Yaomura T, Hayashi H, Kanoh T, Kurata K, Ishihara S, Machida H, Inaguma D, Kumon S
Department of Nephrology, Tosei General Hospital, Aichi, Japan.
Nihon Jinzo Gakkai Shi. 1999 Aug;41(5):505-10.
We report a case of non-Hodgkin's lymphoma (NHL) presenting with acute renal failure. A-56-year-old male was admitted to our hospital on October, 1997 with fever and renal dysfunction. Physical examination showed no abnormality except for hepatomegaly. Body surface lymphadenopathy was not observed. Computed tomography (CT) of the abdomen showed markedly enlarged kidneys bilaterally and a mass of soft tissue density, which was considered as a swelling lymph node, around the aortic artery. The renal biopsy revealed parenchymal involvement of the NHL cells without normal tubulo-interstitial structure, but the glomeruli were almost intact. Our case rapidly fell into oliguria and acute renal failure, hence needed hemodialysis. After chemotherapy was performed, his renal function gradually improved and the kidney became smaller on subsequent CT. Unfortunately, the patient happened to suffer from methicillin-resistant staphylococcus aureus (MRSA) infection in a neutropenic state and died. Necropsy revealed recovery of the renal interstitium without residual NHL cells. Renal lymphoma without any other organ or nodal involvement is a rare type of NHL, which considered primary renal lymphoma (PRL). However, we believe this case to have been a result of lymphomatous infiltration of the kidneys in disseminated lymphoma.
我们报告一例以急性肾衰竭为表现的非霍奇金淋巴瘤（NHL）。一名56岁男性于1997年10月因发热和肾功能不全入住我院。体格检查除肝肿大外无异常。未观察到体表淋巴结肿大。腹部计算机断层扫描（CT）显示双侧肾脏明显肿大，主动脉周围有一软组织密度肿块，考虑为肿大的淋巴结。肾活检显示NHL细胞累及实质，肾小管间质结构破坏，但肾小球基本完整。我们的病例迅速发展为少尿和急性肾衰竭，因此需要进行血液透析。化疗后，他的肾功能逐渐改善，后续CT显示肾脏变小。不幸的是，患者在中性粒细胞减少状态下发生耐甲氧西林金黄色葡萄球菌（MRSA）感染并死亡。尸检显示肾间质恢复，无残留NHL细胞。无其他器官或淋巴结受累的肾淋巴瘤是一种罕见的NHL类型，被认为是原发性肾淋巴瘤（PRL）。然而，我们认为该病例是弥漫性淋巴瘤肾脏淋巴瘤浸润的结果。
