title: Papillary renal cell carcinoma with extensive paraaortic nodal metastasis mimicking malignant lymphoma.
abstract: A 52-year-old woman with abdominal distension underwent computed tomography (CT) that demonstrated extensive paraaortic lymphadenopathy and a right renal mass. Compared to the renal cortex, the lesions exhibited low signal intensity on T(1)- and T(2)-weighted images and high intensity on diffusion-weighted magnetic resonance (MR) images. We suspected malignant lymphoma and performed excisional biopsy, which revealed metastatic papillary renal cell carcinoma. Retrospectively, significantly reduced signal on in-phase chemical shift MR images compared to out-of-phase images suggested the presence of intratumoral hemosiderin, a characteristic finding of this entity.
authors.affiliation: Department of Radiology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Mitsufuji
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Fujimitsu
authors.forename: Mikiko
authors.initials: M
authors.lastname: Ida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Urakawa
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Kora
authors.forename: Morishige
authors.initials: M
authors.lastname: Takeshita
authors.forename: Shigerou
authors.initials: S
authors.lastname: Miyajima
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
mesh_terms: D001012:Aorta, Abdominal / Q000473:pathology; D001706:Biopsy; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000175:diagnosis; D008875:Middle Aged; D011859:Radiography