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Lee SB, Yoon YM, Hong R. Primary renal lymphoma presenting as renal failure: A case report and review of literature from 1989. World J Clin Cases 2023; 11:7113-7126. [PMID: 37946781 PMCID: PMC10631424 DOI: 10.12998/wjcc.v11.i29.7113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Primary renal lymphoma (PRL) is extremely rare with an incidence of 0.7% among extranodal lymphomas. Occult renal lymphoma, which mimics medical renal disease and bilateral renal involvement, presents a diagnostic challenge to nephrologists and radiologists as the clinical and radiological findings are mostly non-specific or inconclusive. Acute kidney injury (AKI) is not an uncommon finding in renal infiltration due to malignant lymphoma. However, only 14% of cases are detected before death, and the low diagnostic rate may be due to the non-specific clinical manifestations of renal involvement, with only 0.5% of these cases presenting with AKI. Moreover, PRL is difficult to diagnose based on clinical, biochemical, and radiologic features, especially, in the case of bilateral diffuse involvement. CASE SUMMARY Herein, we report a 74-year-old woman with primary diffuse large B-cell lymphoma who presented with AKI diagnosed by ultrasound-guided needle biopsy. We also report the clinicopathologic findings of 121 PRL cases reported since 1989, by conducting a literature review of published cases. CONCLUSION A timely renal biopsy provides the most expedient means of establishing the diagnosis. Thus, early identification of the disease by the clinician facilitates early diagnosis toward effective treatment.
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Affiliation(s)
- Seul-Bi Lee
- Department of Hemato-Oncology, Medical School, Chosun University, Gwangju 61453, South Korea
| | - Young-Min Yoon
- Department of Nephrology, Medical School, Chosun University, Gwangju 61453, South Korea
| | - Ran Hong
- Department of Pathology, Medical School, Chosun University, Gwangju 61453, South Korea
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Saeed F, Osunkoya AO. Secondary Tumors of the Kidney: A Comprehensive Clinicopathologic Analysis. Adv Anat Pathol 2022; 29:241-251. [PMID: 35249993 DOI: 10.1097/pap.0000000000000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Metastases to the kidney are rare and were historically described in autopsy series, and the incidence ranged between 2.36% and 12.6%. However, in the contemporary literature with the improvements in imaging modalities (computed tomography scan and magnetic resonance imaging) and other health care screening services, metastatic tumors to the kidney are being diagnosed more frequently in surgical specimens. The utility of needle core biopsies in the primary evaluation of renal masses has also increased the number of sampled metastases, and as a result, only limited histologic material is available for evaluation in some cases and may potentially lead to diagnostic pitfalls. In the last decade, a few large clinical series have been published. In these series, the majority of metastatic tumors to the kidney are carcinomas, with the lung being the most common primary site. A significant number of the various tumor types with metastasis to the kidney are also associated with widespread metastases to other organs, and the renal metastasis may present several years after diagnosis of the primary tumor. The majority of secondary tumors of the kidney are asymptomatic, incidentally discovered, and solitary. There should be a high index of suspicion of metastasis to the kidney in patients with an associated enlarging renal lesion with minimal to no enhancement on imaging and tumor progression of a known high-grade nonrenal malignancy. Secondary tumors of the kidney can be accurately diagnosed by correlating histopathologic features with clinical and radiographic findings and the judicious use of ancillary studies.
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Affiliation(s)
| | - Adeboye O Osunkoya
- Departments of Pathology
- Urology, Emory University School of Medicine
- Winship Cancer Institute of Emory University, Atlanta
- Department of Pathology, Veterans Affairs Medical Center, Decatur, GA
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Renal Masses Detected on FDG PET/CT in Patients With Lymphoma: Imaging Features Differentiating Primary Renal Cell Carcinomas From Renal Lymphomatous Involvement. AJR Am J Roentgenol 2017; 208:849-853. [PMID: 28095016 DOI: 10.2214/ajr.16.17133] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study is to analyze the 18F-FDG PET/CT features of solid renal masses detected in patients with lymphoma and to evaluate the ability of PET/CT to differentiate renal cell carcinoma (RCC) from renal lymphomatous involvement. MATERIALS AND METHODS Thirty-six patients with solid renal masses on PET/CT performed for staging or follow-up of lymphoma were evaluated retrospectively. The features recorded for each renal mass included the following standardized uptake values (SUVs) on PET/CT: the maximum SUV (SUVmax), the mean SUV (SUVmean), the ratio of the SUVmax of the tumor to that of the normal kidney cortex, the ratio of the SUVmean of the tumor to that of the normal kidney cortex, the ratio of the SUVmax of the tumor to that of the normal liver, and the ratio of the SUVmean of the tumor to that of the normal liver. Renal mass size and margins (well defined vs infiltrative) and the presence of calcifications were evaluated on CT. Renal biopsy results were used as the reference standard. Relationships between imaging parameters and histopathologic findings were assessed. RESULTS Of the 36 renal masses evaluated, 22 (61.1%) were RCCs and 14 (38.9%) were renal lymphomas. All SUV metrics were higher for renal lymphomas than for RCCs (p < 0.0001, for all). All renal lymphomas had an SUVmax higher than 5.98 g/mL (median, 10.99 g/mL), whereas all RCCs had an SUVmax lower than 5.26 g/mL (median, 2.91 g/mL). No statistically significant differences in mass size or margins were found between RCCs and renal lymphoma. CONCLUSION PET/CT features may be useful for differentiating RCCs from renal involvement in patients with lymphoma with solid renal masses.
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Radiological diagnosis of perinephric pathology: pictorial essay 2015. Insights Imaging 2017; 8:155-169. [PMID: 28050791 PMCID: PMC5265200 DOI: 10.1007/s13244-016-0536-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/14/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023] Open
Abstract
The perinephric space, shaped as an inverted cone, sits between the anterior and posterior renal fasciae. It can play host to a variety of clinical conditions encountered daily in the reporting schedule for a radiologist. Lesions may be classified and diagnosed based on their imaging characteristics, location and distribution. A broad range of differential diagnoses can be attributed to pathology sitting within this space, often without clinical signs or symptoms. An understanding of commonly encountered conditions affecting the perinephric space, along with characteristic imaging findings, can illustrate and often narrow the likely diagnosis. The aim of this essay is to describe commonly encountered neoplastic and non-neoplastic entities involving the perinephric space and to describe their key imaging characteristics. TEACHING POINT • Despite often a bulky disease, perinephric lymphoma does not produce obstruction or stenosis. • In primarily fatty masses, defects within the renal capsule likely represent angiomyolipoma. • Consider paraganglioma if biopsy is planned; biopsy may lead to catecholamine crisis.
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Shetty S, Singh AC, Babu V. Primary Renal Lymphoma - A Case Report and Review of Literature. J Clin Diagn Res 2016; 10:XD05-XD07. [PMID: 27790565 PMCID: PMC5072065 DOI: 10.7860/jcdr/2016/20901.8577] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 08/10/2016] [Indexed: 11/24/2022]
Abstract
Primary Renal Lymphoma (PRL) is rare and its existence has been called into question due to the absence of lymphatic tissue within renal parenchyma. Non-specific abdominal pain with mass in the lumbar region and otherwise unexplained renal failure is the most common presentation. Almost all patients eventually develop extrarenal lymphomatous disease and few patients survive beyond one year. Surgical treatment is rarely feasible as primary modality of treatment since the tumour often encases major vessels and surrounding organs necessitating major resection. Instead, an attempt can be made to downstage the tumour with chemotherapy before attempting surgery. Here we present a case of primary renal Non-Hodgkins Lymphoma (NHL) which was treated with chemotherapy but the patient succumbed to disease before the third cycle.
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Affiliation(s)
- Shraddha Shetty
- Resident, Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Avinash Chandra Singh
- Resident, Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Vinod Babu
- Resident, Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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Chen X, Zhu Q, Li B, Cui W, Zhou H, Duan N, Liu Y, Kundra V, Wang Z. Renal cell carcinoma associated with Xp11.2 translocation/TFE gene fusion: imaging findings in 21 patients. Eur Radiol 2016; 27:543-552. [DOI: 10.1007/s00330-016-4421-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 02/29/2016] [Accepted: 05/19/2016] [Indexed: 02/03/2023]
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7
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Low G, Huang G, Fu W, Moloo Z, Girgis S. Review of renal cell carcinoma and its common subtypes in radiology. World J Radiol 2016; 8:484-500. [PMID: 27247714 PMCID: PMC4882405 DOI: 10.4329/wjr.v8.i5.484] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 01/20/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023] Open
Abstract
Representing 2%-3% of adult cancers, renal cell carcinoma (RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased at a rate of 2% per year. The increased incidence is at least partly due to improved tumor detection secondary to greater availability of high-resolution cross-sectional imaging modalities over the last few decades. Most RCCs are asymptomatic at discovery and are detected as unexpected findings on imaging performed for unrelated clinical indications. The 2004 World Health Organization Classification of adult renal tumors stratifies RCC into several distinct histologic subtypes of which clear cell, papillary and chromophobe tumors account for 70%, 10%-15%, and 5%, respectively. Knowledge of the RCC subtype is important because the various subtypes are associated with different biologic behavior, prognosis and treatment options. Furthermore, the common RCC subtypes can often be discriminated non-invasively based on gross morphologic imaging appearances, signal intensity on T2-weighted magnetic resonance images, and the degree of tumor enhancement on dynamic contrast-enhanced computed tomography or magnetic resonance imaging examinations. In this article, we review the incidence and survival data, risk factors, clinical and biochemical findings, imaging findings, staging, differential diagnosis, management options and post-treatment follow-up of RCC, with attention focused on the common subtypes.
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Erdoğmuş Ş, Aktürk S, Kendi Çelebi Z, Kiremitçi S, Kaygusuz G, Altınbaş NK, Üstüner E, Keven K. Diffuse Large B-Cell Lymphoma Presenting with Bilateral Renal Masses and Hematuria: A Case Report. Turk J Haematol 2016; 33:159-62. [PMID: 27095511 PMCID: PMC5100730 DOI: 10.4274/tjh.2015.0238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Renal involvement is most often seen in conjunction with multisystemic, disseminated lymphoma either by direct extension from a retroperitoneal mass or via hematogenous spread. Primary lymphoma of the kidney is not a common entity and it is a controversial issue on account of the absence of lymphatic tissues in the normal kidney. In this case report, we describe a 19-year-old male with hematuria, acute kidney injury, and bilateral renal masses due to massive lymphomatous infiltration of the kidneys, which was diagnosed as diffuse large B-cell non-Hodgkin lymphoma by Tru-Cut biopsy.
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Affiliation(s)
- Şiyar Erdoğmuş
- Ankara University Faculty of Medicine, Department of Nephrology, Ankara, Turkey, Phone : +90 312 508 21 68, E-mail :
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9
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Wu J, Zhu Q, Zhu W, Chen W, Wang S. Comparative study of CT appearances in renal oncocytoma and chromophobe renal cell carcinoma. Acta Radiol 2016; 57:500-6. [PMID: 25972369 DOI: 10.1177/0284185115585035] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 04/08/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Renal oncocytoma (RO) and chromophobe renal cell carcinoma (ChRCC) share histologic and some imaging features. PURPOSE To investigate the multidetector computed tomography (MDCT) characteristics of these two tumor types. MATERIAL AND METHODS Fifty-six patients with RO and 54 patients with ChRCC were studied retrospectively. MDCT was undertaken to investigate differences in tumor characteristics. RESULTS Calcifications were visible in 24 (42.8%) patients with RO and in 11 (20.4%) patients with ChRCC (P = 0.011). 26 patients with RO had stellate scars as did 14 patients with ChRCC (P = 0.025). Spoken-wheel-like enhancement was visible in 41 patients with RO and in 11 with ChRCC (P < 0.001). Thirty-nine (69.6%) patients with RO and nine (16.7%) patients with ChRCC showed segmental inversion (P < 0.001). Two patients with RO had retroperitoneal lymph node enlargement as did 13 patients with ChRCC (P = 0.002). Combined evaluation of stellate scar, spoken-wheel-like enhancement, and segmental enhancement inversion features were found to have a sensitivity of 99.1% (106 of 107), a specificity of 100% (3 of 3), a positive predictive value of 100% (106 of 106), and a negative predictive value of 75% (3 of 4). The attenuation of RO tumors was greater than that of ChRCC tumors, normal renal parenchyma on unenhanced CT (P = 0.031). Enhancement was higher with RO than with ChRCC tumors in all phases (P = 0.021, < 0.001, and 0.007, respectively). CONCLUSION CT imaging features such as stellate scar, spoken-wheel-like enhancement, and segmental enhancement inversion were more common in RO and they may help in differentiating RO from ChRCC.
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Affiliation(s)
- Jingtao Wu
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, PR China
| | - Qingqiang Zhu
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, PR China
| | - Wenrong Zhu
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, PR China
| | - Wenxin Chen
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, PR China
| | - Shouan Wang
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, PR China
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Singh SK, Sharma AP, Mittal A, Lal A. Perinephric Stranding and Bulky Psoas Mimicking Pyelonephritis in a Case of Non-Hodgkin Lymphoma of Kidney. Urology 2015; 85:e31-e32. [DOI: 10.1016/j.urology.2015.01.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/17/2015] [Accepted: 01/27/2015] [Indexed: 11/29/2022]
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Mainali NR, Jalota L, Pathak R, Jain S. A case of disseminated recurrent retroperitoneal plasmacytoma with left obstructive hydronephrosis. BMJ Case Rep 2014; 2014:bcr-2013-202563. [PMID: 24994764 DOI: 10.1136/bcr-2013-202563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Retroperitoneal extramedullary plasmacytoma (EMP) is a rare condition that often poses a diagnostic challenge. This is mainly due to its unusual location and non-specific symptoms especially in its early stages. Retroperitoneal plasmacytoma with renal involvement is an extremely rare entity and to date, less than 25 cases have been reported in the literature. We describe a case of a 65-year-old woman with primary retroperitoneal plasmacytoma, confirmed by ultrasound-guided biopsy and histopathological examination, with unilateral left obstructive hydronephrosis and metastasis to the lungs. Our patient was started on chemotherapy to which she did not respond. Subsequently, she resorted to palliative measures. Our case highlights key aspects of clinical presentation, diagnosis and treatment options available for management of retroperitoneal plasmacytoma.
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Affiliation(s)
- Naba Raj Mainali
- Department of Medicine, Reading Health System, West Reading, Pennsylvania, USA
| | - Leena Jalota
- Department of Medicine, Reading Health System, West Reading, Pennsylvania, USA
| | - Ranjan Pathak
- Department of Medicine, Reading Health System, West Reading, Pennsylvania, USA
| | - Shashank Jain
- Department of Medicine, Reading Health System, West Reading, Pennsylvania, USA
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12
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Zhu Q, Zhu W, Wu J, Chen W, Wang S. The clinical and CT imaging features of metanephric adenoma. Acta Radiol 2014; 55:231-8. [PMID: 23884840 DOI: 10.1177/0284185113493411] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients with metanephric adenoma have a good prognosis after undergoing total nephrectomy or local resection with kidney preservation. Accurate diagnosing is important for guiding clinical treatment. Only few previous case reports have been found focusing on the imaging findings of metanephric adenoma. PURPOSE To evaluate the multislice computed tomography (MSCT) imaging characteristics of metanephric adenoma. MATERIAL AND METHODS The imaging findings in eight patients with metanephric adenoma were studied retrospectively. MSCT was undertaken to investigate tumor location, size, attenuation, cystic or solid appearance, calcification, capsule sign, and enhancement pattern. RESULTS Tumors (mean diameter, 3.3 ± 1.0 cm) were solitary (8/8), solid (7/8) with cystic components (2/8), no calcifications (7/8), had a poorly-defined margin (8/8), were centered in the renal medulla (7/8), compressed the renal pelvis (3/8), and none had retroperitoneal lymph node metastasis. The attenuation of metanephric adenoma tumors was less or equal compared to the renal cortex or medulla on unenhanced CT (30.6 ± 2.6 vs. 36.3 ± 4.6 vs. 33.2 ± 3.9, P > 0.05), while tumor enhancement after administration of an contrast agent was lower than that of normal renal cortex and medulla during all phases (P < 0.05). CONCLUSION Metanephric adenoma tends to be a solitary, poorly defined margin, isodense or hypodense mass arising from the renal medulla with enhancement less than the cortex and medulla during all phases.
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Affiliation(s)
- Qingqiang Zhu
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, China
| | - Wenrong Zhu
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, China
| | - Jingtao Wu
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, China
| | - Wenxin Chen
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, China
| | - Shouan Wang
- Department of Medical Imaging, Subei People’s Hospital, Medical School of Yangzhou University, Yangzhou, China
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Multiple hypovascular tumors in kidney: a rare case report and differential diagnosis. Case Rep Med 2013; 2013:595193. [PMID: 24368919 PMCID: PMC3866866 DOI: 10.1155/2013/595193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 10/20/2013] [Indexed: 12/04/2022] Open
Abstract
The most common malignant renal tumor is renal cell carcinoma and surgery is the standard treatment. The proportion of lymphoma with renal involvement is 2~15% and lymphoma could be cured by chemotherapy without nephrectomy. Sonography, computed tomography (CT), and magnetic resonance imaging (MRI) can detect and characterize a renal mass. We present a case of right renal hypovascular tumors and differential diagnosis of hypovascular tumors by image study. CT scan showed hypovascular tumors and MRI image revealed multifocal hypovascular solid tumors with significantly increased apparent diffusion coefficient (ADC) of diffusion weighted imaging (DWI). Based on image finding, renal lymphoma was highly suspected. Renal lymphoma was confirmed by renal biopsy and this patient received chemotherapy without surgery. The noninvasive CT scan and MRI image can help clinicians to diagnose the characteristics of renal mass and to avoid unnecessary nephrectomy.
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14
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Lymphomas and lymphoproliferative disorders clinically presenting as renal carcinoma: A clinicopathological study of 14 cases. Pathology 2013; 45:657-63. [DOI: 10.1097/pat.0000000000000006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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15
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Zhu QQ, Wang ZQ, Zhu WR, Chen WX, Wu JT. The multislice CT findings of renal carcinoma associated with XP11.2 translocation/TFE gene fusion and collecting duct carcinoma. Acta Radiol 2013; 54:355-62. [PMID: 23446748 DOI: 10.1258/ar.2012.120255] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Renal cell carcinoma associated with Xp11.2 translocation and TFE gene fusion (Xp11.2/TFE RCC), and collecting duct carcinoma (CDC) are uncommon subtypes of renal cell carcinomas. PURPOSE To investigate the multislice CT (MSCT) characteristics of these two tumor types. MATERIAL AND METHODS Nine patients with Xp11.2/TFE RCC and 10 patients with CDC were studied retrospectively. MSCT was undertaken to investigate differences in tumor characteristics and enhancement patterns. RESULTS All patients had single tumors centered in the renal medulla. Two patients with each tumor type had lymph node involvement and there was a single case of hepatic metastasis (Xp11.2/TFE RCC). The mean tumor diameter of Xp11.2/TFE RCC tumors was significantly larger than for CDC tumors. Two patients with Xp11.2/TFE RCC had cystic components as did eight patients with CDC (P < 0.05). Calcifications were present in six patients, each with CDC. Clear tumor boundaries were visible in two patients with CDC and in nine with Xp11.2/TFE RCC (P < 0.05). The density of Xp11.2/TFE RCC tumors was greater than that of CDC tumors, normal renal cortex, or medulla on unenhanced CT. Enhancement was higher with Xp11.2/TFE RCC than with CDC tumors during all phases. Xp11.2/TFE RCC enhancement was higher than in the renal medulla during cortical and medullary phase but lower than in normal renal medulla during the delayed phase. CDC tumor enhancement was lower than that for normal renal medulla during all enhanced phases. CONCLUSION Both tumor types originated from the renal medulla. Distinguishing features included density on unenhanced CT, enhancement patterns, and capsule signs. Identifying these differences may aid diagnosis.
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Affiliation(s)
- Qing-Qiang Zhu
- Subei People's Hospital, Clinical School of Medical College, Yangzhou
| | - Zhong-Qiu Wang
- Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wen-Rong Zhu
- Subei People's Hospital, Clinical School of Medical College, Yangzhou
| | - Wen-Xin Chen
- Subei People's Hospital, Clinical School of Medical College, Yangzhou
| | - Jing-Tao Wu
- Subei People's Hospital, Clinical School of Medical College, Yangzhou
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Abstract
In patients presenting with acute renal failure and known/suspected lymphoma, the diagnosis of diffuse renal involvement is important, as there is potential for rapid resolution with chemotherapy. Although FDG is excreted through the kidneys and focal renal disease may be difficult to identify, diffuse renal FDG is more easily recognized and is always abnormal. We report a patient presenting with acute renal failure and suspected lymphoma. F-18 FDG PET/CT study demonstrated diffuse increased FDG uptake in bilaterally enlarged kidneys. Following 1 cycle of chemotherapy, the renal function normalized. An interim F-18 FDG PET/CT demonstrated normal size and FDG uptake within both kidneys.
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17
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Moore AE, Johnston WH, Hever A, Peng S, Kujubu DA. Systemic mastocytosis presenting with acute oliguric renal failure: report of a case and review of the literature. Int Urol Nephrol 2010; 44:639-42. [DOI: 10.1007/s11255-010-9878-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Accepted: 11/09/2010] [Indexed: 01/08/2023]
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Moslemi MK, Tahvildar SA, Ashtari AAR. Primary Lymphoma of the Kidney in an Adult Male - The First Reported Case from Iran. Case Rep Oncol 2010; 3:72-76. [PMID: 20740162 PMCID: PMC2918847 DOI: 10.1159/000298470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a case of primary renal lymphoma in a 48-year-old man. He was admitted with a large homogenous right renal mass that was revealed by computed tomography scan of the abdomen and pelvis. The patient underwent transperitoneal right radical nephrectomy. Pathologic diagnosis was in favor of primary renal lymphoma.
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Affiliation(s)
- Mohammad Kazem Moslemi
- Department of Urology, Kamkar Hospital, School of Medicine, Qom Medical Sciences University, Qom, Iran
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A possible case of primary renal lymphoma: a case report. CASES JOURNAL 2009; 2:6233. [PMID: 19829773 PMCID: PMC2740007 DOI: 10.4076/1757-1626-2-6233] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Accepted: 07/20/2009] [Indexed: 12/03/2022]
Abstract
Introduction The entity primary renal lymphoma is controversial and rare. Case presentation We report a case in a 60-year-old man. Computed tomography revealed a large, homogeneous, retroperitoneal mass with 14.8 × 11.5 cm size arising from the right kidney. An ultrasound guided percutaneous biopsy was performed and the tumour was diagnosed histopathological as non-Hodgkin lymphoma. The patient was treated by systemic chemotherapy and thereafter a nephrectomy was performed. Conclusion Primary renal lymphoma is a controversial and infrequent disease. However, there is growing evidence that it does exist.
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20
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Hong W, Yu XM, Jiang MQ, Chen B, Wang XB, Yang LT, Zhang YP. Solitary extramedullary plasmacytoma in retroperitoneum: A case report and review of the literature. World J Gastroenterol 2009; 15:2425-7. [PMID: 19452592 PMCID: PMC2684616 DOI: 10.3748/wjg.15.2425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Extramedullary plasmacytoma (EPM) is a plasma cell tumor arising outside of the bone marrow. Solitary EMP is an uncommon neoplasm and rarely occurs in the retroperitoneum and lacks distinctive clinical manifestations. We report a 26-year-old man with a solitary EMP in the retroperitoneum and discuss its clinical features, diagnosis and treatment.
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Gionanlis LC, Bamichas GI, Smias CV, Tzarou VN, Sombolos KI. Retroperitoneal plasmacytoma causing renal obstruction. Int Urol Nephrol 2008; 40:555-6. [PMID: 18188673 DOI: 10.1007/s11255-007-9320-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Accepted: 11/29/2007] [Indexed: 11/29/2022]
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