Non-Hodgkin's lymphoma presenting with lower extremity edema and radiculopathy in a post-kidney transplant patient: A case report.

RATIONALE

Non-Hodgkin lymphoma (NHL) can present with vague and nonspecific symptoms, making early diagnosis challenging, especially in immunocompromised patients. Kidney transplant recipients, due to long-term immunosuppressive therapy, have an increased risk of developing malignancies, including NHL.

PATIENT CONCERNS

A post-kidney transplantation patient presented with lower extremity symptoms. Initial lumbar spine magnetic resonance imaging suggested foraminal stenosis and disc herniation. However, persistent symptoms and lack of clinical improvement prompted further investigation. A contrast-enhanced computed tomography revealed a retroperitoneal mass compressing the iliac vessels. Biopsy confirmed diffuse large B-cell lymphoma.

DIAGNOSES

Abdominal computed tomography showed multiple hepatic nodules, ascites, and right pleural effusion, consistent with systemic involvement of NHL.

INTERVENTIONS

The patient was treated with R-CHOP chemotherapy, the standard regimen for diffuse large B-cell lymphoma.

OUTCOMES

The patient demonstrated a favorable response to chemotherapy, with symptomatic improvement and a reduction in the retroperitoneal mass size. Continued follow-up emphasized supportive management and oncologic surveillance.

LESSONS

This case highlights the need for a broad differential diagnosis in posttransplant patients with common musculoskeletal complaints. Early consideration of malignancy is crucial to avoid delayed diagnosis and optimize outcomes.