Imaging features of primary renal lymphoma

Abstract

Background: Cases of primary renal lymphoma (PRL) are quite rare and are often mistaken for renal cell carcinoma. Purpose: To determine the multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) characteristics of PRL. Materials and Methods: Twenty-three patients with PRL were identified by CT and MRI, and their tumor characteristics were assessed. Results: Tumors exhibited single or multifocal nodules (n = 19) and diffuse renal enlargement (n = 4). Twenty-two tumors exhibited an infiltrative appearance. There was no evidence of calcification in any of the cases. Twenty-one tumors displaced or wrapped around abdominal vessels rather than encasing them. Enlarged retroperitoneal nodes were observed in three cases. Neither extension into the venous system nor distant metastasis was found. Tumor enhancement was of low attenuation compared with that of normal renal cortex and medulla (P < 0.05). PRL was isointense on T1-weighted imaging, slightly hypointense on T2-weighted imaging and hyperintense on diffusion-weighted imaging. Twenty-two patients exhibited biopsy-confirmed PRN. There were four, 12, and seven cases of low-grade, intermediate-grade, and high-grade tumors, respectively. Patient were followed up over 16 to 166 months. Six patients died within three years and five patients died within five years. Conclusion: Infiltrative appearance and tumor displacement or extension around abdominal vessels rather than vessel encasement are common findings on CT or MRI imaging and may suggest a diagnosis of PRL.