Chatzipantelis Paschalis, Mastorakis Emmanouil, Tzortzakakis Dimitrios, Salla Charitini
Department of Cytology, Athens General Hospital, Athens, Greece.
Acta Cytol. 2010 Jan-Feb;54(1):71-4. doi: 10.1159/000324971.
Primary renal lymphoma is a rare disease (< 1% of kidney lesions). We present a case of renal large B-cell type non-Hodgkin's lymphoma (NHL) with right sided pleural involvement.
A 70-year-old man was admitted with persistent, painless, macroscopic hematuria for 1 month. Ultrasound examination, abdominal computed tomography and magnetic resonance imaging techniques revealed a large tumor in the right kidney extending in the perirenal area. The patient underwent a radical nephrectomy for suggested renal cell carcinoma. He developed thoracic pain and pleural effusion in the 10 days after surgery. The pleural fluid was cytologically processed using conventional and ThinPrep (Cytyc Corporation, Boxborough, Massachusetts, U.S.A.) cytopreparatory techniques, slides were Papanicolaou and Giemsa stained, and immunocytochemistry was performed on the ThinPrep slides. The cytologic examination of the fluid specimen revealed a highly cellular smear composed of dispersed neoplastic cells of intermediate and large size. Immunocytochemically, the neoplastic cells were: CD45 (LCA) (+), CD20 (+), CK7 (-), CK20 (-), NSE (-), CD45 RO (UCHL-1) (-) and CD30 (-). On cytomorphologic and immunocytologic examination, the specimen fulfilled the criteria of a large B-cell type NHL. Histologic evaluation of the nephrectomy specimen revealed an infiltrating, diffuse large cell renal NHL, B-cell type, of immunoblastic and centroblastic morphology. This NHL was considered a renal primary because no peripheral lymphadenopathy or hepatosplenomegaly was revealed by the imaging techniques.
Cytomorphologic and immunocytologic examination revealed the typical features of a renal large B-cell type NHL in a case with pleural involvement.
原发性肾淋巴瘤是一种罕见疾病（占肾脏病变的比例小于1%）。我们报告一例右侧胸膜受累的肾大B细胞型非霍奇金淋巴瘤（NHL）病例。
一名70岁男性因持续1个月的无痛性肉眼血尿入院。超声检查、腹部计算机断层扫描和磁共振成像技术显示右肾有一个大肿瘤，延伸至肾周区域。患者因疑似肾细胞癌接受了根治性肾切除术。术后10天，他出现胸痛和胸腔积液。胸腔积液采用传统和ThinPrep（美国马萨诸塞州博克斯伯勒市赛迪科公司）细胞制备技术进行细胞学处理，玻片进行巴氏染色和吉姆萨染色，并对ThinPrep玻片进行免疫细胞化学检测。液体标本的细胞学检查显示涂片细胞丰富且分散，由中等大小和大尺寸的肿瘤细胞组成；免疫细胞化学检测显示肿瘤细胞：CD45（LCA）（+）、CD20（+）、CK7（-）、CK20（-）、NSE（-）、CD45RO（UCHL-1）（-）和CD30（-）。根据细胞形态学和免疫细胞学检查，该标本符合大B细胞型NHL的标准。肾切除标本的组织学评估显示为浸润性弥漫大细胞肾NHL B细胞型，具有免疫母细胞和中心母细胞形态。由于影像学检查未发现外周淋巴结肿大或肝脾肿大，该NHL被认为是原发性肾淋巴瘤。
细胞形态学和免疫细胞学检查揭示了一例胸膜受累的肾大B细胞型NHL的典型特征。
