Medical image of the week: bilateral symmetrical nephromegaly

• Main Authors: Elaini T, Omar M, Natt B
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2015-02-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: nephromegaly; hepatomegaly; splenomegaly; lymphadenopathy; lymphoma; B-cell lymphoma; misty mesenteric sign; CT scan; mesenteric fat; increased attenutation
• Online Access: http://www.swjpcc.com/imaging/2015/2/18/medical-image-of-the-week-bilateral-symmetrical-nephromegaly.html

No abstract available. Article truncated at 150 words. A 70-year-old man was evaluated for symptoms of fatigue, abdominal pain and a 20 pound weight loss. Abdominal imaging was obtained as a part of work up and showed hepatomegaly, splenomegaly, nephromegaly, mesenteric infiltration and diffuse lymphadenopathy (Figures 1 and 2). A liver biopsy was obtained and a diagnosis of diffuse large B-cell lymphoma was made. The patient opted for a palliative approach and was discharged to an inpatient hospice after a short hospital stay. Bilateral symmetrical nephromegaly is an uncommon radiological finding in adults, and in the absence of infection, the differential includes HIV-associated nephropathy, amyloidosis, lymphoma, acute tubular necrosis and lupus nephritis. Also seen in Figure 1 is the "misty mesenteric sign" (white arrow) which is a term used to describe the CT appearance of mesenteric fat with increased attenuation and stranding (1). A number of processes can lead to the appearance including infiltration by inflammatory cells, edema ...