with the impression from the CT study.
Case Discussion
An uncommon, but recognized complication of chronic renal stone disease.
Primary renal squamous cell carcinoma constitutes less than 1% of all urinary tract neoplasms.
The radiological suspicion from the CT was of SCC, given the soft tissue around the long standing pelvic stone, without the typical appearances of the most common urological primary tumors of RCC and TCC.
This was proven on image guided biopsy.
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