Invasive renal pelvic cancer refers to tumors of stage T2 and above, accounting for 50%-60% of all renal pelvic tumors. When the tumor develops to stage T3, the tumor invades the muscular layer and invades the renal parenchyma or perirenal fat, and the clinical disease progresses rapidly, which may be accompanied by fever and lumbago and is prone to early local and distant metastases. Some patients without hematuria may present with fever, lumbar pain, and weight loss, and ultrasound and CT are easily diagnosed as renal cyst co-infection as well as inflammation of the renal parenchyma. Two patients in the study presented with hematuria, one of which was accompanied by significant lumbar pain and fever, and CT showed wedge-shaped ischemic changes in the renal parenchyma. Inflammatory lesions of the renal parenchyma caused by lobar nephritis were first considered, and biopsy puncture was performed in this patient, and the results were considered to be renal clear cell carcinoma, but the final result was uroepithelial carcinoma, probably due to the small amount of punctured tissue, which affected the diagnostic analysis. When the imaging manifestation of renal pelvis tumor is dominated by tumor invasion of renal parenchyma manifestation, or invasion of part of renal pelvis, or tumor is located in the center of renal parenchyma, or is a wedge-row lesion, it is difficult to differentiate imaging from renal parenchymal inflammation or renal cell carcinoma. (1) Most renal pelvis tumors grow concentrically, and the renal parenchyma is surrounded by them. CT shows that the kidney shape often increases, but generally does not change the surface morphology of the kidney, so the kidney shape of renal pelvis cancer is basically normal; while renal cancer grows eccentrically, resulting in changes of the kidney shape. (2) Renal pelvic tumors often have uneven enhancement on CT, with CT values around 30-40 on plain scan and not >100 Hu after enhancement. (3) Renal pelvic tumors do not show “fast in and fast out” when enhanced, while renal cancer has abundant blood flow and often shows “fast in and fast out”. (3) During enhancement, renal pelvic tumors do not show “fast in-fast out”, while renal cancer has abundant blood flow and often shows “fast in-fast out. Because of the tendency of metastatic cell carcinoma to cause implantation, percutaneous puncture biopsy of tumor is usually not chosen.