A rare life-threatening disease: unilateral kidney compressed by huge chronic spontaneous retroperitoneal hemorrhage

Figures & data

Figure 1 Imaging for Cases 1 and 2.

Notes: (A) Magnetic resonance imaging of the abdomen on presentation of Case 1. Multiple cystic lesions were seen with short T1 and long or short T2 signals (white arrow); left kidney was pushed and compressed by the mass (yellow arrow). (B) Computed tomography scan shows a huge mass from the left side of retroperitoneal to iliac fossa (yellow arrow) in Case 2; the functional solitary left kidney was pushed and compressed by the mass (white arrow).

Table 1 Laboratory test results before surgery

Test	Case 1	Case 2	Normal reference range
Blood
PT, s	15	45.9	9–13
PT INR	1.26	3.73	0.8–1.2
Activated partial thromboplastin time, s	60.1	76.2	20–40
TT, s	16.5	15.6	14–21
FIB, g/L	2.72	4.25	2–4
D-dimer, mg/L	12.19	2.15
Platelets,/L	386×10^9	390×10^9	100–300×10^9
Hemoglobin, g/L	87.0	54.0	131–172
MCV, fL	86.0	85.7	86–100
MCH, pg	28.4	27.2	26–31
White blood cell count,/L	21.47×10^9	20.86×10^9	3.97–9.15×10^9
Neutrophils, %	88.3	92.6	45–77
Lymphocytes, %	5.5	2.5	20–40
CRP, mg/L	79.69	45.41	0–10
hs-CRP, mg/L	4.83	5.62	0–3
IgG, g/L	11.53	8	8–16
Alexin C3, g/L	0.63	0.6	0.9–1.5
Alexin C4, g/L	0.12	0.19	0.2–0.4
Creatinine, μmol/L	548	246	53–123
Total protein, g/L	51.8	62.6	60–80
Globulin, g/L	20.9	32.9	25–35
Albumin:globulin ratio	0.68	1.11	1–2.5
Urine
Blood, μL	5	0	0–5

Abbreviations: CRP, C-reactive protein; FIB, fibrinogen; IgG, immunoglobulin G; INR, international nor malized ratio; MCH, mean corpuscular hemoglobin; MCV, mean corpuscular volume; PT, prothrombin time; TT, thrombin time.

Figure 2 Pathologic findings of Case 1.

Notes: The majority of mass consisted of blood clots and fibrinous exudate cells, and a few broken and necrotic glomerular and renal tubules were seen. No evidence of malignancy and no bacteria were found in the necrotic foci. PAS and D-PAS were negative. Magnification ×100.
Abbreviations: PAS, periodic acid-Schiff; D-PAS, D-periodic acid-Schiff stain.