Fever , renal mass ! | Figure 1

Fever, Renal Mass!

54-year-old female patient presented with intermittent fever and tachypnea for a month, associated with anorexia. No pain was reported.

Sonar showed:

• Hepatosplenomegaly
• Mild ascites

CT showed:

• Malignant renal cyst.
• CT chest free

Labs:

• Elevated bilirubin, ALT, GGT
• Normal alpha-feto protein
• Virology negative, positive Epstein Barr IgM and IgG
• Hg 7 (for which she received 2 packs), thrombocytopenia, leukopenia

Past history:

• Cholecystectomy 20 years ago
• No cardiac diseases, no HTN, no diabetes