Presentation
Left loin pain. The patient underwent left ureteric stent placement.
Patient Data
The following findings are present:
- paucity of air-filled bowel within the pelvic cavity.
- central blank area within the abdomen.
- enlarged splenic shadow with medial displacement of the descending colon.
- the left ureteric metallic stent is displaced medially.
The spleen is markedly enlarged with a rounded hypodense focal lesion close to its anterior pole.
Multiple celiac, paraaortic, aortocaval, preaortic, bilateral common iliac, external, and internal iliac lymph nodes are noted. The enlarged left internal iliac lymph node displaces the metallic ureteral stent medially. Also, there is mild hydronephrosis.
Case Discussion
The internal iliac lymph nodes compressed the left ureter and caused hydronephrosis for which placement of a ureteric stent was necessary. The centrally located paraaortic, preaortic, and aortocaval lymphadenopathies were responsible for the central abdominal blank area.
Diagnosis: Non-Hodgkin lymphoma
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