Retroperitoneal Fibrosis: A Review of Clinical Features and Imaging Findings

Cronin, Carmel G.; Lohan, Derek G.; Blake, Michael A.; Roche, Clare; McCarthy, Peter; Murphy, Joseph

doi:10.2214/ajr.07.3629

Cited by 178 publications

(126 citation statements)

References 49 publications

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“…Laboratory tests exhibit typically unremarkable remarks, aside from an elevated ESR and CRP levels in the majority of patients, although acute kidney failure also occurs in some cases (4). RPF is typically diagnosed based on radiographic images (CT scans) as symptoms are diverse and range from mild back pain and generalized weakness to the development of obstructive acute kidney failure (4,5). In a small number of cases, RPF is combined with pericardial fibrosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Retroperitoneal fibrosis and constrictive pericarditis-IgG4 related diseases: A case report

Terzić

Spasić

Djuric

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Retroperitoneal fibrosis (RPF) is a rare disease characterized by infiltration of inflammatory cells and deposition of thickened fibrous tissues. The present study presents the case of a 53-year-old patient treated for generalized weakness and fatigue for 1 year prior to hospitalization. A cardiac ultrasound revealed pericardial effusion that required pericardiocentesis, during which 1,400 ml serous fluid with the characteristics of an exudate was aspirated. A pericardiectomy was performed due to persistent effusion and histological examination indicated pericardial fibrosis. A thoracic-abdominal computed tomography scan revealed the presence of retroperitoneal fibrosis. The patient was treated with corticosteroids and azathioprine. Follow-up examinations showed a significant reduction in the amount of abdominal fibrous tissue and no increase in pericardial effusion 1 year following the end of treatment. The patient continues to have regular follow-up control examinations with a cardiologist and nephrologist.

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Section: Discussionmentioning

confidence: 99%

“…The first, idiopathic RPF, makes up ~70% of cases (5) and may be linked with other immunoglobulin (Ig) G4 related diseases (6). The other, more rare form of RPF is secondary RPF, which is associated with malignancy, infection, drug use and other primary causes (1,4,7).…”

Section: Introductionmentioning

confidence: 99%

Retroperitoneal fibrosis and constrictive pericarditis-IgG4 related diseases: A case report

Terzić

Spasić

Djuric

et al. 2017

Experimental and Therapeutic Medicine

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“…CT is most often used to determine the extent of disease and to monitor disease over time. Fluorodeoxyglucose-positron emission tomography allows for assessment of the metabolic activity of the mass, determination of the full extent of vascular inflammatory involvement, and identification of other disease sites (such as those seen in multifocal fibrosclerosis) (3,39). Combined positron emission tomography-CT imaging offers the ability to assess both the extent and metabolic activity of the mass and therefore, when available, is useful for monitoring response to treatment.…”

Section: Discussionmentioning

confidence: 99%

A 45‐year‐old man with flank pain and inability to ejaculate

Muskardin

Gertner

2012

Arthritis Care & Research

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A 45-year-old man with left-sided flank pain and difficulty ejaculating. History of the Present IllnessThe patient developed left-sided flank pain in April 2010. He was evaluated in the emergency department when the pain had persisted for 3 weeks. He reported worsening of the pain in the evening and difficulty with ejaculation since the pain began: "I get a knot in my side," then "I can't ejaculate." He also reported associated low back pain and increased pain with bending to his left. His general physical examination was unremarkable. Urine analysis demonstrated 30 mg/dl protein, 10 mg/dl ketones, 8 mg/dl urobilinogen (reference value Ͻ2.0), 8 red blood cells/ high-power field (hpf), 2 white blood cells/hpf, and mucous. He was prescribed ibuprofen for abdominal pain and was advised to follow up with his primary care provider.The pain persisted. He saw his primary provider in July with worsening epigastric and left-sided abdominal and flank pain. By this time, he had decreased appetite, early satiety, and weight loss of 22 pounds. His primary provider ordered a computed tomographic (CT) scan of his abdomen and pelvis, which demonstrated a rind of soft tissue in the retroperitoneum surrounding the aorta and inferior vena cava and wall thickening of the sigmoid colon and rectum. A biopsy of the mass was done by interventional radiology at another hospital. Since his pain was unrelieved by acetaminophen/hydrocodone, he was admitted to our hospital for further evaluation and pain control. He did not know the results of the biopsy. Medical HistoryHe had been relatively healthy prior to the onset of illness in April. Atheromatous calcification of the aorta with mild ectasia inferiorly measuring up to 2.3 cm in diameter was noted incidentally on a CT scan obtained to evaluate for ureteral calculi in September 2008. He had a remote history of gonorrhea and chlamydia infections, which were treated. He had been seen in the emergency department for right testicular pain following trauma at age 35 years and left testicular pain without clear etiology at ages 40 and 43 years. The first episode of left testicular pain was attributed to epididymitis. The second was attributed to suspected passage of a ureteral calculus. Social and Family HistoryThe patient's family history was negative for rheumatic disorders. Several family members, including his mother, had diabetes mellitus and hypertension. His sister had thyroid disease. He was unemployed, but previously worked as a baker. He smoked one-quarter of a pack of cigarettes per day for several years, and previously smoked marijuana. He consumed, on average, 1 alcoholic beverage per week and denied intravenous drug use. He was sexually active and did not consistently use barrier protection. Review of SystemsThe patient reported persistent inability to ejaculate, without decrease in arousal or orgasm and without associated pain. He also reported low back pain that preceded his current illness by years. He had constipation for 2 weeks.

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“…25,26 Pour le diagnostic et la distinction entre les formes bénignes et malignes, la TDM et l'IRM sont les examens de choix. Elles permettent de mettre en évidence la plaque de fibrose, de préciser sa morphologie, son emplacement et sa propagation aux structures avoisinantes.…”

Section: 24unclassified

“…Elles permettent de mettre en évidence la plaque de fibrose, de préciser sa morphologie, son emplacement et sa propagation aux structures avoisinantes. 26,27 Elles peuvent également révéler d'autres atteintes de la maladie à IgG4 : pancréatite autoimmune, péricardite chronique avec fibrose médiastinale, etc. L'aspect typique est une masse bien limitée mais irrégulière du tissu péri-aortique qui s'étend du niveau des AR aux vaisseaux iliaques, et progresse dans le rétropéritoine en enveloppant les uretères et la VCI.…”

Section: 24unclassified

Fibrose rétropéritonéale : revue de littérature

Jakhlal

Elghazoui

Jabbour

et al. 2017

CUAJ

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RésuméLa fibrose rétropéritonéale (FRP) est une maladie rare, caractérisée par la présence d'un tissu fibro-inflammatoire aberrant qui se forme souvent autour de la portion sous-rénale de l'aorte abdominale et des artères iliaques. Une obstruction urétérale est souvent observée. Récemment, la FPR idiopathique est rapportée parmi les manifestations de la maladie à IgG4. L'imagerie joue un rôle important dans le diagnostic de la FRP. Les glucocorticoïdes sont le traitement de référence, utilisés en monothérapie ou en association avec d'autres agents médicamenteux. En cas d'échec des mesures conservatrices, la chirurgie peut être proposée. Récemment, des techniques minimalement invasives ont été utilisées.

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Retroperitoneal Fibrosis: A Review of Clinical Features and Imaging Findings

Abstract: Familiarity with the realm of imaging manifestations of retroperitoneal fibrosis is vital to ensure correct diagnosis and optimal treatment.

Cited by 178 publications

References 49 publications

Retroperitoneal fibrosis and constrictive pericarditis-IgG4 related diseases: A case report

Retroperitoneal fibrosis and constrictive pericarditis-IgG4 related diseases: A case report

A 45‐year‐old man with flank pain and inability to ejaculate

Fibrose rétropéritonéale : revue de littérature

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