Multimodality imaging of renal inflammatory lesions

Figure 19 Fungal infection. A: CECT shows liver, spleen and bilateral kidneys studded with small hypodense lesions in a 10 years old leukemia patient who was proven to have Aspergillus infection on aspiration cytology. The patient also had lung involvement with contiguous cardiac thrombus (not shown); B, C: Nephrographic (B) and delayed (C) phase CECT in a 26 years old aplastic anemia patient reveal a poorly enhancing, non-excreting left kidney with perinephric inflammation. Aorta and left renal artery are almost completely occluded by a non-enhancing thrombus (arrow B). On delayed image (Figure C), patchy areas of enhancement (arrow) noted in left kidney are characteristic of acute pyelonephritis. FNAC from the perirenal soft tissue revealed fungal hyphae and diagnosis of angioinvasive fungal infection (mucor) was made and Amphotericin B was started. However patient expired two days later. CECT: Contrast-enhanced computed tomography.