61-year old man with hypertension, morbid obesity, osteoarthritis and bilateral hip replacement. He was healthy and came to attention after slipping and falling on ice. His physical exam was unremarkable and a CBC was normal. An abdominal CT scan performed to rule out trauma showed the presence of a 7 cm, exophytic, partially calcified heterogeneous mass located on the postero-lateral aspect of the left kidney. The patient had recalled that approximately 20 years before, he had been diagnosed with a calcified left renal cyst, but had not had any follow up since then. Due to concern for renal parenchymal invasion he underwent a radical nephrectomy. There were no other sites of involvement by lymphoma. HIV and EBV PCR were negative.