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Renal Lymphoma: CT Patterns with Emphasis on Helical CT¹

¹ From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, 600 N Wolfe St, Baltimore, MD 21287. Recipient of a Certificate of Merit award for a scientific exhibit at the 1998 RSNA scientific assembly. Received February 8, 1999; revision requested March 19 and received April 6; accepted April 6. Address reprint requests to B.A.U.

Renal lymphoma is most often seen in conjunction with multisystemic, disseminated lymphoma or as tumor recurrence. Renal lymphoma may also be seen in immunocompromised patients or, rarely, as primary disease. Computed tomography (CT) is the most sensitive, efficient, and comprehensive examination for evaluation of the kidneys in patients with suspected renal lymphoma. Helical CT in particular improves detection and characterization of lymphomatous renal involvement by optimizing contrast dynamics and data acquisition and is the current modality of choice for accurate staging of lymphoma. Typical CT patterns in renal lymphoma include single and multiple masses, invasion from contiguous retroperitoneal disease, perirenal disease, and diffuse renal infiltration. Atypical CT patterns may also be encountered and provide a diagnostic challenge. These include spontaneous hemorrhage, necrosis, heterogeneous attenuation, cystic transformation, and calcification. Solid renal masses including renal cell carcinoma and metastases are the most commonly encountered entities that mimic renal lymphoma at CT and require biopsy for definitive diagnosis. CT (particularly helical CT) is useful in the evaluation of patients with suspected renal lymphoma, and familiarity with the spectrum of findings in renal lymphoma is important for accurate diagnosis.

Index Terms: Computed tomography (CT), helical, 81.12112, 81.12115 • Kidney neoplasms, 81.34 • Kidney neoplasms, CT, 81.12112, 81.12115 • Lymphoma, CT, 81.12112, 81.12115, 81.34

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