EURORAD ESR

Case 15403

Renal involvement in Rosai-Dorfman disease

Author(s)
Tonolini Massimo, M.D.

"Luigi Sacco" University Hospital, Radiology Department; Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
female, 54 year(s)
 
 
  • Figure 1
    Ultrasound
     

    Sonographically, both kidneys were partially surrounded (particularly at their poles) by perirenal tissue (*), mildly hypoechoic compared to the renal cortex, which did not exert appreciable mass effects. No...

     
    Area of Interest: Kidney; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Sonographically, both kidneys were partially surrounded (particularly at their poles) by perirenal tissue (*), mildly hypoechoic compared to the renal cortex, which did not exert appreciable mass effects. No...

     
    Area of Interest: Kidney; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Additionally, the spleen was enlarged (17 cm craniocaudal diameter) with a "gross" echotexture, without clearly defined focal lesions.

     
    Area of Interest: Spleen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 2
    Unenhanced and post-contrast multidetector CT
     

    Multiplanar post-contrast images (a...f) showed symmetrical, mildly delayed nephrographic enhancement on both sides, confirmed bilateral, lobulated perirenal soft-tissue (+) measuring 85-90 Hounsfield units (HU)...

     
    Area of Interest: Kidney; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Multiplanar post-contrast images (a...f) showed symmetrical, mildly delayed nephrographic enhancement on both sides, confirmed bilateral, lobulated perirenal soft-tissue (+) measuring 85-90 Hounsfield units (HU)...

     
    Area of Interest: Kidney; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Multiplanar post-contrast images (a...f) showed symmetrical, mildly delayed nephrographic enhancement on both sides, confirmed bilateral, lobulated perirenal soft-tissue (+) measuring 85-90 Hounsfield units (HU)...

     
    Area of Interest: Kidney; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Multiplanar post-contrast images (a...f) showed symmetrical, mildly delayed nephrographic enhancement on both sides, confirmed bilateral, lobulated perirenal soft-tissue (+) measuring 85-90 Hounsfield units (HU)...

     
    Area of Interest: Kidney; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Detail coronal (e) and axial (f) post-contrast images showed bilateral hilar extension of the perirenal soft-tissue (*) encasing both kidneys, without hydronephrosis.

     
    Area of Interest: Kidney; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Detail coronal (e) and axial (f) post-contrast images showed bilateral hilar extension of the perirenal soft-tissue (*) encasing both kidneys, without hydronephrosis.

     
    Area of Interest: Kidney; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    On precontrast CT images the perirenal soft tissue (*) appeared isoattenuating (40-45 HU) with the renal parenchyma.

     
    Area of Interest: Kidney; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Delayed excretory-phase acquisition confirmed bilateral perirneal soft tissue (*) with persistent enhancement (85-90 HU). Note non-dilated, opacified collecting systems. Additionally, a ovoid subfascial solid...

     
    Area of Interest: Kidney; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
Sonographically, both kidneys were partially surrounded (particularly at their poles) by perirenal tissue (*), mildly hypoechoic compared to the renal cortex, which did not exert appreciable mass effects. No hydronephrosis.
 
Sonographically, both kidneys were partially surrounded (particularly at their poles) by perirenal tissue (*), mildly hypoechoic compared to the renal cortex, which did not exert appreciable mass effects. No hydronephrosis.
 
Additionally, the spleen was enlarged (17 cm craniocaudal diameter) with a "gross" echotexture, without clearly defined focal lesions.
 
Multiplanar post-contrast images (a...f) showed symmetrical, mildly delayed nephrographic enhancement on both sides, confirmed bilateral, lobulated perirenal soft-tissue (+) measuring 85-90 Hounsfield units (HU) attenuation, without appreciable mass effect.
 
Multiplanar post-contrast images (a...f) showed symmetrical, mildly delayed nephrographic enhancement on both sides, confirmed bilateral, lobulated perirenal soft-tissue (+) measuring 85-90 Hounsfield units (HU) attenuation, without appreciable mass effect.
 
Multiplanar post-contrast images (a...f) showed symmetrical, mildly delayed nephrographic enhancement on both sides, confirmed bilateral, lobulated perirenal soft-tissue (+) measuring 85-90 Hounsfield units (HU) attenuation, without appreciable mass effect.
 
Multiplanar post-contrast images (a...f) showed symmetrical, mildly delayed nephrographic enhancement on both sides, confirmed bilateral, lobulated perirenal soft-tissue (+) measuring 85-90 Hounsfield units (HU) attenuation, without appreciable mass effect.
 
Detail coronal (e) and axial (f) post-contrast images showed bilateral hilar extension of the perirenal soft-tissue (*) encasing both kidneys, without hydronephrosis.
 
Detail coronal (e) and axial (f) post-contrast images showed bilateral hilar extension of the perirenal soft-tissue (*) encasing both kidneys, without hydronephrosis.
 
On precontrast CT images the perirenal soft tissue (*) appeared isoattenuating (40-45 HU) with the renal parenchyma.
 
Delayed excretory-phase acquisition confirmed bilateral perirneal soft tissue (*) with persistent enhancement (85-90 HU). Note non-dilated, opacified collecting systems. Additionally, a ovoid subfascial solid homogeneous mass (+) isoattenuating with perirenal tissue was noted.
 
 
 
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