Case Study

06-00040 William E Lymphoma—NEEDS OB—-NO IMAGES—-

A 15 year old NM DLH was presented for evaluation of intermittent PU/PD, weight loss, and a change in his voice. On physical examination an abdominal mass was palpable. Approximately 6 years prior the left kidney was enlarged wheareas the right kidney could not be palpated.

A 15 year old NM DLH was presented for evaluation of intermittent PU/PD, weight loss, and a change in his voice. On physical examination an abdominal mass was palpable. Approximately 6 years prior the left kidney was enlarged wheareas the right kidney could not be palpated.

Sonographic Differential Diagnosis

This is highly consistent with renal lymphoma with the possibility of renal FIP or the minor possibility of chronic infection such as pyelonephritis. Ultrasound-guided biopsy of the cortical region would be recommended as well as fine-needle aspirates of the spleen.

Image Interpretation

The left kidney in this patient was severely enlarged and measured 7.1 cm. The kidneys presented a hypoechoic, subcapsular rim with significant parenchymal enlargement and loss of corticomedullary definition. The left kidney had pelvic dilation at 0.38 cm. The right kidney presented a relatively normal size with a diffuse, interstitial fibrosis pattern that measured 3.6 cm. Corticomedullary detail was largely maintained. The spleen was swollen in contour with diffuse, micronodular changes and undulating contour.

DX

Highly consistent with renal lymphoma, possibly renal FIP, or minor possibility of pyelonephritis

Comments

Do you want all the differentials in DX? F

Clinical Differential Diagnosis

Liver/spleen/kidney/GI tract – neoplasia, abscess, granuloma. Hydonephrosis. Organomegaly. Spleen – congestion, torsion. Lymphadenomegaly.

Sampling

None

Patient Information

Type of Imaging : Ultrasound