A 47-year-old man presented to the urology department with visible hematuria. He was found to have a high-grade non-muscle-invasive transitional cell carcinoma of the bladder and was subsequently treated with intravesical Bacillus Calmette-Guérin instillations. On routine surveillance computed tomography scan following treatment, he was found to have multiple rounded areas of low density in the right kidney, suspicious for renal malignancy. He underwent renal biopsy that revealed necrotizing granulomatous inflammation suggestive of mycobacterial infection. He was successfully treated with antituberculosis therapy.
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