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Perirenal lymphatics: anatomy, pathophysiology, and imaging spectrum of diseases

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A Letter to the Editor to this article was published on 23 September 2023

Abstract

Despite being rarely discussed, perinephric lymphatics are involved in many pathological and benign processes. The lymphatic system in the kidneys has a harmonious dynamic with ureteral and venous outflow, which can result in pathology when this dynamic is disturbed. Although limited by the small size of lymphatics, multiple established and emerging imaging techniques are available to visualize perinephric lymphatics. Manifestations of perirenal pathology may be in the form of dilation of perirenal lymphatics, as with peripelvic cysts and lymphangiectasia. Lymphatic collections may also occur, either congenital or as a sequela of renal surgery or transplantation. The perirenal lymphatics are also intimately involved in lymphoproliferative disorders, such as lymphoma as well as the malignant spread of disease. Although these pathologic entities often have overlapping imaging features, some have distinguishing characteristics that can suggest the diagnosis when paired with the clinical history.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Baylor College of Medicine, Houston, TX, USA

    Dane E. Eskildsen & Richard J. Fagan

  2. Baylor Scott & White Health, Dallas, TX, USA

    Jeffrey Guccione

  3. Department of Radiology, Mayo Clinic Arizona, Scottsdale, AZ, USA

    Christine O. Menias

  4. Department of Radiology, University of Utah, Salt Lake City, UT, USA

    Akram M. Shaaban

  5. Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Ajaykumar C. Morani, Mostafa A. Shehata, Emad D. Singer, Moamen A. Abdelaal, Corey T. Jensen & Khaled M. Elsayes

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  1. Dane E. Eskildsen
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Correspondence to Khaled M. Elsayes.

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Eskildsen, D.E., Guccione, J., Menias, C.O. et al. Perirenal lymphatics: anatomy, pathophysiology, and imaging spectrum of diseases. Abdom Radiol 48, 2615–2627 (2023). https://doi.org/10.1007/s00261-023-03948-4

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