Abstract
BACKGROUND: We present a rare case of Primary Renal Lymphoma (PRL) diagnosed on histopathology following robotic nephroureterectomy. This case explores the diagnostic and management challenges urologists face, when treating renal masses. CASE PRESENTATION: An 82-year-old male presented with recurrent macroscopic haematuria and a computed tomography intravenous pyelogram (CT IVP) reported renal papillary necrosis and an associated mass effect at the right renal pelvis. Urine cytology was inconclusive, whilst inpatient pyeloscopy revealed a renal pelvis tumour. This was biopsied and reported as suspicious for urothelial carcinoma. Multidisciplinary team discussion (MDT) recommended curative surgery. Following right nephroureterectomy, postoperative histology revealed a diffuse large B-Cell lymphoma (DLBCL) extending through the renal capsule into perirenal fat, renal vein and renal pelvis. CONCLUSION: We highlight the clinical similarities between upper tract urothelial carcinoma (UTUC) and PRL, encouraging urologists to consider biopsies of indeterminate lesions, particularly amongst the frail population.