Case Report: Bilateral renal lymphangiomatosis with atypical manifestations in an elderly patient

Renal lymphangiomatosis is a rare, benign malformation of the renal lymphatic system. This case report describes an atypical presentation in a 63-year-old male who presented with acute fever and left lower abdominal pain, accompanied by elevated inflammatory markers. Contrast-enhanced computed tomography (CT) revealed bilateral, non-enhancing cystic lesions within the renal pelves, which was diagnostic. The patient was managed conservatively with antibiotics and anti-inflammatory medication, resulting in complete resolution of symptoms. This case highlights the variable clinical presentation of renal lymphangiomatosis, emphasizes the central role of contrast-enhanced CT in its diagnosis, and demonstrates that conservative management can be effective, even in the context of an acute inflammatory episode.