I would appreciate your opinion on these kidneys. Colleague referring this case who presented Vomiting and on acute renal failure.

Basically to rule out neoplasia involved. A thourough scan not done but I checked a bit the whole abdomen and no signs of enlarged regional LNs.

I would appreciate your opinion on these kidneys. Colleague referring this case who presented Vomiting and on acute renal failure.

Basically to rule out neoplasia involved. A thourough scan not done but I checked a bit the whole abdomen and no signs of enlarged regional LNs.

LK appears severely degenerated and atrophied and RK markedly hypertrophic. To me this presentation is usually a kidney that has compensatory hyperthrophy, however, the bigger kidney usually presents thickened cortex and lesions that make me question whether infiltrative disease is possible. In this case, there is marked hyperechogenicity of cortex and lithiasis in CMJ as well as some hyperechoic lines/stripes in cortex-medulla. Should I question diffuse infiltrative disease?or all lesions are likely to be due to hypertrophied RK?

How often do you find a diffuse unilateral neoplasia with a degenerated contralateral kidney?

Thanks for any input.