Korean J Urol.  2008 May;49(5):454-456. 10.4111/kju.2008.49.5.454.

Metachronous Bilateral Renal Lymphangiomatosis Mimicking as a Simple Renal Cyst

• Jang HA
• Ban JH
• Jin MH
• Oh MM
• Moon DG
• Yoon DK

• KMID: 1204528
• DOI: http://doi.org/10.4111/kju.2008.49.5.454

Abstract

Renal lymphangiomatosis is a rare developmental malformation of the perirenal lymphatic system, and this can result in the development of cystic masses in the peri-pelvic or peri-renal areas. This is difficult to differentiate from other cystic renal disease on imaging studies. We present here a case of metachronous bilateral renal lymphangiomatosis that was falsely diagnosed as a simple renal cyst. A 47 year-old man was referred for a large amount of drainage after right renal cyst marsupialization. The abdominal computed tomography(CT) findings and fluid analysis were compatible with a lymphangiomatosis. After 6 month, he presented with flank pain on his left side and CT showed intracystic hemorrhage on the left renal lymphangiomatosis. Percutaneus drainage and conservative management were done.

Keyword

Renal lymphangiomatosis; Cysts; Percutaneous therapy

MeSH Terms

Male
Humans
Cysts

Figure

• 

  Fig. 1 Abdominal computerized tomography shows a huge simple cystic mass compressing the right kidney to the medial side and both kidneys showed multiple tiny cysts.

• 

  Fig. 2 The follow-up abdominal computerized tomography shows a much decreased right renal cyst.

• 

  Fig. 3 The follow-up abdominal computerized tomography shows a large amount of fluid collection around the left kidney with accompanying internal hemorrhage.

Reference

1. Murray KK, McLellan GL. Renal peripelvic lymphangiectasia: appearance at CT. Radiology. 1991. 180:455–456.

2. Leder RA. Genitourinary case of the day. Renal lymphangiomatosis. AJR Am J Roentgenol. 1995. 165:197–198.

3. Sarikaya B, Akturk Y, Bekar U, Topaloglu S. Bilateral renal lymphangiomatosis mimicking hydronephrosis: multidetector CT urographic findings. Abdom Imaging. 2006. 31:732–734.

4. Han KS, Cho KS, Im YJ, Hong SJ. Cystic lymphangioma of the kidney. Korean J Urol. 2005. 46:89–92.

5. Lee HY, Han KS, Oh YT, Rha KH. Laparoscopic excision of a retroperitoneal cystic lymphangioma encasing the renal vessels. Korean J Urol. 2005. 46:640–643.

6. Wadhwa P, Kumar A, Sharma S, Dogra PN, Hemal AK. Renal lymphangiomatosis: imaging and management of a rare renal anomaly. Int Urol Nephrol. 2007. 39:365–368.

7. Varela JR, Bargiela A, Requejo I, Fernandez R, Darriba M, Pombo F. Bilateral renal lymphangiomatosis: US and CT findings. Eur Radiol. 1998. 8:230–231.

8. Ozmen M, Deren O, Akata D, Akhan O, Ozen H, Durukan T. Renal lymphangiomatosis during pregnancy: management with percutaneous drainage. Eur Radiol. 2001. 11:37–40.

9. Burkett JS, Pickleman J. The rationale for surgical treatment of mesenteric and retroperitoneal cysts. Am Surg. 1994. 60:432–435.