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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…

Case: A 32-year-old Man With a Left Testicular Mass

A 32-year-old Caucasian man was diagnosed with a left 1.2 cm solid testicular mass during evaluation of new gynecomastia (see image). He underwent a computed tomography scan of the chest, abdomen, and pelvis that did not demonstrate evidence of retroperitoneal lymphadenopathy and his tumor markers (AFP, B-HCG, LDH) were within normal limits.

A Rare Case of Post-renal Obstruction Causing AKI

A 61-year-old man with no significant past medical history presented to the hospital with bilateral flank pain and 20 lbs weight loss in the previous few months. Computed tomography (CT) showed bilateral ureteral obstruction in the mid-ureter with thickening of tissue around the great vessels. There were no stones. These findings are consistent with retroperitoneal fibrosis.…

A 66-year-old Man With Bilateral Renal Masses

A 66-year-old black man initially presented for evaluation of incidentally detected, Stage I, cT1aN0M0, synchronous, bilateral, clinically localized tumors that were suspicious for renal cell carcinoma (RCC). He has a history of hypertension but is otherwise healthy, with normal renal function (creatinine 0.80 mg/dL; estimated glomerular filtration rate >60 mL/min/1.73m2). Triphasic abdominal imaging (see figure)…

A Man With Elevated Serum Creatinine, History of Gout

A 40-year-old man presented for evaluation from his primary care doctor with an elevated serum creatinine level. Of note, his grandmother died from kidney failure, and his father suffered from kidney failure and underwent a kidney transplant at age 50 years. No family members suffer from gout. The patient’s only medication is a multivitamin. Physical…

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