Patterns of glomerular injury in kidneys infiltrated by lymphoplasmacytic neoplasms

Fludarabine in Chronic Lymphocytic Leukemia with Membranous Nephropathy

“…A series of immunohistochemical stains should be performed to establish (a) the lineage of cell type, (b) clonality, and (c) specific gene rearrangement. 2 In our patient, extensive lymphocyte perivascular infiltration was present; immunohistochemistry on renal biopsy specimen showed that infiltrating lymphocytes were CD20þ. Moreover, DNA from tissue fractions was analyzed by qualitative PCR-based detection of clonal gene rearrangements of the immunoglobulin heavy chain gene, confirming the monoclonality of the infiltrating lymphocytes.…”

“…Mechanisms proposed to explain the renal pathologic findings include, but are not limited to, autoimmunity due to T-cell dysregulation, hyperglobulinemia, cytokine-induced altered glomerular permeability, Vascular Endothelial Growth Factor (VEGF) and Transforming Growth Factor (TGF) β 1-induced glomerulosclerosis, dysproteinemia with or without cryoglobulinemia, followed by immune complex formation and subsequent immune complex deposition in glomeruli, viral infections, toxins, and others. 2 The demonstration of immunoglobulins and complement in paraneoplastic glomerular lesions, even in the absence of monoclonal component and complement consumption, suggests that the deregulation of humoral and cellular immunity that characterizes CLL contributes to MN. The production of autoantibodies that recognize renal epithelial cell structure as well as altered glomerular permeability caused by cytokines produced by T-cells are postulated to participate in the genesis of MN.…”

“…In some autopsy series, the prevalence of renal involvement was found in up to 90% of patients. 2 Despite the relative frequency of this type of leukemia, the association of glomerular disease is extremely rare. In 1957, Scott first reported the association of the nephrotic syndrome (NS) with CLL.…”

“…4 To date, only 12 cases of MN complicating CLL have been reported in literature. 2,[4][5][6][7][8][9][10][11][12][13] We present another case of MN during CLL treated with fludarabine.…”

Clinical, laboratory, and morphological characteristics of kidney damage in lymphoproliferative disorders

“…При неходжкинских лимфомах (НХЛ) пораже-ние почек обнаруживается в основном при прогрес-сировании или рецидиве заболевания [4]. Наиболее часто вовлечение почек определяется при хрониче-ском лимфолейкозе (ХЛЛ) / мелкоклеточной лимфо-цитарной лимфоме (МЛЛ) (40 %), несколько реже -при диффузной В-крупноклеточной лимфоме (ДВККЛ) и NK / T-клеточной лимфоме (20 %) [5]. По данным J.…”