Internal Medecine Department, Charles Nicolle Hospital, Bab Saadoun, Tunis, Tunisia.
Internal Medecine Department, Charles Nicolle Hospital, Bab Saadoun, Tunis, Tunisia
BMJ Case Rep. 2021 Feb 5;14(2):e238153. doi: 10.1136/bcr-2020-238153.
Renal involvement in mantle cell lymphoma (MCL) is rare. We present the case of a man followed for MCL presented with acute kidney injury and positive antineutrophil cytoplasmic antibody (ANCA) type anti proteinase 3 (PR3). He was treated as for a rapidly progressing glomerulonephritis with cyclophosphamide and methylprednisolone followed by oral prednisone. Renal biopsy revealed diffuse endocapillary proliferation and segmental extracapillary proliferation in four glomeruli. Immunohistochemistry confirmed the renal invasion of lymphomatous cells. He started improving his renal function shortly after starting treatment. The coexistence of renal MCL infiltration, extracapillary proliferation and ANCA positive is exceptional.
Mantle 细胞淋巴瘤（MCL）很少累及肾脏。我们报告 1 例 MCL 患者，表现为急性肾损伤和抗中性粒细胞胞浆抗体（ANCA）型抗蛋白酶 3（PR3）阳性。患者被诊断为快速进展性肾小球肾炎，接受环磷酰胺和甲基强的松龙治疗，随后口服泼尼松。肾活检显示 4 个肾小球均有弥漫性毛细血管内增生和节段性毛细血管外增生。免疫组化证实了淋巴瘤细胞对肾脏的侵犯。开始治疗后不久，患者的肾功能开始改善。肾脏 MCL 浸润、毛细血管外增生和 ANCA 阳性同时存在的情况非常罕见。
