Morinaga Shingo, Aoki Shigeyuki, Tobiume Motoi, Nishikawa Genya, Higuchi Fusako, Ikenohata Yuusuke, Honda Manabu, Kubo Hiroe, Sawada Tomoko, Yamada Yoshiaki
Department of Urology Japan Community Health Care Organization Kani Tono Hospital Kani Gifu Japan.
Department of Urology Japan Organization of Occupational Health and Safety Asahi Rosai Hospital Owariasahi Aichi Japan.
IJU Case Rep. 2025 Apr 9;8(3):271-275. doi: 10.1002/iju5.70022. eCollection 2025 May.
Waldenström macroglobulinemia is a low-grade B-cell lymphoma characterized by lymphoplasmacytic lymphoma infiltration of the bone marrow and immunoglobulin M (IgM) protein.
An 80s-year-old male presented to our hospital with chief complaints of weight loss and general fatigue. Computed tomography (CT) showed homogeneous tumor around the kidney with elevated soluble Interleukin-2 receptor, serum IgM, and β2-microglobulin levels. Histopathological analysis by ultrasonography-guided biopsy revealed dense lymphocytic proliferation, plasmacytoid differentiation, and Dutcher bodies, positive for CD20, CD138, and IgM, but negative for CD3 and CD5, consistent with lymphoplasmacytic lymphoma. Bone marrow biopsy revealed infiltration of the lymphoplasmacytic lymphoma. The patient received four courses of bortezomib, cyclophosphamide, and dexamethasone along with dexamethasone, rituximab, and cyclophosphamide therapy. Twelve months after treatment, CT revealed only slightly enlarged abdominal para-aortic lymph nodes.
Malignant lymphoma in perinephric lesions is a relatively rare condition; however, a definitive diagnosis can be obtained by ultrasound-guided biopsy, allowing early initiation.
华氏巨球蛋白血症是一种低度B细胞淋巴瘤，其特征为骨髓中淋巴细胞浆细胞性淋巴瘤浸润以及免疫球蛋白M（IgM）蛋白。
一名80多岁男性因体重减轻和全身乏力为主诉前来我院就诊。计算机断层扫描（CT）显示肾脏周围有均匀的肿瘤，可溶性白细胞介素-2受体、血清IgM和β2-微球蛋白水平升高。超声引导下活检的组织病理学分析显示有密集的淋巴细胞增殖、浆细胞样分化和Dutcher小体，CD20、CD138和IgM呈阳性，但CD3和CD5呈阴性，符合淋巴细胞浆细胞性淋巴瘤。骨髓活检显示淋巴细胞浆细胞性淋巴瘤浸润。该患者接受了四个疗程的硼替佐米、环磷酰胺和地塞米松治疗，同时接受了地塞米松、利妥昔单抗和环磷酰胺治疗。治疗12个月后，CT显示仅腹主动脉旁淋巴结轻度肿大。
肾周病变中的恶性淋巴瘤是一种相对罕见的疾病；然而，通过超声引导下活检可以获得明确诊断，从而能够早期开始治疗。
