Renal Lymphangiectasia: The Transcending of Serendipity.

Renal lymphangiectasia, a rare entity of the renal lymphatic system affecting both genders and all ages, can manifest bilaterally or unilaterally and has been referred to by various terms, such as renal lymphangiomatosis, renal lymphangioma, and others. Distinguishing this condition from common pathologies, such as polycystic kidney disease or hydronephrosis, is crucial. This article presents an innovative clinical case of unilateral renal lymphangiectasia in a 67-year-old woman with a relevant medical history. Detection was achieved by ultrasound in primary care using the point-of-care ultrasound (POCUS) technique under the focused assessment with sonography in trauma (FAST) protocol, revealing findings suggestive of renal lymphangiomatosis. This case highlights the utility of advanced technologies, such as bedside ultrasound, in addressing and transforming the approach to rare medical conditions, offering a compelling reminder of the positive influence of technological innovation in clinical practice.

A Rare Case of Transplanted Kidney Lymphangiectasia in a Patient With Joubert Syndrome.

Renal lymphangiectasia is one of the rarest surgical complications in post-transplant kidney patients. A few patients may clinically complain of nonspecific symptoms, and the other few might be diagnosed incidentally. We report the case of a 32-year-old female patient with a known case of Joubert syndrome who presented with nonspecific clinical manifestations. The patient underwent ultrasound, magnetic resonance imaging (MRI), and nuclear medicine (NM) imaging to confirm the diagnosis, which showed radiologic features of renal lymphangiectasia. Conservative medical management was delivered to the patient.

Contrast enhanced ultrasound for the diagnosis of bilateral renal lymphangiectasia: literature review and contrast enhanced ultrasound findings.

Renal lymphangiectasia (RLmp) is a rare benign lymphatic malformation which should be distinguished from other more common pathologies. Ultrasound (US) examination can define the first diagnostic suspicion, but the definitive diagnosis is usually reached with a second level imaging such as computed tomography (CT) or magnetic resonance imaging (MRI). We herein describe for the first time in literature, the use of the contrast enhanced ultrasound (CEUS) in disclosing the nature of peri-renal anechoic lesions in a 27-years old woman, that were initially confused with parenchymal cysts at B-Mode US. The diagnosis of RLmp may be particularly demanding due to its rarity and different clinical presentations. We suggest a possible role of CEUS as a real time, cost saving and easily accessible second level diagnostic tool, that can represent an appealing alternative in the diagnostic work up of suspected RLmp, respect to other imaging modalities.

Bilateral Renal Lymphangiectasia Associated With Polycythemia: A Rare Case Report.

Renal lymphangiectasia is a rare benign mesenchymal tumor of unclear etiology resulting from dilatation of perinephric lymphatic channels and formation of cystic masses. Polycythemia is a rarely associated finding with only five cases reported in the literature. We report a case of bilateral renal lymphangiectasia associated with polycythemia in a 38-year-old man who was managed conservatively with pain control. There are no clear guidelines for the management of renal lymphangiectasia; although most patients can be treated conservatively, some cases, whose diagnosis is unclear or develop complications, require definitive surgical excision.

Refractory lymphatic ascites following laparoscopic management of renal lymphangiectasia: An unusual presentation.

Renal lymphangiectasia characterised by either unilocular or multilocular cystic lesion in and around the kidney is an uncommon condition. Presentation of these lesions is quite varied, which along with its uncommon occurrence adds to the challenges in the management of this condition. Most of these cases are managed conservatively and very rarely need any intervention. We present an unusual complication of refractory lymphatic ascites following laparoscopic deroofing of a unilocular renal lymphangiectasia in a 21-year-old gentleman who presented with left flank pain. The ascitic fluid analysis suggested non-chylous lymphatic ascites. The surgical outcome was rather exasperating for the patient than the disease itself. Hence, in the interest of the patient with minimal symptoms, if the imaging is highly suggestive of renal lymphangiectasia, either no intervention or the least invasive procedures should be attempted, whenever possible.

Linfangiectasia renal bilateral / Bilateral renal lymphangiectasia

Introducción: La linfangiectasia renal es una afección infrecuente en la que existe dilatación de los vasos linfáticos renales. Usualmente es bilateral y de buen pronóstico. Objetivos: Presentar un caso de linfangiectasia renal bilateral, sus características clínicas y aspectos del diagnóstico imaginológico. Caso clínico: Paciente femenina de 59 años de edad, hipertensa controlada, que asistió a la consulta externa de urología por dolor lumbar bilateral, de moderada intensidad y coloración rojiza de la orina, ambos de forma intermitente. El examen físico general y regional fue negativo. Se confirmó microhematuria en el examen general de la orina. Los estudios de la analítica sanguínea fueron normales. El ultrasonido renal reportó pielocaliectasia bilateral moderada y quistes parapiélicos, bilaterales, a predominio izquierdo. La tomografía axial computarizada renal contrastada, reveló la presencia de formaciones hipodensas renales bilaterales, de aspecto quístico parapiélicas y en el seno renal, compatibles con linfangiectasia bilateral. La paciente ha evolucionado favorablemente. Conclusiones: La linfangiectasia renal se debe tener en cuenta en el diagnóstico deferencial de la enfermedad quística renal. Para el diagnóstico imaginológico de certeza es esencial la tomografía axial computarizada renal contrastada(AU)

Introduction: The renal linfangiectasia is an uncommon, in which dilatation of the lymphatic renal vessels exists. It is usually bilateral and of good presage. Objectives: To present a case of renal bilateral lymphangiectasia, their clinical characteristics and aspects of the imaginologic diagnosis. Clinical case: Patient feminine of 59 years of age, with controlled hypertension that attended the external consultation of Urology for lumbar bilateral pain, of moderate intensity, and reddish coloration of the urine, both in an intermittent way. The general and regional physical exam was negative. Microhematuria was confirmed in the general exam of the urine. The sanguine studies of the analytic one were all normal ones. The renal ultrasound reported bilateral moderate pielocaliectasia and parapielic cysts, with left prevalence. The renal contrasted computed tomography revealed the presence of bilateral renal hipodenses formations, of aspect cystic parapielic and in the renal sinus, and compatible with bilateral linfangiectasia. The patient has evolved favorably. Conclusions: The renal linfangiectasia it should be kept in mind in the deferential diagnosis of the cystic renal illness. For the imaginologic diagnostic of certainty it is essential the renal contrasted computed tomography(AU)

Pleural effusion and ascites in extrarenal lymphangiectasia caused by post-biopsy hematoma: A case report.

BACKGROUND: The renal system has a specific pleural effusion associated with it in the form of "urothorax", a condition where obstructive uropathy or occlusion of the lymphatic ducts leads to extravasated fluids (urine or lymph) crossing the diaphragm via innate perforations or lymphatic channels. As a rare disorder that may cause pleural effusion, renal lymphangiectasia is a congenital or acquired abnormality of the lymphatic system of the kidneys. As vaguely mentioned in a report from the American Journal of Kidney Diseases, this disorder can be caused by extrinsic compression of the kidney secondary to hemorrhage. CASE SUMMARY: A 54-year-old man with biopsy-proven acute tubulointerstitial nephropathy experienced bleeding 3 d post hoc, which, upon clinical detection, manifested as a massive perirenal hematoma on computed tomography (CT) scan without concurrent pleural effusion. His situation was eventually stabilized by expeditious management, including selective renal arterial embolization. Despite good hemodialysis adequacy and stringent volume control, a CT scan 1 mo later found further enlargement of the perirenal hematoma with heterogeneous hypodense fluid, left side pleural effusion and a small amount of ascites. These fluid collections showed a CT density of 3 Hounsfield units, and drained fluid of the pleural effusion revealed a dubiously light-colored transudate with lymphocytic predominance (> 80%). Similar results were found 3 mo later, during which time the patient was free of pulmonary infection, cardiac dysfunction and overt hypoalbuminemia. After careful consideration and exclusion of other possible causative etiologies, we believed that the pleural effusion was due to the occlusion of renal lymphatic ducts by the compression of kidney parenchyma and, in the absence of typical dilation of the related ducts, considered our case as extrarenal lymphangiectasia in a broad sense. CONCLUSION: As such, our case highlighted a morbific passage between the kidney and thorax under an extraordinarily rare condition. Given the paucity of pertinent knowledge, it may further broaden our understanding of this rare disorder.

Renal lymphangiectasia treated with percutaneous drainage and sclerotherapy.

Renal lymphangiectasia is a rare benign condition of the lymphatic system. Primarily, the diagnosis is based upon characteristic imaging findings along with biochemical analysis of aspirated fluid. No definitive algorithm exists for treating this condition owing to its rarity. The literature describes various modes of management ranging from conservative management to nephrectomies. We present a case of bilateral renal lymphangiectasia managed with percutaneous drainage along with sclerotherapy. Our initial findings show a favorable outcome with this approach.

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

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.

Bilateral renal lymphangiectasia: radiological findings by ultrasound, computed tomography, and magnetic resonance imaging.

Renal lymphangiectasia is a rare benign condition of the kidney without specific clinical presentations. Classic imaging findings are described in literature. Here, we present a case of renal lymphangiectasia with history of bilateral flank pain and abnormal renal function tests. The radiological appearance on ultrasound (US) and computed tomography (CT) showed features of bilateral renal lymphangiectasia but the patient refused invasive procedure for aspiration of the cysts. So, follow-up of the patient was done by magnetic resonance imaging (MRI). Imaging findings of our case on US, CT, and MRI are discussed along with details of the additional finding of dilated retroperitoneal lymphatic channels, cisterna chyli, as well as the thoracic duct.

Bilateral Renal Lymphangiectasia in a Thirty-two-Year-Old Woman.

INTRODUCTION: Renal lymphangiectasia is a rare disorder of the lymphatic system that might be confused with various other renal cystic diseases and urinoma. Clinical presentation is non-specific and characteristic findings in radiologic imaging are the mainstay of diagnosis. CASE PRESENTATION: We reported a case of bilateral lymphangiectasia in a 32-year-old woman who presented with flank pain and hypertension. DISCUSSION: Renal lymphangiectasia is an uncommon benign condition. Most of the cases improve with conservative treatment. Surgery is rarely required, except in cases such as those with persistent pain refractory to medication.

[Renal lymphangiectasia, a rare case of perirenal infiltration]. / La lymphangiectasie rénale, un cas rare d'infiltration périrénale.

Renal lymphangiectasia is a bilateral cystic infiltration of the perirenal and parapelvic space which is caused by the obstruction of the renal lymphatic tissue. To our knowledge only numbers have been reported in the literature. Renal lymphangiectasia usually asymptomatic and incidentally diagnosed has absolutely no effect on the patient outcome. Radiological imaging is typical so that the diagnosis does not need to be confirmed by a cyst punction. The lack of knowledge concerning renal lymphangiectasia make it usually confused with another cause of polycystic renal infiltration, such as the polycystic kidney disease. We report herein a case of renal lymphangiectasia diagnosed incidentally by an abdominal ultrasonography.

Linfangiectasia renal: achado incidental em tomografia computadorizada multicorte e revisão da literatura / Renal lymphangiectasia: incidental finding at multislice computed tomography and literature review

Linfangiectasia renal é uma condição rara, caracterizada por coleções parapiélicas e perirrenais, que pode progredir de assintomática para insuficiência renal crônica. É apresentado um caso de achado incidental em tomografia computadorizada de linfangiectasia renal bilateral em paciente assintomático, com descrição dos principais achados à luz dos métodos de imagem e ampla revisão da literatura.

Renal lymphangiectasia is a rare condition characterized by parapyelic and perirenal fluid collections, which may progress from asymptomatic condition to chronic renal failure. The present report describes a case of incidental computed tomography finding of bilateral lymphangiectasia in an asymptomatic patient, as well as the main imaging findings with a comprehensive literature review.

Hennekam lymphangiectasia syndrome.

Hennekam lymphangiectasia syndrome is a rare disorder comprising of intestinal and renal lymphangiectasia, dysmorphic facial appearance and mental retardation. The facial features include hypertelorism with a wide, flat nasal bridge, epicanthic folds, small mouth and small ears. We describe a case of a multigravida with bad obstetric history and characteristic facial and dental anomalies and bilateral renal lymphangiectasia. To our knowledge this is the first case of Hennekam lymphangiectasia syndrome with anodontia to be reported from India.

Renal lymphangiectasia presented by pleural effusion and ascites.

A young male patient complaining of vague abdominal pain, dyspnea, generalized weakness and abdominal distension for 6 months was referred for abdominal ultrasound. Ultrasound showed enlarged echogenic kidneys, perinephric and renal sinus cystic fluid collections bilaterally with ascites and right pleural effusion. The ultrasound findings were confirmed by abdomen CT scan. Renal function test was within normal. Laboratory analysis of aspirated perinephric fluid revealed abundant lymphocytes. The radiological findings and perinephric fluid aspiration analysis are consistent with renal lymphangiectasia. Pleural effusion, in addition to ascites and perinephric fluid collections, is a new presentation of the disease. Ascites and pleural effusion were improved by diuretics.