Imaging of Renal Lymphoma: Patterns of Disease with Pathologic Correlation

Abstract

Extranodal spread of lymphoma often affects the genitourinary system, with the kidneys being the most commonly involved organs. Contrast material-enhanced computed tomography (CT) remains the modality of choice for the detection, diagnosis, staging, and monitoring of renal lymphoma. Magnetic resonance (MR) imaging is particularly useful in patients in whom intravenous administration of iodinated contrast material is contraindicated. Ultrasonography (US), although very valuable for diagnosing lymphoma in the testis or epididymis, is less sensitive than CT and MR imaging for detecting renal lymphoma. Typical imaging findings of renal lymphoma include multiple poorly enhancing or hypoechoic masses, retroperitoneal tumors directly invading the kidneys, bilateral renal enlargement, and perirenal soft-tissue masses. Cystic lesions and tumors predominantly affecting the renal sinus and collecting system are uncommon. Unless the renal lesions manifest in the setting of widespread lymphoma, percutaneous biopsy is indicated to differentiate lymphoma from metastases, hypovascular renal cell carcinoma, uroepithelial carcinoma, or atypical infection, with US routinely being used to guide the procedure. Current immunohistochemical techniques allow accurate diagnosis and characterization of renal lymphoma. Radiologists should be familiar with both typical and atypical manifestations of renal lymphoma and should recommend imaging-guided percutaneous biopsy for diagnostic confirmation to avoid unnecessary nephrectomy.

Extensive Extranodal Involvement of Rare Sites in Non Hodgkin’s Lymphoma Detected on 18F- FDG PET-CT: A Case Report

“…In most of the cases it is secondary and occurs by hematogenous spread or by direct extension of the disease from a retroperitoneal mass. Villa et al concluded that there is a high incidence of central nervous system relapse in patients with DLBCL and kidney involvement at diagnosis [18][19][20]. Fig.…”

Lymphoid neoplasms of the urinary tract and male genital organs: a clinicopathological study of 40 cases

“…This modality not only depicts the renal lesions, but also aids in the identification of extrarenal extension to adjacent anatomic structures and thus can determine the systemic spread of the disease. 14 Both clinically and pathologically, they can be mistaken for carcinomas of the kidney. In the series by Ferry et al, 6 the majority of patients had unilateral disease and B-cell lineage tumors.…”

Rare Renal Tumors

“…BT'de çoklu kitle olabileceği gibi soliter tümör olarak görülüp RHK ile karışabilir. Bazı hastalarda böbrekte diffüz tutulum ve böbreği dışarıdan invaze eden bir kitle olarak da görülebilir (26). Böbrek lenfomasından şüphelenmemizi sağlayacak klinik bulgular büyük retroperitoneal LAP'lar, splenomegali ve böbrek ile ilişiksiz alanlarda tespit edilen LAP`lardır.…”