Primary renal non-Hodgkin’s lymphoma: A narrative review of literature

Abstract

Renal involvement by Non-Hodgkin’s lymphoma (NHL) is very rare, and involvement of the kidney as the primary site of NHL (PRNHL) is much more uncommon. Gold standard for the diagnosis of PRNHL is histology and imaging modalities although helpful are not specific. Nephrectomy has been mostly recommended for low grade lymphomas, and for high grade PRNHLs, chemotherapy without nephrectomy has been recommended as the treatment of choice. This tumor is aggressive with poor prognosis. This poor prognosis is partly because of delayed diagnosis and partly because of unnecessary surgeries, so it should be kept in mind, especially in bilateral renal tumors with unusual imaging characteristics, to take a tissue biopsy before nephrectomy. In this review, we will discuss all the detailed aspects of clinical, pathologic, and imaging characteristics of 83 cases of PRNHL reported in the last 20 years in the English literature so far. For this purpose, all the published cases of the primary non-Hodgkin’s lymphoma of kidney were reviewed via a search in PubMed, Scopus, and Google Scholar, (1999–2019), using the keywords of “Primary renal lymphoma” and “Non-Hodgkin’s lymphoma and kidney,” “renal Non-Hodgkin’s lymphoma,” “renal lymphoma,” and “lymphoma and kidney.” There were 83 cases in the published English literature which were reviewed for this article. There was some missing information in some cases which has been recorded as “not reported.”

Fibrin-Associated Large B-Cell Lymphoma (FA-LBCL) Involving Solid Organs as Necrotic Cystic Lesions—A Rare Entity with Potential Diagnostic Pitfalls: A Two-Case Series and Review of the Literature

“…A systematic review of 187 primary adrenal lymphomas reported in the English literature till 2013 demonstrated that is a typically symptomatic and aggressive, high grade disease, which primarily affects elderly males and is bilateral in 70% of patients. 17 In the past two decades, a total of 83 patients of primary renal NHL lymphoma, including 17 patients with simultaneous involvement of other sites, were reported in the English literature, 18 the majority being DLBCL (n = 47), two of which were incidental findings. [19][20][21] A retrospective review of the cancer registry in Gundersen Health System from 1995 through 2014 yielded 36 patients with lymphoid neoplasms involving prostate, kidney, bladder, and penis.…”

Primary lymphoma of the kidney

“…Some authors consider nephrectomy as part of the management plan in addition to chemotherapy in unilateral PRL. 1 …”

“…However, PRL is extremely rare and comprises less than 1% of all renal masses and less than 1% of extranodal lymphomas. [1][2][3][4][5][6] Primary renal lymphoma is a distinct clinicopathological entity with highly aggressive behavior, and 50% of the cases also exhibit extrarenal involvement. 6,7 Utilizing the Surveillance, Epidemiology, and End Result )SEER( database, Taneja et al 2 and Chen et al 4 showed that diffuse large B-cell lymphoma )DLBCL( is the most common histopathological subtype.…”

“…Some authors consider nephrectomy as part of the management plan in addition to chemotherapy in unilateral PRL. 1 Primary renal lymphoma must be differentiated from renal cell carcinoma. Standard treatment of renal masses is nephrectomy, but PRL differs in that it is usually managed with chemotherapy followed by nephrectomy.…”

Pediatric primary renal lymphoma presenting with multiple masses: A challenging case report and narrative review

“…Primary renal lymphoma (PRL), one type of NHL, restricting to kidney without other organ infiltration, is extremely rare in children. [ 2 ] Given the rarity and greatly overlapped presentations with other malignant renal lesions, pediatric PRL may be easily misdiagnosed. [ 3 ] As per literature review, most of the time they were diagnosed post-surgical resection for other clinically diagnosed malignancies.…”