PMC5216159_01
Chest X-ray on the day of admission. Chest X-ray showed nodular lesions (arrows) in the left lung field.
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Chest X-rays showed multiple nodular lesions on the left lung field (Fig. 1).
Chest and abdominal CT on admission day. Chest CT (a) showed multiple centrilobular nodules. Abdominal CT showed bilateral hydronephrosis (white arrows), cortical thinning of the right kidney (white triangles) (b), dilatation of both ureters (black arrows) (c), and the calcification of the bladder wall (black triangle) (d).
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Chest computed tomography (CT) showed multiple centrilobular nodules (Fig. 2a), and abdominal CT showed bilateral hydronephrosis: dilatation of both ureters; severe cortical thinning of the right kidney, indicating a complete loss of function; and calcification of the bladder wall (Fig. 2b-d).
Schematic illustration of urinary tract. (a) On Day 6, the patient suddenly developed anuria due to the deterioration of the left ureteral stricture. (b) A smaller-bore catheter was inserted into the middle of the left ureter, resolving the postrenal acute renal failure. However, no urine output was recognized from the balloon catheter. (c) On Day 27, corticosteroid administration was initiated. Urine started leaking from the balloon catheter, indicating the improvement of the ureteral stricture. (d) On Day 35, the ureteral catheter was removed.
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On the 6th hospital day, the patient developed anuria with a fever of 39C, and his serum creatinine levels rose to 4.21 mg/dL (Fig. 3a). A smaller-bore catheter was therefore placed to relieve the obstruction, but it could not reach the pelvis of the left kidney (Fig. 3b). This indicated improvement in the ureteral stricture (Fig. 3c). Although the patient complained of frequent urination, probably due to a shrunk bladder, there was no sign of re-occlusion thereafter (Fig. 3d).