PMC9660287_01
A multiple low-density lesions at right kidney. The enhancement degree was similar with renal parenchyma both in arterial [(A, B), arrows] and venous phases [(C, D), arrows]. Lower enhancement in excretory phase were imaged [(E, F), arrows].
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Contrast-enhanced CT revealed a multiple low-density lesion with marginal haziness in the right kidney ( Figure 1 ). The enhancement degree was similar to that of the renal parenchyma in both the arterial ( Figures 1A, B ) and venous ( Figures 1C, D ) phases but was lower in the excretory phase ( Figures 1E, F ).
Magnetic resonance imaging showed an inhomogeneous lesion approximately 44x23mm in diameter [(A, B), coronal T1-weighted image; (C, D), coronal T2-weighted image, arrows]. The central area presented progressive enhancement in delayed phase [(E, F), arrows]. The lesion also showed an opposite signal found in center on diffusion-weighted sequences [(G, H), arrows]. The ADC map on corresponding areas presented low signal appearance [(I, J), arrows].
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On MRI ( Figure 2 ), T2-weighted imaging revealed a mass with low signal intensity and unclear margins in the exterior of the middle pole of the right kidney ( Figures 2C, D ). The central area showed progressive enhancement in the delayed phase, and the retroperitoneal lymph nodes were homogeneously enhanced ( Figures 2E, F ). A diffusion-weighted imaging sequence revealed patchy enhancement of the lesion, with a lower signal in the center ( Figures 2G, H ).
There were both acute and chronic inflammatory cells infiltration, compared with many small abscesses.
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The final pathological result confirmed a renal abscess ( Figure 3 ), and the lesion gradually diminished after one further month of antibiotic therapy with cefoxitin sodium ( Figure 4 ).
The lesions were diminished. They were enhanced equally with renal parenchyma in arterial [(A, B), arrows] and venous phases [(C, D), arrows], while less degree in excretory phase [(E, F), arrows].
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The final pathological result confirmed a renal abscess ( Figure 3 ), and the lesion gradually diminished after one further month of antibiotic therapy with cefoxitin sodium ( Figure 4 ).