case_images: PMC6110045_01
case_images: Ultrasound of the abdomen showed heterogeneous mass involving the right kidney and lower pole of the left kidney extending to the retroperitoneal space. The right kidney measured 17.1 cm, and the left kidney measured 14.6 cm. Both kidneys had loss of normal configuration. There was presence of staghorn calculi within the right kidney and calculus at the upper pole of the left kidney.
case_images: CRIM2018-8425985.001.jpg
case_images: PMC6110045_01_CRIM2018-8425985.001.jpg
case_images: fig1
case_images: Ultrasound abdomen (Figure 1) and 4-phase renal computed tomography (CT) (Figure 2) were done.
case_images: Four-phase renal computed tomography (CT) showed both kidneys were enlarged with the right kidney measuring 18 cm (white arrow) and the left kidney 14 cm (black arrow). There was a concomitant large renal calculus bilaterally, with the largest on the right measuring 1.5 cm x 2.0 cm x 2.2 cm (thick white arrow) and the left measuring 2.2 cm x 1.7 cm x 1.0 cm in the renal pelvis. Smaller renal calculi are seen in the rest of the pelvicalyceal systems.
case_images: CRIM2018-8425985.002.jpg
case_images: PMC6110045_01_CRIM2018-8425985.002.jpg
case_images: fig2
case_images: Ultrasound abdomen (Figure 1) and 4-phase renal computed tomography (CT) (Figure 2) were done.
case_images: Three strips of tissue infiltrated by diffuse sheets of malignant cells (hematoxylin-eosin x40). There were no normal glomeruli seen.
case_images: CRIM2018-8425985.003.jpg
case_images: PMC6110045_01_CRIM2018-8425985.003.jpg
case_images: fig3
case_images: Histopathology and immunochemistry result of left renal tissue showed diffuse large B cell lymphoma with the germinal center type (Figures 3-5).
case_images: Malignant lymphoid cells exhibit marked pleomorphism with hyperchromatism. They were large with high nuclear to cytoplasmic ratio (hematoxylin-eosin x400).
case_images: CRIM2018-8425985.004.jpg
case_images: PMC6110045_01_CRIM2018-8425985.004.jpg
case_images: fig4
case_images: Histopathology and immunochemistry result of left renal tissue showed diffuse large B cell lymphoma with the germinal center type (Figures 3-5).
case_images: Immunohistochemical studies showed the malignant cells positive for CD20 (a), CD10, and BCL6. They are negative for CD3 (b) and MUM-1 (c), and Ki-67 (proliferative index) is 95% (d).
case_images: CRIM2018-8425985.005.jpg
case_images: PMC6110045_01_CRIM2018-8425985.005.jpg
case_images: fig5
case_images: Histopathology and immunochemistry result of left renal tissue showed diffuse large B cell lymphoma with the germinal center type (Figures 3-5).