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Retroperitoneum » Paraortic/Pericaval Disease
Lymphomatous involvement of the kidneys and the retroperitoneum
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Presentation A 62-year-old male with a known diagnosis of lymphoma presents for abdominal evaluation. An ultrasound was performed.
 
 
 
Caption: Sagittal scan of the right kidney
Description: The right kidney shows moderate hydronephrosis. There is no evidence of parenchymal thinning or any obvious masses or surface nodularity.
 
 
 
Caption: Sagittal image of left kidney
Description: A hypoechoic soft tissue mass is seen arising from the capsular surface of the left kidney in the inter-polar region. There is no evidence of any obvious hydronephrosis or intraparenchymal masses.
 
 
 
Caption: Transverse image of left kidney
Description: The hypoechoic soft tissue mass situated at the lateral capsular surface of the kidney is seen again.
 
 
 
Caption: Transverse color Doppler image of left kidney
Description: The hypoechoic mass is solid and demonstrates color flow.
 
 
 
Caption: Spectral waveform of the abnormal area
Description: The mass on the surface of the kidney demonstrates an arterial waveform confirming the solid nature of the mass.
 
 
 
Caption: Transverse view of upper pole of the left kidney
Description: Another small, discrete hypoechoic mass is noted on the capsular surface at the upper pole of the left kidney.
 
 
 
Caption: Transverse scan of the lower mid-abdomen
Description: Peri-aortic soft tissue mass is noted in this image. This most likely represents a conglomerated mass of lymphomatous lymph nodes. Vascular wall calcification is also seen.
 
 
 
Caption: Sagittal scan of the lower abdomen
Description: The large nodal mass encasing the aorta is seen here, with the mass demonstrating internal vascularity.
 
Differential Diagnosis Lymphoma, metastases, renal cell carcinoma with retroperitoneal adenopathy
 
Final Diagnosis Retroperitoneal lymph nodes, right hydronephrosis and lymphomatous involvement of the left kidney in a known case of follicular non-Hodgkin’s lymphoma
 
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