Renal lymphoma

• Most commonly multiple bilateral hypoechoic masses
• Can have near-anechoic or anechoic appearance
  • Due to homogeneity with monotnous histologic composition and little stromal tissue resulting in very few internal reflectors
  • Lack of acoustic enhancement deep to mass is clue that it is solid and not cystic
• Fairly characteristic to involve perinephric space
• Suspected lymphoma is one of the situations where percutaneous biopsy is indicated