Mortar Kidney

Keywords: renal tuberculosis

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An 88-year-old Japanese woman was hospitalized for the treatment of acute pneumonia. On admission, we observed a highly calcified mass in her left abdomen, surrounded by satellite calcifications (Picture A). A detailed medical interview revealed her medical history of tuberculosis (TB) and left thoracoplasty in her 30s, although further information was unavailable. Computed tomography revealed a wholly calcified left kidney (Picture A, coronal section). Despite the lack of data on acid-fast staining and mycobacterial culture, the radiologic findings suggested mortar kidney or renal TB.

Mortar kidney is a rare condition associated with TB, wherein the kidney appears as if it were packed with mortar (1). Although the active TB incidence trends in Japan have decreased, roughly 10 TB cases per 100,000 population are still reported (2). Clinicians, especially young ones unfamiliar with TB, should remember that this ancient disease may involve any organ in humans.

References

1. Isao M, Saito T, Bandobashi K, Kuroda N, Ohtsuki Y, Taguchi H. Renal tuberculosis (mortar kidney). Intern Med 45: 111-112, 2006. 

2. Hagiya H, Koyama T, Zamami Y, Minato Y, Tatebe Y, Mikami N, et al. Trends in incidence and mortality of tuberculosis in Japan: a population-based study, 1997-2016. Epidemiol Infect 147: 1-10, 2018.