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Figure 1. CT abdomen revealing a large complex 16 x 11 x 12cm right anterior cystic renal mass with a calcified rim abutting the right colon.

A 64-Year-Old Woman With a Renal Cystic Neoplasm

A 64-year-old woman underwent a screening colonoscopy at the direction of her primary care physician. The colonoscopy revealed an infiltrative, polypoid, and ulcerated large non-obstructing mass in the mid ascending colon that was biopsy-proven to be a well to moderately differentiated invasive adenocarcinoma. She underwent staging cross sectional imaging that revealed an incidentally diagnosed 16…

Figure 1. Purpuric erythematous rash on patient’s arm.

Acute Kidney Injury in Patient With a Purpuric Rash

A 62-year-old white man with past medical history of ulcerative colitis presented with purpuric rash and abdominal pain that started 4 weeks previously. The abdominal pain was associated with nausea, bloating, episodes of diarrhea, and hematochezia. He stopped taking mesalamine prior to symptom onset. A week earlier, he presented to a local hospital where computed…

Figure 1. Scrotal ultrasound demonstrates a 5.5 × 5.5cm right intra-testicular mass with peripheral nodularity.

A 58-Year-Old Man Presenting With a Cystic Neoplasm of the Testis

A 58-year-old white man with a history of hypertension presented for urologic evaluation for obstructive voiding symptoms and an elevated PSA (3.1 ng/dL). On physical examination he was noted to have a palpable right testicular mass. He underwent a scrotal ultrasound that revealed a large (5.5 × 4.0 × 5.5cm) intra-testicular cystic mass with at…

Figure 1. Parathyroid scan of the patient shows focal increased activity posterior to the lower pole of the right thyroid lobe.

An ESRD Patient With Uncontrolled Secondary Hyperparathyroidism

This is a case involving a 64-year-old woman with end-stage renal disease (ESRD) due to lupus nephritis who has been on hemodialysis for 7 years. She also has dementia, hypertension, obstructive sleep apnea on CPAP, and stage 1 non-small cell lung cancer post wedge resection. Over the past 12 months, her secondary hyperparathyroidism (SHPT) has…

CT urogram showing a pear-shaped inverted bladder with extensive venous collateralization.

A 54-Year-Old Man With Painless Gross Hematuria and a Fatty Pelvic Tumor

The patient is a 54-year-old Caucasian male with a history of hidroadenitis who presented with a 1-week history of painless gross hematuria. His past medical history is otherwise unremarkable. He underwent a CT urogram in the emergency department that revealed an inverted pear-shaped bladder due to hypertrophy of perivesical and perirectal fat as well as…

Hematoxylin and eosin stain of the kidney showing brown deposits within the tubules of the kidney.

Chronic Kidney Failure in a Woman With a History of Kidney Stones

A 52-year-old woman presented for nephrologic consultation due to progressive chronic kidney failure. One year previously, her estimated glomerular filtration rate (eGFR) was 55 mL/min/1.73m2. She continued to follow up with her primary doctor and was found to have an eGFR of 40 mL/min/1.73m2 6 months later. The patient’s past medical history was significant for…

CT Urogram demonstrating a left upper tract filling defect and a left 1.5 x 1.2cm left para-aortic lymph node

Upper Tract Filling Defect in a Man With Bladder Cancer History

The patient is a 64-year-old Caucasian man with a history of stage I, pT1N0Mx, high grade urothelial carcinoma (nested variant) treated with a radical cystoprostatectomy and creation of an orthotopic, continent, neobladder which was performed in January of 2017. His past medical history is otherwise unremarkable. Surveillance imaging revealed no evidence of disease recurrence until…

Hyponatremia in an Alcoholic Man

A 50-year-old man with history of alcohol abuse was sent to the emergency room (ER) after developing generalized weakness. He was recently diagnosed with hypertension and started on lisinopril and hydrochlorothiazide 2 weeks prior. He typically drinks 8 beers a day and drinks a lot of water to “stay hydrated.” He attempted to stop his…

Abdominal CT scan showing 2 adrenal adenomas.

Two Left Adrenal Masses in a 62-Year-Old Man

A 62-year-old black man initially presented to discuss bilateral clinically localized stage I, cT1bNxMx, bilateral multifocal renal masses  (5.6 × 5.4 cm and 1.3 × 1.2 cm right lower pole renal masses; 4.9 × 4.8 cm left interpolar renal mass) suspicious for synchronous bilateral renal cell carcinomas. He was also noted to have 2 left…

Figure 1. Patient's kidney biopsy images. Light microscopy showed focal glomerulosclerosis (A) and meningeal and endocapilary proliferation (B). Electron microscopy showed electron dense deposits in the meningeal region (C). The podocyte foot processes are well preserved.

A Case of Hematuria in a Young Woman

A 19-year-old Asian woman with no significant past medical history was referred to the nephrology clinic for hematuria. She noticed tea-colored urine 3 days after an upper respiratory illness. It lasted for 1 week. During that time, urinalysis showed 3+ blood, 1+ protein, >60 RBCs. Since then, she has had recurrent pink-tinged urine lasting a…

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