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Pseudotumoral Renal Sarcoid: MRI, PET, and MDCT Appearance with Pathologic Correlation

Maureen Heldmann1, William Behm1, Madhusudhan P. Reddy1, Caleb Bozeman2, Greg Welman3, Fleurette Abreo3 and Alireza Minagar4

1 Department of Radiology, Louisiana State University Health Sciences Center, 1501 Kings Hwy., Shreveport, LA 71130.
2 Department of Urology, Louisiana State University Health Sciences Center, Shreveport, LA 71130.
3 Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, LA 71130.
4 Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA 71130.



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  		Fig. 1A —37-year-old black man with pseudotumoral renal sarcoid. Specimen from core biopsy of renal mass shows noncaseating granulomata characterized by aggregates of epithelioid macrophages. (H and E, original magnification x100)

 


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  		Fig. 1B —37-year-old black man with pseudotumoral renal sarcoid. Coronal PET image shows focus of intense abnormal activity (arrow) in left kidney.

 


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  		Fig. 1C —37-year-old black man with pseudotumoral renal sarcoid. Enhanced CT scan before therapy shows large lesion (arrow).

 


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  		Fig. 1D —37-year-old black man with pseudotumoral renal sarcoid. Fast spoiled gradient echo T1-weighted MR image (TR/TE, 150/1.3; slice thickness, 7 mm) (D) and fast spin-echo T2-weighted image (2,500/96; 7-mm slice thickness) (E) 90 sec after administration of contrast material show pseudotumoral infiltration of left kidney as heterogeneity and regional expansion that are best perceived after administration of gadolinium.

 


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  		Fig. 1E —37-year-old black man with pseudotumoral renal sarcoid. Fast spoiled gradient echo T1-weighted MR image (TR/TE, 150/1.3; slice thickness, 7 mm) (D) and fast spin-echo T2-weighted image (2,500/96; 7-mm slice thickness) (E) 90 sec after administration of contrast material show pseudotumoral infiltration of left kidney as heterogeneity and regional expansion that are best perceived after administration of gadolinium.

 


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  		Fig. 1F —37-year-old black man with pseudotumoral renal sarcoid. Enhanced CT scan after therapy confirms lesion regression (arrow) after institution of glucocorticoids. Compare with C.

 

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