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[Perirenal involvement in Waldenström disease]
Antonio Márquez Moreno1, José Ruiz Escalante, Inmaculada Pérez Fernández
1Servicios de Radiodiagnóstico, Hospital Clínico Universitario, Málaga, España.
Archivos Espanoles De Urologia
|March 4, 2003
Summary
Waldenström disease can rarely involve the kidneys, presenting as perirenal masses. This unusual presentation requires consideration in the differential diagnosis of kidney masses.
Area of Science:
- Nephrology
- Oncology
- Hematology
Background:
- Waldenström macroglobulinemia is a rare lymphoproliferative disorder.
- Kidney involvement in Waldenström macroglobulinemia is typically due to direct infiltration or amyloidosis.
Observation:
- A 68-year-old male with Waldenström macroglobulinemia presented with bilateral perirenal masses on ultrasound.
- These masses were hypoecogenic, suggesting an unusual pattern of involvement.
Findings:
- Histopathological examination and cytometric analysis of fine-needle aspiration biopsy revealed a monoclonal lymphoplasmacytic proliferation of B-cells.
- The cells were arranged in a diffuse pattern within the perirenal space.
Implications:
- This case highlights an uncommon presentation of Waldenström macroglobulinemia involving the perirenal space.
- Radiological, histological, and cytometric findings are crucial for differentiating this from other perirenal pathologies like extramedullary hematopoiesis, liposarcoma, or hematoma.