Granulomatosis with polyangiitis presenting as multiple renal masses: A case report with MRI findings

Takahiro Yamamoto, MD; Yuki Maruchi, MD, PhD; Ayumi Asai, MD; Yumi Takehara, MD; Yu Koshikawa, MD; Shuji Ikeda, MD, PhD; Keishi Kajikawa, MD, PhD; Shogo Banno, MD, PhD; Kojiro Suzuki, MD, PhD

Radiology Case Reports (Mar 2023)

Granulomatosis with polyangiitis presenting as multiple renal masses: A case report with MRI findings

Takahiro Yamamoto, MD,
Yuki Maruchi, MD, PhD,
Ayumi Asai, MD,
Yumi Takehara, MD,
Yu Koshikawa, MD,
Shuji Ikeda, MD, PhD,
Keishi Kajikawa, MD, PhD,
Shogo Banno, MD, PhD,
Kojiro Suzuki, MD, PhD

Affiliations

Takahiro Yamamoto, MD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, 480-1195, Japan; Corresponding author.
Yuki Maruchi, MD, PhD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, 480-1195, Japan
Ayumi Asai, MD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, 480-1195, Japan
Yumi Takehara, MD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, 480-1195, Japan
Yu Koshikawa, MD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, 480-1195, Japan
Shuji Ikeda, MD, PhD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, 480-1195, Japan
Keishi Kajikawa, MD, PhD: Department of Urology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan
Shogo Banno, MD, PhD: Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, Japan
Kojiro Suzuki, MD, PhD: Department of Radiology, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi, 480-1195, Japan

Journal volume & issue: Vol. 18, no. 3
pp. 1292 – 1296

Abstract

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It is extremely rare for granulomatosis with polyangiitis to form masses in the kidneys. Magnetic resonance imaging findings of renal masses caused by this disease have been infrequently reported. In this study, we report a case of renal masses caused by granulomatosis with polyangiitis with different findings. While on steroid treatment for a recently diagnosed granulomatosis with polyangiitis, a man in his 60s underwent computed tomography for a hepatic dysfunction. Computed tomography showed incidental findings of a 40 mm × 35 mm mass in the left kidney and two 8 mm × 8 mm masses in the right kidney; all masses were hypovascular. On magnetic resonance imaging, the left renal mass showed a hyperintense signal with slightly hypointense signal rim on T2-weighted imaging. The left renal mass showed a strong hypointense signal where the mass abutted the renal capsule. On diffusion-weighted imaging, the left renal mass showed an isointense signal with a hyperintense signal rim. Both right renal masses showed an isointense signal with slightly hypointense signal rim on T2-weighted imaging and hyperintense signal on diffusion-weighted imaging. Suspecting renal masses caused by the disease, the patient was then treated with steroids and methotrexate. After 6 months of treatment, both right renal masses resolved; however, the left renal mass shrank but abnormal signal remained. Based on the treatment course, it is conceivable that the renal masses were caused by granulomatosis with polyangiitis.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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