Ohsawa M, Hashimoto M, Yasunaga Y, Shingu N, Aozasa K
Department of Pathology, Osaka University Medical School, Osaka, Japan.
Oncology. 1998 Sep-Oct;55(5):482-6. doi: 10.1159/000011899.
Previous epidemiological studies showed an increased risk for the development of renal cell carcinoma (RCC) after adjuvant therapy or simultaneous discovery of non-Hodgkin's lymphoma (NHL). However, clinicopathological features of NHL complicated by RCC are not well known. We summarized the clinicopathological features of 42 cases with malignant lymphoma complicated by renal tumors collected in a nationwide study in Japan. There were 27 males and 15 females, and the age at initial diagnosis of NHL ranged from 51 to 85 years (median 69 years). The clinical stages of NHL were stage I in 13 patients, stage II in 8, stage III in 8 and stage IV in 13 patients. RCC was simultaneously detected in 4 patients, within 1 year after the diagnosis of NHL in 20 and after more than 1 year in 13 patients. In the remaining 3 patients, NHL was diagnosed 1 year (2 cases) or 6 years (1 case) after nephrectomy. Histologically, all but 2 cases of NHL were diagnosed as diffuse lymphoma, with the large-cell type being the most common. The remaining 2 cases were follicular lymphoma. NHL in 35 cases (85%) were immunophenotyped as B cell type and 4 (10%) as T cell type. Renal tumors in all but 2 cases were classified as RCC: clear-cell type in 29, chromophobic type in 3, chromophilic type in 7 and Bellini duct carcinoma in 1 case. All RCC showed a cellular malignancy of grade II or III. When compared to sporadic autopsy cases of NHL in Japan, the frequency of extranodal lymphoma and B cell type was higher in the current cases (p = 0.06). In addition, leiomyosarcoma occasionally occurred among complicated renal tumors.
以往的流行病学研究表明，辅助治疗后或同时发现非霍奇金淋巴瘤（NHL）后，发生肾细胞癌（RCC）的风险增加。然而，NHL合并RCC的临床病理特征尚不清楚。我们总结了在日本全国性研究中收集的42例恶性淋巴瘤合并肾肿瘤患者的临床病理特征。其中男性27例，女性15例，NHL初诊年龄为51至85岁（中位年龄69岁）。NHL的临床分期为：Ⅰ期13例，Ⅱ期8例，Ⅲ期8例，Ⅳ期13例。4例患者同时检测到RCC，20例在NHL诊断后1年内，13例在诊断后1年以上。其余3例患者在肾切除术后1年（2例）或6年（1例）被诊断为NHL。组织学上，除2例NHL外，其余均诊断为弥漫性淋巴瘤，其中大细胞型最为常见。其余2例为滤泡性淋巴瘤。35例（85%）NHL免疫表型为B细胞型，4例（10%）为T细胞型。除2例患者外，所有肾肿瘤均归类为RCC：透明细胞型29例，嫌色细胞型3例，嗜色细胞型7例，Bellini管癌1例。所有RCC均显示Ⅱ级或Ⅲ级细胞恶性程度。与日本NHL的散发性尸检病例相比，当前病例中外周性淋巴瘤和B细胞型的发生率更高（p = 0.06）。此外，平滑肌肉瘤偶尔发生于合并的肾肿瘤中。
