December 2009

Abnormal right kidney

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Clinical information

Pain in the right flank with high fever and raised infection parameters

Ultrasound Images & Clips

Male 65 year old, Pain in the right flank with high fever and raised infection parameters

Longitudinal image of the right kidney with an ill defined iso and hypoechoic mass in the kidney

Transverse image of the right kidney. The mass is inhomogeneous with small cystic areas.

Transverse image of the right kidney the mass has a target like appearance with a central hypoechoic area.

Transverse image of the right kidney with color Doppler. There is no flow in the central hypoechoic area.

Longitudinal image of the right kidney with color Doppler. There is a wedge shaped area without vascularity and a central hypoechoic area.

Longitudinal image of the normal left kidney

CT scan of the same lesion in the right kidney

CT scan of the same lesion in the right kidney.

Conclusion

Although a mass in the kidney is always suspicious for a renal cell carcinoma, in this case the aspect of the mass and the clinical findings were more suggestive for a focal pyelonephritis with abscess formation. The follow up confirmed this diagnosis.

References
Vourganti S, Agarwal PK, Bodner DR, Dogra VS. Ultrasonographic evaluation of renal infections.Radiol Clin North Am. 2006 Nov;44(6):763-75. Review.

Details

Sex: Male
Age: 65

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Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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