A 45-year-old male presented with history of left flank pain for 1 year, which was mild dull aching in nature. Plain X-ray film of the urinary tract (Fig. 1) was suggestive of diffuse calcification in the left renal area (broad arrow) along with calcification in the ipsilateral ureter region (thin arrows). Chest X-ray was normal. Non-contrast computed tomography (CT) of kidney, ureter and bladder (axial section) showed replacement of entire left kidney with calcification (Fig. 2A). After contrast injection, the left kidney was not visualised while normal contrast uptake was seen in the right kidney (Fig. 2B) (coronal section). CT urogram showed calcification of the left kidney and ureter and normal excretion of contrast by the right kidney (Fig. 3). Urine report was positive for acid fast bacilli staining. Purified protein derivative skin test for tuberculosis was positive. Patient was managed with 6 months of multi-drug anti-tubercular therapy (ATT) along with opioid analgesics, as and when required. Nephrectomy was not required in this patient. Patient is symptom free and doing well at 1 year of follow-up.
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