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A Large Renal Mass: Dilemmas With Unusual Features on Imaging
Subodh K Regmi1, Christopher J Weight1
1Department of Urology, University of Minnesota, Minneapolis, MN.
Urology
|February 29, 2020
Summary
A large abdominal mass was diagnosed as primary urinary tract diffuse large B cell lymphoma (DLBCL). Early biopsy of large renal masses, even without metastasis, is crucial for accurate diagnosis and treatment.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Primary urinary tract lymphomas are rare, accounting for less than 1% of all renal tumors.
- Diffuse large B cell lymphoma (DLBCL) in the urinary tract presents unique challenges compared to nodal DLBCL.
Observation:
- A 50-year-old male presented with a palpable abdominal mass.
- CT imaging revealed a large tumor replacing the right kidney, extending into the bladder, with retroperitoneal lymphadenopathy.
- Urine cytology and metastatic workup were negative.
Findings:
- Ultrasound-guided renal biopsy confirmed diffuse large B cell lymphoma (DLBCL).
- The patient initiated combination chemotherapy for the primary renal lymphoma.
Implications:
- Primary urinary tract DLBCL has a poorer prognosis than nodal DLBCL.
- Biopsy of large renal masses, even without hematuria or distant metastasis, can significantly alter patient management and treatment strategies.
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