Renal failure due to lymphomatous infiltration of the kidneys report of three new cases and review of the literature

Abstract

Three new cases of renal failure due to lymphomatous infiltration of the kidneys are described and the clinical features of 14 similar patients in the literature are reviewed. The diagnosis of renal failure secondary to lymphomatous infiltration was made by ruling out other causes of renal failure and demonstrating prompt improvement in renal function after systemic chemotherapy or local irradiation of one or both kidneys. Histiocytic lymphoma was the most common underlying disease. In the setting of diffuse lymphoma with other causes of renal failure reasonably excluded, radiographic demonstration of enlarged kidneys without obstruction suggests the need for intensive combination chemotherapy in most cases.

Clinical characteristics and outcome of dogs with presumed primary renal lymphoma

“…While data reassessing renal values were not available for all, five of 11 dogs had improved or resolved azotaemia. Similarly, improvement in serum creatinine values is associated with longer survival in human primary renal lymphoma (Glicklich et al 1986). In addition, one dog demonstrated improved clinical signs while ultrasound abnormalities remained unchanged.…”

“…However, the AKI grading system, as determined by a single measurement, reflects a moment in the disease course. In addition, the mechanism of renal failure in human primary renal lymphoma is thought to be neoplastic infiltration and compression of the tubular lumen resulting in intrarenal obstruction, leading to tubular atrophy and necrosis (Glicklich et al 1986). The canine necropsies demonstrated these lesions microscopically.…”

The Spectrum of Kidney Involvement in Lymphoma: A Case Report and Review of the Literature

“…Absence of clinical signs gives explanation for the under-diagnosis: kidney failure was present in only 0.5% of patients with LIK, and most lacked flank pain or features of volume overload. Other signs suggesting LIK include bilateral kidney enlargement and sub-nephrotic range proteinuria 3, 4 . Biopsy typically shows diffuse infiltration of monomorphic lymphocytes and resultant tubule compression 3, 5 .…”

Kidney involvement and renal manifestations in non‐Hodgkin's lymphoma and lymphocytic leukemia: a retrospective study in 700 patients

“…Specific involvement is the most common cause of renal failure in these cases (8, 16, 18). The existence of this primary disorder has been seriously questioned (2, 8–10, 13) but it is generally agreed that the criteria for PRL should include (1): renal failure as the initial presentation; (2) enlargement of the kidneys without obstruction and other organ or nodal involvement; (3) absence of other causes of renal failure; (4) diagnosis made by renal biopsy and (5) rapid improvement of renal function after therapy (1, 6, 8, 16).…”

“…Cryoglobulinemia, amyloid formation, nephrosis or nephritis may also be encountered. Therapy‐related causes of renal failure include radiation nephritis and tumor lysis syndrome, while therapeutic agents or antibiotics may also cause renal damage (2–12). In this retrospective study we report the incidence of renal failure in 700 chronic lymphocytic leukemia (CLL) and LY patients, and also discuss primary renal lymphoma and report the incidence and associated renal syndromes in these patients.…”