Lerma-Verdejo Ana, Monroy-Condori Maribel, Guerra-Torres Xavier E, Paredes Nahir Daniela Moreno, Egea Anastasio Serrano, Díaz Francisco, Morales-Montoya Jorge L, Vega Jacobo Galán, Arenas-Moncaleano Iván, Ramos Fernando Solano
Department of Hematology and Hemotherapy, Hospital General Universitario Nuestra Señora del Prado, Talavera de La Reina, Spain.
Department of Nephrology, Hospital General Universitario Nuestra Señora del Prado, Talavera de La Reina, Spain.
J Hematop. 2024 Dec;17(4):237-244. doi: 10.1007/s12308-024-00596-5. Epub 2024 Jul 20.
Mantle cell lymphoma (MCL) is a rare and aggressive type of lymphoma that can affect the kidneys. The disease can lead to kidney impairment, and glomerulonephritis (GN) is a rare but serious complication of MCL. We report a case of MCL with kidney interstitial infiltration and membranoproliferative glomerulonephritis with focal and segmental glomerulosclerosis. A 75-year-old man presented recurrent acute kidney failure and worsening of nephrotic syndrome. Kidney biopsy revealed membranoproliferative glomerulonephritis presented immunoglobulin and complement deposition, focal and segmental glomerulosclerosis of not otherwise specified type, and infiltration by mantle cell lymphoma. Bone marrow biopsy and PET/CT scan confirmed the diagnosis of mantle cell lymphoma. The patient was treated with R-CHOP21 chemotherapy with cyclophosphamide dose adjustment for nephroprotection. He achieved complete remission with normalization of hematological parameters, improvement of kidney function, and reduction of proteinuria and albuminuria. This case shows the importance of considering alternative diagnoses in patients with recurrent chronic kidney disease and worsening nephrotic syndrome. Early diagnosis and treatment of mantle cell lymphoma can lead to favorable outcomes.
套细胞淋巴瘤（MCL）是一种罕见且侵袭性的淋巴瘤类型，可累及肾脏。该疾病可导致肾功能损害，而肾小球肾炎（GN）是MCL一种罕见但严重的并发症。我们报告一例伴有肾间质浸润及膜增生性肾小球肾炎合并局灶节段性肾小球硬化的MCL病例。一名75岁男性出现反复急性肾衰竭及肾病综合征加重。肾活检显示膜增生性肾小球肾炎伴有免疫球蛋白和补体沉积、未另行特指类型的局灶节段性肾小球硬化以及套细胞淋巴瘤浸润。骨髓活检及PET/CT扫描确诊为套细胞淋巴瘤。该患者接受了R-CHOP21化疗，并调整环磷酰胺剂量以保护肾脏。他实现了完全缓解，血液学参数恢复正常，肾功能改善，蛋白尿和白蛋白尿减少。该病例显示了对于反复出现慢性肾脏病及肾病综合征加重的患者考虑其他诊断的重要性。套细胞淋巴瘤的早期诊断和治疗可带来良好预后。
