Chi Po-Jui, Pei Sung-Nan, Huang Tung-Liang, Huang Shun-Chen, Ng Hwee Yeong, Lee Chien-Te
Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan.
Division of Hematology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan.
J Formos Med Assoc. 2014 Apr;113(4):255-7. doi: 10.1016/j.jfma.2011.02.007. Epub 2012 Mar 10.
Mucosa associated lymphoid tissue lymphoma (MALT lymphoma) is mostly seen in the gastrointestinal tract; origin from the kidney is extremely rare. Waldenström macroglobulinemia (WM) is a clinicopathologic syndrome denoted by the presence of monoclonal gammopathy in the serum, typically caused by lymphoproliferative disorder. Literature review did not find any report of renal MALT lymphoma accompanied by WM. Herein, for the first time, we report a 72 year-old female patient with a history of chronic kidney disease, presenting with solitary renal mass; MALT lymphoma was confirmed by pathological examination. A serology study identified the presence of WM. No manifestation of hyperviscosity syndrome was noted. Bone marrow biopsy disclosed the concurrent systemic involvement. Her treatment response was uneventful and the renal mass responded with regressive change in size after chemotherapy. The renal function remained stable during follow-up. MALT lymphoma should be considered as an underlying pathology of isolated renal mass. Furthermore, patients with MALT lymphoma should be screened for Waldenström macroglobulinemia and hyperviscosity syndrome.
黏膜相关淋巴组织淋巴瘤(MALT淋巴瘤)多见于胃肠道;起源于肾脏极为罕见。华氏巨球蛋白血症(WM)是一种临床病理综合征,其特征为血清中存在单克隆丙种球蛋白病,通常由淋巴增殖性疾病引起。文献回顾未发现肾MALT淋巴瘤合并WM的任何报道。在此,我们首次报告一例72岁女性患者,有慢性肾脏病病史,表现为孤立性肾肿块;病理检查确诊为MALT淋巴瘤。血清学研究发现存在WM。未发现高黏滞综合征表现。骨髓活检显示有全身并发受累。她的治疗反应平稳,化疗后肾肿块大小出现退缩性变化。随访期间肾功能保持稳定。MALT淋巴瘤应被视为孤立性肾肿块的潜在病理。此外,MALT淋巴瘤患者应筛查华氏巨球蛋白血症和高黏滞综合征。