Julia R. Fielding, M.D. Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts

60 Year-old Male with Bilateral Hydronephrosis

This gentleman with a remote history of lymphoma had a CT scan performed for routine surveillance and subsequently underwent IVU.

Axial non contrast-enhanced CT images demonstrate bilateral mild hydronephrosis (Figure 1) and abnormal soft tissue anterior to the aorta (Figure 2). IVU demonstrates medial deviation and dilation both ureters to the level of L3 (Figure 3). Differential diagnosis includes lymphoma, metastatic disease (especially testicular tumors) and retroperitoneal fibrosis. Diagnosis of retroperitoneal fibrosis was confirmed using open biopsy.