– 10 year old FS DSH presented for hematuria
– eating well with no other signs of illness
– both kidneys enlarged on abdominal palpation
– u/s shows bilaterally enlarged kidneys with irregular shaped capsule with thin hypoechoic halo, hyperehoic cortices and mild pyelectasia (highly suspicious for lymphoma)
– enlarged renal LN’s seen but no medial iliac LN’s
– urinary bladder wall irregularly thickened, most prominent in trigone with large, stringy blood clot present in lumen (no colour Doppler flow seen)
– 10 year old FS DSH presented for hematuria
– eating well with no other signs of illness
– both kidneys enlarged on abdominal palpation
– u/s shows bilaterally enlarged kidneys with irregular shaped capsule with thin hypoechoic halo, hyperehoic cortices and mild pyelectasia (highly suspicious for lymphoma)
– enlarged renal LN’s seen but no medial iliac LN’s
– urinary bladder wall irregularly thickened, most prominent in trigone with large, stringy blood clot present in lumen (no colour Doppler flow seen)
– money case so no biopsy 
Is it possible to have lymphoma affect the the urinary bladder? (I don’t think this just looks like partially distended bladder with thickened walls)
If lymphoma, how treatable are these patients with chemo – any experience here?
Comments
Jacquie i would fna the
Jacquie i would fna the kidney in the first still image there as there is subcapsular capping and enlargement concerned for renal lsa. The bladder thickening is consistent with interstitial cystitis or lsa. The LK will give you the best sample. parenchymal renomegaly think lsa, fip, pyelo but pyelonephritis tends to hold its structure best. When you have that subcapsular hypoechoic ring (capping) think lsa and needs a needle.
Jacquie i would fna the
Jacquie i would fna the kidney in the first still image there as there is subcapsular capping and enlargement concerned for renal lsa. The bladder thickening is consistent with interstitial cystitis or lsa. The LK will give you the best sample. parenchymal renomegaly think lsa, fip, pyelo but pyelonephritis tends to hold its structure best. When you have that subcapsular hypoechoic ring (capping) think lsa and needs a needle.
Last I heard in renal lsa if
Last I heard in renal lsa if in failure < 6 months if not in failure 6-12 months with chop or wisconsin. Too bad they wont do even a 25 g fna in house. If monopop of lymphoid cells its lsa if pyelonephritis or other nephritis then you get a mixed population of cells. Not an absolute theory but a valid one so if you can tell the difference in house may not even need to send it out.
Last I heard in renal lsa if
Last I heard in renal lsa if in failure < 6 months if not in failure 6-12 months with chop or wisconsin. Too bad they wont do even a 25 g fna in house. If monopop of lymphoid cells its lsa if pyelonephritis or other nephritis then you get a mixed population of cells. Not an absolute theory but a valid one so if you can tell the difference in house may not even need to send it out.