Case of the Month

October 2005

Patient Data: 70 years old male

Clinical Info: Impaired renal function

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Longitudinal image showing a mass ventral of the distal abdominal aorta and a normal proximal aorta.

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Transverse image showing the mass around the distal aorta.

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Longitudinal image of the right kidney with a dilatated collecting system.

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Transverse image of the right kidney with a dilatated collecting system.

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Longitudinal image of the left kidney with a dilatated collecting system.

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Transverse image of the left kidney with a perirenal effusion caused by a fornix rupture.

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Transverse color doppler image showing a medial displaced and dilatated right ureter ventral of the vena cava and next to the aortic mass (arrow).

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Longitudinal color doppler image of the aorta with ventral mass and origin of the inferior mesenteric artery (arrow).

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Longitudinal image of the distal aorta and proximal left common iliac artery showing the mass extending along the proximal left common iliac artery.

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Longitudinal image of the left common iliac artery showing the mass extending along the proximal left common iliac artery. The distal common iliac artery is normal.

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Longitudinal image of the right common iliac artery showing the mass extending along the proximal right common iliac artery. The distal common iliac artery and external iliac artery are normal.

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CT image at the level of the kidneys showing the right kidney with a dilatated collecting system and the left kidney with a perirenal effusion. The aorta at this level is normal.

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CT image showing the mass around the aorta.

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CT image showing the mass around the proximal right and left common iliac artery.

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Plain abdominal X ray showing a stent in the right and left ureter. The above images present the typical characteristics off a case of retroperitoneal fibrosis. Retroperitoneal fibrosis often presents with a dilatation of the renal collecting system caused by a mass around the aorta. Retroperitoneal fibrosis should be differentiated from enlarged retroperitoneal lymphe nodes and pathology of the aorta such as an inflammatory aneurysm.

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