CLINICAL HISTORY.—This 6-year-old Negro boy had a ten-month history of pallor, lethargy, and dyspnea on exertion. The diagnosis of idiopathic pulmonary hemosiderosis was established by physical examination and laboratory methods.
Serial chest radiographs obtained during the course of investigation of the patient's illness showed diffuse, bilateral pulmonary infiltration and mild cardiomegaly, compatible with idiopathic pulmonary hemosiderosis. Another unsuspected and unrelated abnormality was also seen as a constant feature. Representative frontal and lateral chest radiographs are presented (Fig 1).
Denouement and Discussion
Superior Renal Ectopia (Thoracic Kidney)
The frontal projection of the chest shows a well-defined, rounded mass related to the medial portion of the left diaphragmatic dome. The same mass is noted posteriorly on the lateral chest radiograph. Intravenous pyelography demonstrates that the mass is the upper pole of a superiorly placed and malrotated left kidney (Fig 2).Superior renal ectopia is an uncommon abnormality which should be considered when