Medullary rim sign 2

Sonopath Forum

  • Follow on post from 15th May
  • Repeat ultrasound of abnormal kidneys
  • Urea, crea normal, usg concentrated, clinically normal, weight normal
  • I think the right kidney has reduced in size and the left is still enlarged/hypertrophied but I am seeing striations within the medulla, does anyone recognise this pattern?
  • I was not given consent to FNA kidneys
  • Do many people see renal lymphoma without azotaemia?

  • Follow on post from 15th May
  • Repeat ultrasound of abnormal kidneys
  • Urea, crea normal, usg concentrated, clinically normal, weight normal
  • I think the right kidney has reduced in size and the left is still enlarged/hypertrophied but I am seeing striations within the medulla, does anyone recognise this pattern?
  • I was not given consent to FNA kidneys
  • Do many people see renal lymphoma without azotaemia?

Comments

EL

You can certainly have renal

You can certainly have renal lsa wihtout renal failure and carriws a better prognosis when RF is not present. There certainly is something smoldering in that kidney. The LK looks ok even may have compensatory hypertrophy owing to progressive disease in the right. This is a subacute on chornic intersitial nephrosis pattern with med rim but cant get more specific than that. Not typical for lsa but needs a needle to know.

bhylands77

My understanding of the

My understanding of the linear stripes in the medulla represent is that they represent dropped nephrons within the cortical layering. Follow me. When the nephron dies, the whole collection of tubules and collecting ducts azssociated with it degrade as well. The collecting system tracts are replaced by fat and hence the markings. This is why there is a set anatomical pattern that is seen on your images. They follow where the collecting ducts would have been hence why they are so structured and parallel to each other. We followed this with histilogy in a few of our cases. This seems to be what we are finding histologically. Whether this tells the real or whole story is open for debate.

veteurope1

That is really interesting,

That is really interesting, thank you once again. 

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