De Melio Jonas, Crevits Ilse
Department of Radiology, AZ Delta campus Rumbeke, Deltalaan 1, 8800 Roeselare, Belgium.
Radiol Case Rep. 2020 Oct 6;15(12):2530-2534. doi: 10.1016/j.radcr.2020.09.040. eCollection 2020 Dec.
Retroperitoneal fibrosis (RPF) is a relatively rare entity, characterized by chronic inflammation and fibrosis in the retroperitoneal periaortic tissues. Due to this rarity, the diagnosis might be delayed or challenging, especially with atypical presentations of RPF. We report the imaging findings of an incidental finding of active RPF in an asymptomatic 84-year-old male patient. This patient was initially diagnosed with a perirenal hematoma due to an atypical imaging presentation on a routine staging computed tomography scan of the chest and the abdomen to stage a recently discovered prostate cancer. However, due to the persistence of the perirenal lesion, subsequent magnetic resonance imaging of this lesion was conducted, which resulted in the final diagnosis of active RPF. With this case report, we want to address attention to the potential atypical presentation of RPF, which could mimic a perirenal mass and demonstrates the importance of a broad differential diagnosis. Secondly, we want to point out the importance of magnetic resonance imaging in the evaluation of RPF, since it can differentiate between inactive or chronic idiopathic RPF and active idiopathic RPF or malignant RPF. Finally, this case shows the importance of comparing current imaging findings with previous imaging results, since a perirenal hematoma would reduce in size on follow-up imaging, which was not the case in our patient.
腹膜后纤维化（RPF）是一种相对罕见的疾病，其特征是腹膜后主动脉周围组织的慢性炎症和纤维化。由于这种罕见性，诊断可能会延迟或具有挑战性，尤其是对于RPF的非典型表现。我们报告了一名84岁无症状男性患者偶然发现的活动性RPF的影像学表现。该患者最初因在胸部和腹部的常规分期计算机断层扫描中出现非典型影像学表现而被诊断为肾周血肿，目的是对最近发现的前列腺癌进行分期。然而，由于肾周病变持续存在，随后对该病变进行了磁共振成像检查，最终诊断为活动性RPF。通过本病例报告，我们希望引起对RPF潜在非典型表现的关注，其可能酷似肾周肿块，并证明广泛鉴别诊断的重要性。其次，我们想指出磁共振成像在评估RPF中的重要性，因为它可以区分非活动性或慢性特发性RPF与活动性特发性RPF或恶性RPF。最后，该病例显示了将当前影像学表现与先前影像学结果进行比较的重要性，因为肾周血肿在随访影像学检查中会缩小，而我们的患者并非如此。
