Anuric Renal Failure Due to Encasement of the Ureters by Lymphoma—Ureteric Obstruction Without Dilatation

Abstract

A case of anuric renal failure due to encasement of the ureters by tumour is described in a patient with advanced non‐Hodgkin's lymphoma. In this patient as well as in two previously reported cases, the IVP showed delayed pyelogram and increasingly dense nephrogram on delayed films with little or no dilatation of the collecting systems. These radiographic features in a patient with extensive intra‐abdominal tumour should strongly suggest the possibility of this unusual form of obstructive uropatby. Correct diagnosis in these cases may enable the administration of effective palliative treatment for the renal failure.

Diffuse Large B-Cell Lymphoma in an Adolescent Male Presenting as Ureteral Stricture

“…When displaced by lymphoma, the ureter classically deviates laterally near the ureteropelvic junction and medially as the ureter traverses the pelvic brim. Encasement of the ureters by NHL may cause functional obstruction without radiographic dilation of the collecting systems [7]. Notably, the patient's flank pain was present prior to radiographic evidence of obstruction, and only persistent symptoms warranted repeat imaging, perhaps consistent with this previously reported observation of obstruction in the absence of collecting system dilation.…”

Acute Non-Dilating Obstructive Renal Failure in a Patient with AIDS

“…Extrinsic ureteral obstruction was subse quently proved by retrograde pyelography. Similar find ings have been described before in separate reports of three patients with lymphomatous involvement of the genitourinary tract [10][11][12], in patients with retroperito neal fibrosis [ 13]. and with other disorders [ 14], In many of these patients as in our patient, the surrounding mass of abnormal tissue appears to have prevented the ex pected dilatation of urinary-tract structures proximal to the obstructing lesion.…”