Renal lymphangiectasia.
Renal lymphangiectasia is a benign disorder of renal lymphatics. Seldom observed, the pathophysiology is unclear. The clinical course may vary, and management alternatives range from percutaneous drainage in symptomatic cases to pharmacological substitutes in the form of anti-hypertensives and diuretics. We present a case of bilateral perinephric collections on imaging, which presented with gross ascites, abdominal pain and reversible hypertension. Ultrasound examination indicated ascites. Computerized tomography revealed bilateral symmetrical large perinephric collections. This is consistent with the appearance of renal lymphangiectasis (enlarged kidneys with fluid collections seen to be abutting the surrounding structures) reported in the literature. Needle aspiration of the perinephric fluid was undertaken, and laboratory analysis was carried out, which revealed a protein level of 643 mg dl(-1) and a total leucocyte count of 50, of which 80% were lymphocytes. Thereafter, a diagnosis of renal lymphangiectasia was made, and conservative treatment with diuretics and anti-hypertensives was initiated. Reassessment at subsequent follow up visits showed improvement in the patient's clinical condition.
Cross-sectional Imaging Section, James Paget University Hospitals, Norfolk NP31 6LA, UK. kashif.ashraf@jpaget.nhs.uk
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Ashraf
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Raza
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Ashraf
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Memon
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Memon
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Zubairi
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000379:methods; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008200:Lymphangiectasis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed / Q000379:methods
D000959:Antihypertensive Agents; D004232:Diuretics