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Case profile of the month
CASE PROFILE
OF THE MONTH
NOTE - Urogmms of interest to our readers are welcome from urologists and radiologists. Contributions, including an abbreviated history and legends for thefilms, are to be sent to Arthur N. Tessler, M.D., feature editor.
FIGURE 1. (A) Retrograde pyelogram revealing scalloping and compression of ureter by retroperitoneal nodes. (B) Arterial phase of selective left angiogram demonstrating elongation, compression, and relatively sparse renal vasculature.
CASE PROFILE A forty-four-year-old man with pain in the left flank and left side of the abdomen was admitted to University Hospital. An excretory urogram revealed a normal right kidney and ureter but no visualization of the left kidney. His history revealed that sixteen months prior to this, he had a superior vena cava obstruction syndrome and cervical lymphadenopathy. Excisional biopsy of the cervical node at that time revealed histiocytic lymphoma. He was treated by external radiation and was well for approximately eight months, when he was again admitted to the hospital for obstructive jaundice. Exploratory surgical procedure revealed nodal obstruction of the common duct, and a bypass was surgically performed.
622
Following admission a left retrograde pyelogram showed the ureter to be compressed extrinsically throughout its length and had a scalloplike appearance (Fig. 1). The pyelocalyceal system could not be better visualized. A selective left angiogram showed elongation, compression, and relatively sparse vascular supply, which is consistent with lymphomatous infiltration of the kidney (Fig. 2). Despite extensive chemotherapy, the patient died after a massive gastrointestinal hemorrhage. Jordan Brown, M.D. 566 First Avenue New York, New York 10016
UROLOGY
/ NOVEMBER1974
/ VOLUMEIV,NUMBER5
OF THE MONTH
NOTE - Urogmms of interest to our readers are welcome from urologists and radiologists. Contributions, including an abbreviated history and legends for thefilms, are to be sent to Arthur N. Tessler, M.D., feature editor.
FIGURE 1. (A) Retrograde pyelogram revealing scalloping and compression of ureter by retroperitoneal nodes. (B) Arterial phase of selective left angiogram demonstrating elongation, compression, and relatively sparse renal vasculature.
CASE PROFILE A forty-four-year-old man with pain in the left flank and left side of the abdomen was admitted to University Hospital. An excretory urogram revealed a normal right kidney and ureter but no visualization of the left kidney. His history revealed that sixteen months prior to this, he had a superior vena cava obstruction syndrome and cervical lymphadenopathy. Excisional biopsy of the cervical node at that time revealed histiocytic lymphoma. He was treated by external radiation and was well for approximately eight months, when he was again admitted to the hospital for obstructive jaundice. Exploratory surgical procedure revealed nodal obstruction of the common duct, and a bypass was surgically performed.
622
Following admission a left retrograde pyelogram showed the ureter to be compressed extrinsically throughout its length and had a scalloplike appearance (Fig. 1). The pyelocalyceal system could not be better visualized. A selective left angiogram showed elongation, compression, and relatively sparse vascular supply, which is consistent with lymphomatous infiltration of the kidney (Fig. 2). Despite extensive chemotherapy, the patient died after a massive gastrointestinal hemorrhage. Jordan Brown, M.D. 566 First Avenue New York, New York 10016
UROLOGY
/ NOVEMBER1974
/ VOLUMEIV,NUMBER5