Primary renal lymphoma mimicking renal cell carcinoma

Abstract

Primary renal lymphoma is very rare. Lymphomatous involvement of the kidney is often seen as a part of disseminated disease. The prognosis is usually poor with median survival less than a year. It is essential to differentiate between renal cell carcinoma and renal lymphoma in patients presenting with solitary renal masses. We present a 52-year-old lady who presented with a solitary renal mass and was diagnosed to have primary lymphoma of the kidney and discuss briefly about primary renal lymphoma.

Primary Lymphoma of the Kidney: Case Report and Review of Literature

“…It has been suggested that the lymphoma may originate from the renal sinus lymphatics or lymph vessels located near the renal capsule and form cords that enter into renal parenchyma, or follow chronic inflammation (such as chronic pyelonephritis, Sjogren's Syndrome, Systemic Lupus Erythematosus, Epstein Barr Virus of mononucleosis). 6 Many of the documented cases of renal lymphoma are secondary, and postmortem studies have found that approximately 50% of patients who died of NHL had renal involvement. PRL most commonly affects older male subjects, those older than 60 years (mean age at diagnosis, 64 years), frequently unilateral, rarely bilateral.…”

“…Survival is extremely low, approximately 75% of patients die within the first year after surgery. 6 The final prognosis can be improved by early diagnosis and systemic chemotherapy. There are several options for the diagnostic evaluation of a possible involvement of the kidney, including renal ultrasonography, intravenous urography, CT, magnetic resonance imaging, and nuclear medicine.…”

“…The total nephrectomy is not indicated, especially if it was possible to make a preoperative diagnosis. 6 Patients with atypical findings suspected for renal cell carcinoma should undergo a percutaneous renal biopsy, which has a sensitivity and a specificity of 70% -92% and 100%, respectively. 5,6 Although renal lymphoma is often part of a generalized process, our case appears to be limited to the kidney, so-called stage IE diffuse large B-cell lymphoma.…”

“…6 Patients with atypical findings suspected for renal cell carcinoma should undergo a percutaneous renal biopsy, which has a sensitivity and a specificity of 70% -92% and 100%, respectively. 5,6 Although renal lymphoma is often part of a generalized process, our case appears to be limited to the kidney, so-called stage IE diffuse large B-cell lymphoma. This early-stage aggressive lymphoma, may be highly curable with CHOP (cyclophosphamide, doxorubicin, vincristine [Oncovin], and prednisone] plus rituximab, based on the revised International Prognostic Index of Sehn et al, 9 but only 41%-53% of patients with advanced disease are alive and disease free at a median follow-up of 3 years, especially when there is an overexpression of Bcl 2.…”

Teenager with a Primary Renal Lymphoma: A Case Report

“…This condition has been doubted along the years due to the fact that the kidney lacks lymphoid tissue; nevertheless, there has been certain case reports around the world with different clinical manifestations that support its existence [2]. It has been said that lymphomagenesis could originate from hematogenous route from subcapsular lymphatics, or by direct extension from retroperitoneal cavity, sometimes associated with chronic inflammatory diseases that could result in these types of lymphoma [3].…”