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.
Comments
The big kidney little kidney
The big kidney little kidney thing in cats, and to a lesser extent in dogs, is usually owing to the chronic sequelae scenario in the small kidney and an acute-on-chronic pathology in the larger one, earlier progression of the disease and compensatory hypertrophy in the larger one. On occasion the larger one can also have LSA in cats but you need an FNA to be sure… the LSA kidney will give you a monopopulation of lypmhocytes… but LSA and bad pyelonephritis for example can look the same in an early phase LSA. Chronic stone movers do the big/little kidney thing all the time with comet tail infacrts following the stone and resultant dystroiphic changes and active multifocal hypertrophy and so forth.
Your title image looks like a mixed bag of hypertrophy, pelvic stones, cortical microinfarcts, and interstitial nephrosis but the CM junction and capsules are in tact so LSA or other neoplasia unlikely.
Your second video also has a touch of pyelectasia so culture for pyelonephritis as well.
Thanks for your response.
Thanks for your response. Always very helpful. This post goes straight to my bookmark:) and thanks for having that organized too.
So, what are the hyperehoic stripes? The comet tails? Scar?
Ps: isn’t it quite early in the morning at your end?? Thanks for your answer.