Primary renal lymphoma: one case report with literature review / 中华泌尿外科杂志

ABSTRACT

Objective To improve the clinical diagnosis and treatment outcome of primary renal lymphoma.Methods The clinical data of one primary renal lymphoma case were reviewed with its clinical manifestation,imaging,pathological study results and treatment outcome in our institute.This was a 61 yrs female patient presented with progressive left flank pain.The abdominal CT scan revealed enlarged left kidney lost ocortico-medullary differentiation and with a lower kidney pole 9.8 cm × 8.9 cm × 8.8 cm hypodensity mass.Results The patient was diagnosed with B-cell non-Hodgkinˊs lymphoma after radical nephrectomy.Extrarenal origin was ruled out by bone marrow biopsy.The pathological results showed that the tumor was limited to the lower kidney pole.Microscopically,there were large sheets of lymphoma cell infiltration in kidney parenchyma.The lymphoma cells were oval or polygonal.The nuclei of the lymphoma cells were anachromasised and irregular in size.The final pathological diagnosis was diffused large B cell lymphoma.The patient was subsequently given six cycles of CHOP (cyclophosphamide,adriamycin,vincristine and prednisone) in conjunction with rituximab.Twenty months post chemotherapy the patient was diseas-free at follow-up.Conclusions Primary renal lymphoma is rare and the mechanism of its development is unclear.Most of the cases reported showed rapid systemic progression and poor prognosis.The clinical manifestation is similar to renal cell carcinoma.Ultrasound and CT have no distinct characteristic.Diagnosis is established on renal biopsy or radical nephrectomy.Effective post-operative treatment is chemotherapy (CHOP) in conjunction with rituximab.