Tuberculoma lesions most commonly form in the upper pole of the kidney and enlarge, rupturing into neighboring calyces and discharging caseous material. This distorts the calyx, causing irregularities on papillae surfaces. Early signs include a "moth-eaten" appearance to the calyx. Irregular tracts then form from the calyx to papilla. Large irregular cavities with extensive destruction can result from papillary necrosis. Cavitation within the renal parenchyma may appear as irregular pools of contrast material on imaging.

1. Tuberculoma--localized caseating lesion, most commonly upper pole. nidus of infection enlarges and
ruptures into a neighboring calyx, discharging necrotic caseous material--distorting the calyx---smudged
papillae due to surface irregularity of the papillae, a moth-eaten calyx (early sign), irregular tract formation
from the calyx to the papilla, and large irregular cavities with extensive destruction secondary to papillary
necrosis. Cavitation within the renal parenchyma may be detected as irregular pools of contrast material.
Mass lesion-cavity/hydrocalcyses

2. 12/06/14
Genitourinary tract tuberculosis. Plain radiograph of the abdomen in a patient with calcified seminal vesicles
due to tuberculosis. Note the amorphous and speckled calcification in the right kidney.

3. 12/06/14
Plain radiograph of the abdomen demonstrates extensive calcification in the left kidney, which was
nonfunctional (the putty kidney), consistent with autonephrectomy from tuberculosis.

4. 12/06/14
Figure 4a. (a) Retrograde ureteropyelogram shows globular calcific areas of increased opacity in the
medial upper pole of the right kidney (arrowheads). The calices are markedly enlarged with ill-defined
margins (white arrows). Small, irregular collections of extracaliceal contrast material are also present (black
arrows). (b)Magnified view from a retrograde ureteropyelogram of the right ureter shows mucosal
irregularities and erosions (arrowheads).