American Board of Pathology (ABPath) 2025 – 400 Free Practice Questions to Pass the Exam

Horseshoe kidney is a condition where the two kidneys fuse together at the lower poles, often leading to a characteristic position within the abdomen that can mimic other conditions. In this case, the structure of the horseshoe kidney can resemble an abdominal lymph node due to its location and shape in the retroperitoneal space.

When imaging studies, such as ultrasound or CT scans, are conducted, the fused kidneys can appear as a mass that might be confused with enlarged lymph nodes, particularly if there is any associated inflammation or lymphadenopathy. The anatomical location and the potential for varying appearances can create a diagnostic challenge, making the distinction between a horseshoe kidney and an abdominal lymph node particularly important for accurate diagnosis and management.

Other options, such as adrenal tumors or liver cysts, usually have more distinct imaging characteristics that help differentiate them from a horseshoe kidney. Splenic enlargement also tends to present differently on imaging due to its location and typical appearance, making abdominal lymph nodes the most likely structure to be mistaken for a horseshoe kidney.