A Case of Primary Bilateral B-cell Renal Lymphoma / 대한신장학회잡지

ABSTRACT

Non-Hodgkin's lymphoma frequently involves the kidneys, with previous reports demonstrating approximately a 48 Yo incidence at autopsy. In contrast, lymphoma originating within the kidneys is a rare event, because the renal parenchyma does not have lymphatics. Most common type of primary renal lyrnphoma that calssified by Working formulation and irnmunohistochemistry was diffuse large B-cell, intermediate grade. A 43-year-old woman presented with epigastric discomfort, anorexia, fever, and weight loss. The past rnedical history was unremarkable. On physical examination, she was febrile, and conjunctiva was pale. Lymph node was enlarged and palpated at right inguinal area. But no other lymphadenopathy or hepatosplenomegaly was found. Laboratory study showed WBC 6,900/mm, hemoglobin 6.7g/dL, serum LDH 783IU/L, GFR 31.45 ml/min. The chest X-ray was within normal limit; no mediastinal lympha- denopathy was present. The abdominal X-ray revealed enlargement of right kidney. The abdominal CT scan showed markedly enlarged both kidneys containing inhomogeneous solid masses with poor excretion of intravenous contrast, a few small paraaortic lymphadenopathies, and contour bulging on the pancreas body. A percutaneous renal biopsy was obtained from this patient at the right kidney. Microscopic exarnination showed a diffuse infiltrate of predominantly large lymphoid cells having round to oval vescicular nuclei. Immunohistochemical studies revealed a B-cell-type lymphoma. The tumor was judged to be an intermediate-grade, large-cell, diffused, B-cell-type non-Hodgkin's lymphoma. We report a case of primary bilateral B-cell renal lymphoma in a 43-year-old female patient with review of the literature.