Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
BMJ Case Rep. 2024 Apr 2;17(4):e259137. doi: 10.1136/bcr-2023-259137.
A male patient in his 60s was admitted to our hospital with symptoms of dyspnoea, asthenia, diaphoresis and acute kidney failure. No tumour or infection was detected in initial screening. However, laboratory examination suggested that the acute kidney failure was due to an intrarenal cause, exhibiting a tubular injury pattern and indications of tumour lysis syndrome. Initial hydration therapy, paired with intravenous rasburicase, rapidly improved the kidney function. Unfortunately, the kidney function deteriorated once again, prompting a kidney biopsy that revealed an aggressive diffuse large B-cell non-Hodgkin lymphoma of the kidney. The chemotherapy, comprised of R-CHOP scheme, led to a full recovery of the kidney function and complete remission of the lymphoma. Primary renal non-Hodgkin lymphoma without nodal manifestation is rare, and its pathophysiology is poorly understood. Therapy schemes can vary significantly between cases, relying primarily on non-renal-specific haemato-oncological guidelines. Therefore, further studies are needed to develop the best therapeutic approaches.
一位 60 多岁的男性患者因呼吸困难、乏力、出汗和急性肾衰竭而入院。初步筛查未发现肿瘤或感染。然而，实验室检查提示急性肾衰竭是由肾内原因引起的，表现为肾小管损伤模式和肿瘤溶解综合征的迹象。最初的水化治疗，加上静脉注射拉布立酶，迅速改善了肾功能。不幸的是，肾功能再次恶化，促使进行肾活检，结果显示为侵袭性弥漫性大 B 细胞非霍奇金淋巴瘤。包含 R-CHOP 方案的化疗使肾功能完全恢复，淋巴瘤完全缓解。无淋巴结表现的原发性肾脏非霍奇金淋巴瘤很少见，其病理生理学尚不清楚。治疗方案在不同病例之间可能有很大差异，主要依赖于非肾脏特异性血液肿瘤学指南。因此，需要进一步研究以制定最佳治疗方法。
