Central nervous system involvement of primary renal lymphoma with diffuse large B-cell type lymphoma.

PATIENT

Female, 27 FINAL DIAGNOSIS: Central nervous system leukemia Symptoms: Abdominal mass • fever • nausea • vomitting

MEDICATION

• Clinical Procedure: - Specialty: Hematology.

OBJECTIVE

Unusual clinical course.

BACKGROUND

Primary lymphoma of urinary system is an uncommon entity including primary renal lymphoma, primary ureter lymphoma, bladder lymphoma, and urethra (including prostate) lymphoma. The pathology of PRL is usually diffuse large B-cell lymphoma.

CASE REPORT

In this study we describe a 27-year-old Chinese woman with central nervous system leukemia due to PRL. It was classified as diffuse large B-cell lymphoma non-GCB type according to kidney biopsy. We selected R-CHOP as a regimen and it showed good curative effect. However, the patient suffered recurrence involving the central nervous system with complaint of intolerable iliac-sacral pain at 26 days after 6 courses of R-CHOP.

CONCLUSIONS

This case shows that prognosis of PRL is poorer than nodal lymphoma. There is an urgent need for a more effective strategy with higher blood-brain barrier permeability.