Secondary amyloidosis causing nephrotic syndrome in a patient with non-Hodgkin's lymphoma: quite a rare diagnosis

Abstract

Secondary amyloidosis is usually a complication of chronic inflammation. Amyloidosis cases during the course of non-Hodgkin's lymphoma (NHL) are usually of AL-type, only one NHL patient with secondary amyloidosis has been reported. Our 79-year-old male patient visited us with multiple lymphadenopathies, and he was diagnosed with nodal marginal zone B-cell lymphoma. After four cycles of combined chemotherapy; his urea, creatinine levels started to increase and he developed nephrotic-range proteinuria. His rectal biopsy demonstrated amyloid deposition in submucosal vessel walls. The patient has been under hemodialysis for 10 months and his lymphoma is still in partial remission. We presented this case because it is the second NHL patient who developed secondary amyloidosis during his disease course.

Paediatric T cell Lymphoma with Nephrotic Syndrome: A Rare Association

“…In some cases nephrosis is caused by invasion of the kidney by neoplastic cells [7], renal amyloidosis [8] or renal vein thrombosis. Amyloidosis cases during the course of NHL are usually of AL-type [8].…”

“…In some cases nephrosis is caused by invasion of the kidney by neoplastic cells [7], renal amyloidosis [8] or renal vein thrombosis. Amyloidosis cases during the course of NHL are usually of AL-type [8]. Neoplastic infiltration has been documented in about one-third of all lymphoma patients who underwent a post-mortem autopsy without signs of prior ARF during their lifetime [3].…”

AA-type amyloidosis in association with non-Hodgkin's lymphoma following CMV viremia: Autopsy case

“…AA amyloidosis associated with NHL is extremely rare, and only four such cases have been reported thus far (Table 1). Two cases were associated with diffuse large B‐cell lymphoma (DLBCL), 1,2 one case with focal DLBCL that progressed from follicular small cleaved cell lymphoma, 3 and the other one with nodal marginal zone B‐cell lymphoma 4 . In the case reported by Piskin et al.…”

“…Two cases were associated with diffuse large B-cell lymphoma (DLBCL), 1,2 one case with focal DLBCL that progressed from follicular small cleaved cell lymphoma, 3 and the other one with nodal marginal zone B-cell lymphoma. 4 In the case reported by Piskin et al chemotherapy was performed to achieve remission of lymphoma with resolution of the amyloidosis. 2 The established concept of 'amyloid enhancing factor' should be considered to explain the mechanism of AA amyloidosis in the present case.…”

“…Two cases were associated with diffuse large B‐cell lymphoma (DLBCL), 1,2 one case with focal DLBCL that progressed from follicular small cleaved cell lymphoma, 3 and the other one with nodal marginal zone B‐cell lymphoma (Table 1). 4 One localized AA‐type amyloid tumor in DLBCL has also been reported 5 …”