Role of CT scan in diagnosis of renal lymphangiectasia: our single-center experience

Abstract

Background: Renal lymphangiectasia is rarely reported benign renal disorder of lymphatic malformation. Though found incidentally; it presents with nonspecific symptoms and shows characteristic findings in radiological imaging studies.Aim: Here, we report eight patients with symptoms, laboratory and imaging findings compatible with renal lymphangiectasia. This report describes clinical and laboratory characteristics, treatment, Imaging findings and outcome of a series of patients with renal lymphangiectasia and reviews the literature.Methods and material: Eight patients (mean age 45 years, male:female ratio 3:1) from 1st January 2011 to 30th June 2016; showing renal lymphangiectasia as incidental finding on CT IVP were included in the series. Imaging and laboratory findings were reviewed. Two out of eight patients (25%) underwent aspiration of collection and laboratory findings confirmed the diagnosis of renal lymphangiectasia. Four out of eight patients (50%) did not undergo aspiration of fluid and were offered conservative treatment. Two out of eight patients (25%) were donors for renal transplantation who were managed conservatively.Results: Renal lymphangiectasia was diagnosed on CT IVP. In each case, where aspiration of collection fluid was offered, the laboratory diagnosis of renal lymphangiectasia was confirmed and patients were managed conservatively. However, large collection in one patient was relieved by percutaneous aspiration.Conclusions: Renal lymphangiectasia can be diagnosed with CT scan and confirmed by laboratory tests. As it may be confused with other cystic lesions of kidney; proper diagnosis and exclusion of other differentials can be effectively offered by CT scan IVP, which can avoid unnecessary invasive treatment options.

Renal peripelvic lymphangiectasia after bilateral renal vein thrombosis

“…RL is mostly asymptomatic and discovered as an incidental finding. Rarely, because of distension of the renal spaces and fascia, bleeding or fistulation in the peritoneal cavity, it may also present with pain, increased abdominal volume, hematuria, ascites, oedema of the lower limbs, arterial hypertension, renal vein thrombosis and chyluria 4…”

“…Lymphoscintigraphy may be useful to provide clear evidence of the abnormal lymphatic flow. In case of haemorrhagic complications, the cystic cavity content may become heterogenous with the typical density and signal of blood at CT and MR, respectively 4 7. Interventional radiology offers minimal invasive treatment (percutaneous drainage with sclerotherapy) in order to avoid the need for marsupialisation, which is associated with a risk of haemorrhage and may result in nephrectomy 8 9…”

Bilateral Renal Lymphangiectasia with No Significant Morbidity for Over 25 Years: A Case Report

“…The renal lymphangiectasia appears as “a well-defined low-attenuation (0–20 HU density) multiseptated collections in perinephric or peri-pelvic regions with normal renal parenchymal enhancement and contrast excretion,” as stated by Pandya et al [ 15 ]. Three-phase modalities of CT scan have more radiological implications; the lymphatics have low-Hounsfield, nonenhanced cysts during the contrast phase; and the delayed phase helps to track the drainage and allows the exclusion of hydronephrosis [ 15 , 16 ]. Magnetic resonance imaging strengthens the CT findings and will show the lymphatic cysts as hypodense or hyperdense on T1 and T2, respectively.…”

Posttransplant Intrarenal Lymphangiectasia

“…Ultrasound usually shows an enlarged kidney with an anechoic multiseptated thin-walled fluid collection with possible increased renal cortical echogenicity [1]. Cross-sectional imaging including computed tomography (CT) and MRI may demonstrate cystic dilatation of the renal sinuses, not connected to the collecting system [6][7][8]. The imaging in the previous two cases with transplant renal lymphangiectasia including ultrasound and CT showed subcapsular and perinephric fluid collections compatible with extrarenal lymphangiectasia [2].…”