ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: TH-PO581

Renal Replacement Lipomatosis in Transplanted Kidney

Session Information

  • Trainee Case Reports - II
    October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Trainee Case Reports

  • 1802 Transplantation: Clinical

Authors

  • Hanna, Wael A., Lehigh Valley Hospital, Breinigsville, Pennsylvania, United States
  • Bollu, Ravindra, Valley Kidney Specialists, Allentown, Pennsylvania, United States
Introduction

Renal sinus lipomatosis (RSL) is a rare disorder where fatty tissue proliferate within the renal sinus and hilum. Renal replacement lipomatosis (RRL) is a severe form of RSL.

Case Description

A 63-year-old female with a history of end stage renal disease due to chronic glomerulonephritis underwent deceased donor renal transplant in February,1997. She has been diagnosed with chronic allograft dysfunction since 2002 with baseline S Cr 1.7-2 mg/dL. Immunosuppression has been maintained with Cyclosporine A, Mycophenolate mofetil and Prednisone. She experienced recurrent urinary tract infections since her kidney transplantation. She presented to emergency department with abdominal pain. On examination, a large right lower quadrant mass could be palpated. S Cr was at her baseline. CT scan of the abdomen and pelvis revealed a 24 cm large fatty mass centered in the hilum of the right lower quadrant renal transplant with splayed transplant parenchyma and collecting system. CT scan reading suggested the possibility of well differentiated liposarcoma. CT guided biopsy of the mass was performed. Pathology demonstrated mature adipose tissue with chronic inflammation.

Discussion

Renal replacement lipomatosis (RRL) is a rare condition, characterized by excessive fatty proliferation of the renal sinus with atrophy of the renal tissue. Aging, obesity and calculus disease are possible risk factors for RRL. Recurrent urinary tract infections has been described in most cases of RRL. The period between renal transplant and RRL diagnosis has been variable in the literature, ranging from 6 months to 8 years. Our case was diagnosed after 21 years from her renal transplant. RRL is a very rare disease in kidney transplant. It should be differentiated from other fat containing tumors like liposarcoma and angiomyolipoma.