Allograft dysfunction in a patient with an odd-looking kidney: case of renal lipomatosis and review of literature

Abstract

Renal lipomatosis was diagnosed in a kidney transplant recipient who presented with acute kidney injury (AKI) several years after transplantation. The patient had an odd-looking kidney transplant on ultrasound and computed tomography (CT) scan, showing a medullary mass with resultant compression of the surrounding renal parenchyma. A biopsy of the renal medulla confirmed fatty infiltration of the renal parenchyma. The patient underwent percutaneous nephrostomy and AKI resolved with relief of the obstruction. Renal lipomatosis is a rare condition that should be differentiated from other neoplasms of the kidney. When it occurs in a functioning transplant kidney, the treatment approach proves to be very challenging.

Bilateral Renal Replacement Lipomatosis: A Case Report on Rare Complication of Obstructive Uropathy

“…Likewise, in RRL, imaging demonstrates the presence of fat tissue intensity inside the renal sinuses and perirenal space with HU of -20 or lower, which is confirmatory for adipose tissue [3]. Additionally, to distinguish RRL from other important renal involving diseases, we have included various radiological and histological features of XPGN, renal angiomyolipoma and liposarcoma in Table 1 [ Currently, there is no identified treatment for this complication, but early removal of the triggering factor can halt the progression [12]. In complete mutilation of renal parenchyma, RRL can manifest as end-stage renal disease and is resulted due to a prolonged process.…”

“…Currently, there is no identified treatment for this complication, but early removal of the triggering factor can halt the progression [ 12 ]. In complete mutilation of renal parenchyma, RRL can manifest as end-stage renal disease and is resulted due to a prolonged process.…”

Imaging Spectrum of Renal Replacement Lipomatosis: A Case Series

“…In some cases, fat may not be radiographically apparent, especially if a large amount of fibrous tissue is associated with it causing mass effect. The radiologic finding of a lucent mass surrounding a staghorn calculus with a non-functioning kidney is pathognomonic of renal replacement lipomatosis [5].…”