Chronic Pyelonephritis Presenting as Multiple Tumor-Like Renal Lesions

Takayuki Tsuji; Takayasu Ohtake; Katsuhiko Yonemura; Hiroshi Sudoko; Akira Komiyama; Akihiko Seki; Akihiko Kato; Akira Hishida

doi:10.2169/internalmedicine.46.1885

CASE REPORTS

Chronic Pyelonephritis Presenting as Multiple Tumor-Like Renal Lesions

Takayuki Tsuji, Takayasu Ohtake, Katsuhiko Yonemura, Hiroshi Sudoko, Akira Komiyama, Akihiko Seki, Akihiko Kato, Akira Hishida

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Keywords: chronic pyelonephritis, lymphoma, tubulointerstitial nephritis, soluble interleukin-2 receptor

JOURNAL OPEN ACCESS

2007 Volume 46 Issue 12 Pages 879-882

DOI https://doi.org/10.2169/internalmedicine.46.1885

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Abstract

We encountered a 49-year-old Japanese man in whom tumor-like renal lesions developed as a result of chronic Staphylococcus aureus pyelonephritis. The patient complained of general fatigue, weight loss, and anorexia for 6 months. Contrast-enhanced computed tomography (CT) of the abdomen revealed multiple low-density lesions in both kidneys and paraaortic lymphadenopathy. A strong uptake of Ga⁶⁷ citrate in the lesions and elevation of serum soluble interleukin-2 receptor and thymidine kinase activity were strongly suggestive of primary renal lymphoma; however, histologic examination of renal biopsy specimens revealed severe tubulointerstitial change, consistent with chronic pyelonephritis. Following systemic antibiotic treatment, multiple tumor-like lesions regressed 4 months later. This case suggested that chronic pyelonephritis could present as bilateral renal tumors.

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