Renal lymphangiectasia is a rare renal condition. We present a case of bilateral renal lymphangiectasia in a 52-year-old man who presented with bilateral flank pain and gross hematuria. The clinical features, diagnosis and characteristic imaging findings are reviewed. This condition should be considered in the differential diagnosis of cystic renal masses in both children and adults.
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History A 65-year-old male patient with a history of sarcomatoid renal cell carcinoma and prior right nephrectomy developed recurrent disease adjacent to the inferior vena cava. The patient underwent surveillance imaging 7 months after initiation of treatment with maximum-dose pazopanib and less than 1 month after completing a 2-month regimen of palliative stereotactic body radiation therapy to the right nephrectomy bed and site of recurrence. (Stereotactic body radiation therapy was initiated 5 months after pazopanib treatment was initiated.
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Feinberg Cardiovascular and Renal Research Institute, Northwestern University Feinberg School of Medicine, Chicago, IL.
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From the Department of Surgery (Ayed), from the Department of Pathology (Sohail, Rizvi), College of Medicine, University of Bisha; and from the Department of Urology (Alwadai), King Abdullah Hospital, Ministry of Health, Bisha, Kingdom of Saudi Arabia.
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- Renal lymphangiectasia (RL) is a rare condition characterized by dilated lymphatic vessels leading to cysts in various kidney locations, and its understanding largely stems from individual case reports.
- The condition can be genetic or acquired, affects individuals of any gender or age, and often presents as abdominal or flank pain, being either focal or diffuse and unilateral or bilateral.
- Diagnosis relies on imaging techniques, and while treatment is typically conservative, there is a need for long-term monitoring for complications like hypertension and renal vein thrombosis; a case of bilateral RL is discussed alongside a literature review.
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Imaging of Perirenal and Intrarenal Lymphatic Vessels: Anatomy-based Approach.
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March 2024
From the Department of Radiology (H.T., A.I., T.A.P., N.T.) and Department of Medicine, Division of Rheumatology (Y.S.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Radiology, Okayama City Hospital, Okayama, Japan (T.T.); Department of Radiology, Jichi Medical University, Tochigi, Japan (S.M.); Department of Diagnostic and Interventional Radiology, University of Tsukuba, Ibaraki, Japan (M.M.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (A.K.).
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