Renal lymphoma

Lymphoma is the most common secondary malignant renal neoplasm (usually systemic NHL).

Imaging (CT)

• Often infiltrative and moulding → tends to preserve renal contour (“bean shape”).
• Typical patterns:
  • Multiple bilateral, homogeneous hypoenhancing renal masses (common).
  • Diffuse infiltration/nephromegaly.
  • Perirenal soft-tissue rind ± renal sinus involvement.
  • Direct extension from bulky retroperitoneal nodes encasing vessels/collecting system.
• Look for supportive disease: retroperitoneal lymphadenopathy ± splenic involvement.
• Less commonly presents as a solitary renal mass → can mimic RCC/metastasis.