Zahner J, Gerharz C D, Bach D, Heer-Sonderhoff A, Winkelmann M, Grabensee B, Schneider W
Division of Hematology/Oncology, Heinrich-Heine University, Dusseldorf, Germany.
Am J Hematol. 1996 Oct;53(2):126-32. doi: 10.1002/(SICI)1096-8652(199610)53:2<126::AID-AJH12>3.0.CO;2-D.
A 27-year-old male developed nonoliguric renal failure. Renal biopsy of the left kidney showed infiltration by a diffuse large-cell non-Hodgkin's lymphoma (NHL). Laparoscopy, CT scans of the abdomen and thorax, and bone-marrow biopsy revealed no further manifestations of lymphoma. Primary renal NHL was diagnosed. The patient attained complete remission with cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP) chemotherapy and remained disease-free for 13 years. Eight years after his first presentation, the patient developed acute oliguric renal failure with nephrotic syndrome. Mesangioproliferative glomerulonephritis was diagnosed in a biopsy of the left kidney. Chronic hemodialysis was required until cadaver kidney transplantation was successfully performed 5 years later. Although the association of NHL and glomerulonephritis has been described several times before, to our knowledge this is the first report of glomerulonephritis in primary renal lymphoma.
一名27岁男性出现非少尿型肾衰竭。左肾肾活检显示弥漫性大细胞非霍奇金淋巴瘤(NHL)浸润。腹腔镜检查、腹部和胸部CT扫描以及骨髓活检均未发现淋巴瘤的进一步表现。诊断为原发性肾NHL。该患者接受环磷酰胺、阿霉素、长春新碱和泼尼松(CHOP)化疗后达到完全缓解,并保持无病状态13年。首次就诊8年后,该患者出现急性少尿型肾衰竭并伴有肾病综合征。左肾活检诊断为系膜增生性肾小球肾炎。在5年后成功进行尸体肾移植之前,需要进行慢性血液透析。尽管之前已经多次描述过NHL与肾小球肾炎的关联,但据我们所知,这是原发性肾淋巴瘤合并肾小球肾炎的首例报告。