Hanada Ken, Shirai Sayuri, Ito Takafumi, Tanabe Kazuaki, Kimura Kenjiro
Clin Nephrol. 2014 Apr;81(4):277-82. doi: 10.5414/CN107744.
Nephrotic syndrome often emerges with malignancy. Membranous nephropathy is generally associated with solid tumors, and minimal change disease is associated with Hodgkin's disease. However, the complication of malignancy cannot be predicted by simply using renal histological findings. We report here three cases of nephrotic syndrome associated with hematological malignancy. On histology, Cases 1 and 2 were membranous nephropathy, and Case 3 was minimal change disease. Cases 1 and 2 were found to have B-cell non-Hodgkin's lymphoma, while Case 3 had Hodgkin's lymphoma. In Cases 1 and 2, proteinuria diminished as chemotherapy was started. All three cases were characterized by glomerular endocapillary proliferation and massive glomerular infiltration of inflammatory cells. These three cases are reported because their histologically atypical findings might be a feature of hematological malignancy- associated nephrotic syndrome and of any help for diagnosis.