PMC9994299_01
Confirmatory referral kidney ultrasound by radiology in sepia tone demonstrating hypoechoic 5.2 cm retroperitoneal lesions likely representing extramedullary plasmacytomas compressing the proximal ureter. Left: right kidney long axis. Right: right kidney short axis.
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Kidney ultrasound revealed enlarged kidneys bilaterally with bilateral hydronephrosis. (Video S4-6 and Figure 1-4). 
Doppler imaging of right kidney, long axis demonstrating absence of flow in the dilated renal pelvis, proximal ureter, and masses in the retroperitoneum at the inferior pole.
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Kidney ultrasound revealed enlarged kidneys bilaterally with bilateral hydronephrosis. (Video S4-6 and Figure 1-4). 
Figure 3. Referral kidney ultrasound of left kidney in long axis demonstrating suspected plasmacytomas 3.7 cm in maximum diameter at the inferior pole. Left: left kidney long axis. Right: left kidney short axis.
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Kidney ultrasound revealed enlarged kidneys bilaterally with bilateral hydronephrosis. (Video S4-6 and Figure 1-4). 
Doppler imaging of left kidney in long axis demonstrating lack of fast flow in the area of suspected plasmacytomas.
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Kidney ultrasound revealed enlarged kidneys bilaterally with bilateral hydronephrosis. (Video S4-6 and Figure 1-4). 
Computed tomography, coronal view in the abdomen demonstrating interval placement of bilateral percutaneous nephrostomies. On the left the plasmacytomas measure 5.3 cm in maximum diameter.
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Ultimately repeat computed tomography demonstrated interval increase in size of retroperitoneal extramedullary plasmacytomas (Figure 5, 6).
Computed tomography, coronal view in the abdomen demonstrating bilateral kidneys with nephrostomies in place and bulky plasmacytomas at inferomedial border of kidneys bilaterally.
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Ultimately repeat computed tomography demonstrated interval increase in size of retroperitoneal extramedullary plasmacytomas (Figure 5, 6).