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Click This is the CT scan of a 77 year-old male with primary renal lymphoma who initially presented to the family practice clinic with gross hematuria. Axial non-contrast CT (a - left; supine, GE LightSpeed Plus 4 slice scanner, kVp 120, mA 214, ST 5) images demonstrate a subcapsular, crescentic-shaped area at the posterolateral aspect of the inferior renal pole that is slightly denser than the adjacent, non-enhanced renal parenchyma.

Click This is the CT scan of a 77 year-old male with primary renal lymphoma who initially presented to the family practice clinic with gross hematuria. Axial contrast-enhanced CT (b - center; supine, GE LightSpeed Plus 4 slice scanner, 100 cc visipaque, 90s delay, kVp 120, mA 131, ST 5) show that the crescentic-shaped subcapsular area is less dense than the enhancing renal cortex.

Click This is the follow-up CT scan of a 77 year-old male with primary renal lymphoma, acquired 3 months after he initially presented to the family practice clinic with gross hematuria. Axial, NCCT (a left; supine, GE LightSpeed Pro 16 slice scanner, kVp 120, mA 113, ST 5) show a persistent crescentic subcapsular mass at the inferior left renal pole with several millimeters of interval growth.

Click This is the follow-up CT scan of a 77 year-old male with primary renal lymphoma, acquired 3 months after he initially presented to the family practice clinic with gross hematuria. Axial CECT in corticomedullary phase (b - middle; supine, GE LightSpeed Pro 16 slice scanner, 100 cc visipaque, 90s delay, kVp 120, mA 80, ST 5), and CECT in early pyelographic phase (c - right; supine, GE LightSpeed Pro 16 slice scanner, 100 cc visipaque, 160s delay, kVp 120, mA 80, ST 5) images better demonstrate the mild enhancement of the crescentic subcapsular mass at the inferior left renal pole from an average HU of 33 on the NCCT to 55 in the corticomedullary phase. There was also several millimeters of interval growth.

Click This is a 77 year-old male who was diagnosed with primary renal lymphoma. The MRI was acquired 6 weeks after the follow-up CT scan. The crescentic subcapsular mass is hypointense to the adjacent renal cortex on the axial T2 fat-saturated MR image (a - top left; Siemens 3 Tesla, TR 3500, TE 102, ST 6).

Click This is a 77 year-old male who was diagnosed with primary renal lymphoma. The MRI was acquired 6 weeks after the follow-up CT scan. There is a crescentic subcapsular mass which is isointense to the renal cortex on axial T1 pre-contrast images (b - top middle; Siemens 3 Tesla, TR 3.26, TE 1.18, ST 2).

Click This is a 77 year-old male who was diagnosed with primary renal lymphoma. The MRI was acquired 6 weeks after the follow-up CT scan. The crescentic subcapsular mass demonstrates mild enhancement on post-contrast images (c - top right; Siemens 3 Tesla, 15 cc Magnevist contrast, TR 3.26, TE 1.18, ST 2).

Click This is a 77 year-old male who was diagnosed with primary renal lymphoma. The MRI was acquired 6 weeks after the follow-up CT scan. The crescentic subcapsular mass demonstrates mild enhancement better seen on the axial subtracted MR images (d - bottom left; Siemens 3 Tesla, 15 cc Magnevist contrast, TR 3.26, TE 1.18, ST 2).

Click This is a 77 year-old male who was diagnosed with primary renal lymphoma. The MRI was acquired 6 weeks after the follow-up CT scan. The crescentic subcapsular mass demonstrates mild enhancement better seen on the coronal subtracted MR images. For comparison, multiple cysts and calyceal diverticula are seen in both kidneys as round intraparenchymal hypointensities which are black because they do not enhance; and are therefore completely subtracted from the pre- to post-contrast images (e - bottom middle image; Siemens 3 Tesla, 15 cc Magnevist contrast, TR 100, TE 2.46, ST 4).

Click This is a 77 year-old male who was diagnosed with primary renal lymphoma. Axial NCCT images (f - bottom right; supine, GE LightSpeed Pro 16 slice scanner, kVp 120, mA 164, ST 5) demonstrate the biopsy trochar centered within the subcapsular mass.

Click These are images of a 18FDG PET-CT scan immediately following the biopsy of radiation in a 77 year-old male diagnosed with primary renal lymphoma. Fused-axial and planar MIP images immediately following the biopsy demonstrates very mild activity in the peripheral lateral aspect of the mass at the inferior pole of the left kidney. 100 mL of IV visipaque contrast was used for the CT (kVp 140, mA 160, slice thickness3.75mm), 19.7 mCi of 18FDG was injected, and imaging took place 60 minutes later.

Click These are images of a 18FDG PET-CT scan 4 months after completion of radiation in a 77 year-old male diagnosed with primary renal lymphoma. Fused-axial and planar MIP images after completion of radiation demonstrates normal collecting system uptake and resolution of the mild activity previously seen in the peripheral lateral aspect of the mass at the inferior pole of the left kidney. No IV contrast was used for the CT (kVp 140, mA 170, slice thickness 3.75mm), 21.2 mCi of 18FDG was injected, and imaging took place 53 minutes later.