Abstract
Objective
The kidney is a frequent site of involvement in lymphoproliferative disorders. The aim of this study was to demonstrate the prevalence and spectrum of morphologic appearances of renal involvement in patients with lymphoma on helical computed tomographic (CT) scan.
Methods
Three phases of post-contrast helical CT of the abdomen in 74 patients with lymphoma were reviewed for possible renal involvement: the cortico-medullary, nephrographic and delayed excretory phases. Tumor characteristics, patterns of distribution and enhancement features were evaluated.
Results
Of the 74 patients with lymphoma, 11 had CT evidence of renal involvement—ten with non-Hodgkin’s lymphoma and one with Hodgkin’s lymphoma—representing 15% of all patients scanned for routine staging of histologically diagnosed lymphoma. Five types of renal involvement were observed: enlarged lobular non-enhancing kidneys (four patients); bilateral multiple renal masses (two patients); focal single non-enhancing mass (two patients); perirenal infiltrations from retroperitoneal extension (two patients); bilateral diffuse areas of non-enhancing hypo-densities (one patient).
Conclusion
Five distinct patterns of renal involvement with lymphoma were detected with helical CT. The most common appearance was enlarged lobular kidneys. CT with intravenous contrast enhancement is currently the approach of choice for both the evaluation of renal involvement as well as for accurate staging of lymphoma. Awareness of different patterns of renal involvement in lymphoma allows proper differentiation from other similar diseases.
Similar content being viewed by others
Abbreviations
- CT:
-
Computed tomography
- HL:
-
Hodgkin lymphoma
- MRI:
-
Magnetic resonance imaging
- NHL:
-
Non-Hodgkin Lymphoma
References
Pickhardt PJ, Lonergan GJ, Davis CJ, Kashitani N et al. (2000) Infiltrative renal lesions: radiologic-pathologic correlation. Radiographics 20:215–243
Hartman DS, David CJ Jr, Goldman SM, Friedman AC et al. (1982) Renal lymphoma: radiologic-pathologic correlation of 21 cases. Radiology 144:759–766
Mavromatis BH, Cheson BD (2002) Pre and post treatment evaluation of non-Hodgkin’s lymphoma. Best Practice Res Clinic Hematol 15:429–447
Jung G, Heindel W, von Bergwelt-Baildon M, Bredenfeld H, Gossman A, Zahringer M, Tesch H (2000) Abdominal lymphoma staging: is MR imaging with T2-weighted turbo-spin-echo sequence a diagnostic alternative to contrast enhanced spiral CT. J Comput Assit Tomogr 24:783–787
Urban BA, Fishman EK (2000) Renal lymphoma: CT patterns with emphasis on Helical CT. Radiographics 20:197–212
Guermazi A, Brice P, de Kerviler EE, Ferme C, Hennequin C, Meignin V, Frija J (2001) Extra nodal Hodgkin disease: spectrum of disease. Radiographics 21:161–179
Richmond J, Sherman RS, Diamond HD et al (1962) Renal lesions associated with malignant lymphomas. Am J Med 32:184–207
Reznek RH, Mootoosamy I, Webb JA, Richards MA (1990) CT in renal and perirenal lymphoma: a further look. Clin Radiol 42:233–238
Sagel SS, Stanlely RJ, Levitt RG et al. (2002) Computed tomography of the kidney. J Urol 167:1028–1038
Jung G, Heindel W, VonBergwel-Baildon M, Bedenfeld H, Gossman A, Zahringer M, Tesch H (2000) Abdominal lymphoma staging: is MR Imaging with T2-weighted turbo-spin-echo sequence a diagnostic alternative to contrast enhanced spiral CT? J Comput Assit Tomogr 24:783–787
Eisenberg PJ, Papanicolaou N, Lee MJ, Yoder IC (1994) Diagnostic imaging in the evaluation of renal lymphoma. Leuk Lymphoma 16:37–50
Burgener FA, Hamlin DJ (1981) Histiocystic lymphoma of the abdomen: radiographic spectrum. Am J Roentgenol 337–342
Horii SC, Bosniak MA, Megibow AJ, Raghavendra BN, Subramanyam BR, Rothberg M (1983) Correlation of CT and ultrasound in the evaluation of renal lymphoma. Urol Radiol 5:69–76
Heiken JP, Gold PR, Schnur MJ et al. (1983) Computed tomography of renal lymphoma with ultrasound correlation. J Comp Assist Tomogr 7:245–250
Sheeran SR, Sussman SK (1988) Renal lymphoma: spectrum of CT findings and potential mimics. Am J Roentgenol 171:1067–1072
Buck DS, Peterson MAS, Borochoviks D et al. (1992) Non-Hodgkin lymphoma of the ureter: CT Demonstration with pathological correlation. Urol Radiol 14:183–187
Chen HH, Panella JS, Rochester D et al (1988) Non-Hodgkin lymphoma of the ureteral wall: CT findings. J Comput Assist Tomogr 12:157–158
Connor SE, Umaria N, Guest PJ (2001) Extranodal peripelvic and periureteric lymphoma-demonstration with computed tomography. Clinic Radiol 56:422–424
Hauser M, Kresin GP, Hagspiel KD (1995) Bilateral solid multifocal and perirenal lesions: differentiation with ultrasonography, computed tomography and magnetic resonance imaging. Clin Radiol 50:288–294
Munker R, Stengel A, Stabler A et al. (1995) Diagnostic accuracy of ultrasound and computed tomography in the staging of Hodgkin’s disease: verification by laparotomy in 100 cases. Cancer 76:1460–1466
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
El-Sharkawy, M.S., Siddiqui, N., Aleem, A. et al. Renal involvement in lymphoma: prevalence and various patterns of involvement on abdominal CT. Int Urol Nephrol 39, 929–933 (2007). https://doi.org/10.1007/s11255-007-9224-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-007-9224-8