Chronic pyelonephritis presenting as multiple tumor-like renal lesions.
We encountered a 49-year-old Japanese man in whom tumor-like renal lesions developed as a result of chronic Staphylococcus aureus pyelonephritis. The patient complained of general fatigue, weight loss, and anorexia for 6 months. Contrast-enhanced computed tomography (CT) of the abdomen revealed multiple low-density lesions in both kidneys and paraaortic lymphadenopathy. A strong uptake of Ga67 citrate in the lesions and elevation of serum soluble interleukin-2 receptor and thymidine kinase activity were strongly suggestive of primary renal lymphoma; however, histologic examination of renal biopsy specimens revealed severe tubulointerstitial change, consistent with chronic pyelonephritis. Following systemic antibiotic treatment, multiple tumor-like lesions regressed 4 months later. This case suggested that chronic pyelonephritis could present as bilateral renal tumors.
Tsuji
Takayuki
T
First Department of Medicine, Hamamatsu University School of Medicine. tsu@hama-med.ac.jp
Ohtake
Takayasu
T
Yonemura
Katsuhiko
K
Sudoko
Hiroshi
H
Komiyama
Akira
A
Seki
Akihiko
A
Kato
Akihiko
A
Hishida
Akira
A
D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D008223:Lymphoma / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis; D016896:Treatment Outcome