Effective management of a rare case of primary renal intravascular large B-cell lymphoma with modified R-CHOP regimen: A case report

Intravascular large B-cell lymphoma, known for its diverse organ involvement, presents significant diagnostic challenges, particularly when it affects the kidneys. This report highlights a rare case of primary renal intravascular large B-cell lymphoma in a 60-year-old male patient, who presented with persistent fever and renal dysfunction. The case underscores the intricacy of diagnosis and the efficacy of personalized treatment. Following the identification of primary renal intravascular large B-cell lymphoma, a modified R-CHOP regimen was administered, resulting in notable amelioration of symptoms and renal function following the initial treatment cycle. The patient achieved sustained complete remission without any complications after completing five subsequent R-CHOP cycles and two additional cycles of rituximab monotherapy, as confirmed by recent assessments. He is currently under regular follow-up for ongoing monitoring and improvement. This case adds to the limited yet expanding pool of knowledge concerning intravascular large B-cell lymphoma, emphasizing the necessity for personalized therapeutic strategies in atypical presentations. It also highlights the importance of early detection and customized intervention in managing rare lymphoma subtypes with unique organ involvement.

A rare primary renal lymphoma with liver infiltration: A case report and literature review

Primary extra-nodal of Non-Hodgkin Lymphomas (NHL) are rare, and one of the very rare primary loci is renal, namely Primary renal lymphoma (PRL), which is about 0,1-0,7%, and the mortality rate reaches as high as 75%. Here, the author shares a 58-year-old man with an imaging test indicating a mass from the upper pole of the right renal with a sixth segment of the liver infiltration. The patient underwent multidisciplinary embolization and nephrectomy. Histopathologic show the anaplastic lymphoid cells in the kidney and the hepar and lead to chemotherapy with a CHOP regimen for six cycles.

Comprehensive treatment for primary right renal diffuse large B-cell lymphoma with a renal vein tumor thrombus: A case report

BACKGROUND

Renal involvement in lymphoma is commonly associated with widespread nodal or extranodal lymphoma. Primary renal diffuse large B-cell lymphoma is an extremely rare extranodal lymphoma, accounting for fewer than 1% of all renal masses. Interestingly, the patient in this study had a renal vein tumor thrombus that was observed after laparoscopic radical nephrectomy.

CASE SUMMARY

We report the case of a 56-year-old female patient with primary renal lymphoma and a renal vein tumor thrombus whose first symptom was right pain in the back and gross hematuria. Histopathology revealed primary renal diffuse large B-cell lymphoma. The patient received 8 standard cycles of rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy after surgery, and no obvious signs of recurrence were observed during the one-year follow-up.

CONCLUSION

We evaluated comprehensive treatment of primary renal diffuse large B-cell lymphoma and multidisciplinary management of this malignancy.

A rare case of bilateral primary renal Burkitt lymphoma presenting with acute renal failure

Acute renal failure due to primary renal Burkitt lymphoma in children is extremely rare. We report a case with acute secondary renal failure in a 4-year-old boy who presented with abdominal pain, anorexia, and vomiting. Abdominal computed tomography scans showed bilateral nephromegaly with multiple hypoenhancing regions. Renal biopsy confirmed Burkitt lymphoma. There was no lymphadenopathy or evidence of other solid organ involvement. The patient was responsive to treatment using the EPOCH-R protocol (etoposide, prednisone, vincristine, cyclophosphamide , doxorubicin, and rituximab). Here, we describe the clinical and imaging features associated with this rare entity.

Primary non-Hodgkin lymphoma of kidney and ureter mimicking an upper tract urothelial carcinoma: A case report

Primary renal lymphoma (PRL) is a rare event, while ureteric involvement by the lymphoma mimicking an UTUC is even rarer. A 30-year-old woman diagnosed for a 6-month history of right flank pain with presumed the UTUC of the right kidney. She underwent radical nephroureterectomy with bladder cuff excision, which reveals the infiltrating papillary mass of the ureter from the proximal region towards the ureterovesical junction. Kidney mass was found mostly solid in the parenchymal region, renal hilus was found adherent towards the wall of the inferior vena cava in which it reveals a similar pathology result of Non-Hodgkin's lymphoma.

[Primary renal lymphoma: a clinical analysis of 5 cases]

Objective: To improve the clinical diagnosis and treatment of primary renal lymphoma. Methods: Clinical data of 5 cases ( 2 male cases and 3 female cases) with primary renal lymphoma was reviewed. The age of patients was 55 to 70 years old, with a mean age of 62 years. No history of glomerulonephritis or nephropathy was recorded. All the cases were unilateral, including 3 cases in the left side and 2 cases in right. The major clinical manifestations were as follows: 2 cases of left lumbar pain, 1 case of gross hematuria, 1 case of hematuria under microscope, and 1 case receiving adjuvant chemotherapy after 12 years. The physical examination was as follows: the superficial lymph nodes of 5 cases were not enlarged; the liver, spleen and abdominal mass were not palpable; 2 cases had left upper quadrant tenderness ( with no rebound pain) and left kidney percussion pain. B-ultrasound, CT or MRI examination were performed before the operation, and renal malignant neoplasm was considered. No abnormality was found in bone marrow aspiration after operation. Four cases underwent radical nephrectomy and 1 case accepted partial nephrectomy. Four cases were administered with six cycles of R-CHOP (cyclophosphamide, pirarubicin, vincristine and prednisone) associated with rituximab, and 1 case was given six cycles of CHOP. Results: Five cases were diagnosed as non-Hodgkin's lymphoma, with 4 cases of diffuse large B-cell lymphoma of the kidney and 1 case of marginal zone B-cell non-Hodgkin lymphoma of mucosa-associated lymphoid tissue. The maximum diameter of the tumor was 3.5 to 10 cm, with the median diameter of 6.5 cm. The tumor was grey and white on the cutting surface, and the texture was fine. Under the microscope, the tumor cells were diffusely infiltrating, oval or polygonal, slightly larger than normal lymphocytes, with large irregular hyperchromatic nuclei. Four cases were followed up for 6 months to 2 years, with an average of 16 months. Chest X - ray and abdominal B-ultrasound were performed every 3 months, and abdominal CT or MRI scan was performed every 6 months. One case lost follow-up after 3 months. Except the case, the rest three are all alive. Conclusions: Primary renal lymphoma is rare. Most of the cases reported showed rapid systemic progression and a poor prognosis. There were no distinct characteristics in B-ultrasound and CT examination. Pathological examination is the key to its diagnosis. The surgical treatment combined with systemic chemotherapy can prolong survival of patients.

Rapidly progressive renal failure in a patient with extranodal non-Hodgkin's lymphoma

A 60-year male was admitted with advanced renal failure and bilaterally enlarged kidneys. Kidney biopsy revealed diffuse interstitial infiltration by CD20 + lymphomatous cells suggestive of diffuse large B-cell, non-Hodgkin's lymphoma. Bone marrow examination was negative for malignant cells. Positron emission tomography-computed tomography showed uniformly diffuse and avid flurodeoxy glucose uptake in both kidneys, multiple hypodense areas of both lobes of liver, and axial and appendicular skeleton. Patient was treated with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine and prednisolone, became afebrile and serum creatinine normalized.

Bilateral primary renal lymphoma in a pediatric patient: staging and response evaluation with ¹⁸F-FDG PET/CT

Primary renal lymphoma (PRL) is a rare disease. We here present the case of an 8-year-old child who presented with bilateral renal masses. On biopsy, it was confirmed to be B-cell non-Hodgkin's lymphoma. (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET/CT) for staging demonstrated (18)F-FDG avid bilateral renal masses, with no other abnormal focus. Follow up (18)F-FDG PET/CT showed complete resolution of the disease after six cycles of chemotherapy. Here we have highlighted the potential role of (18)F-FDG PET/CT in staging and response evaluation of a patient with PRL and presented a brief review.

Primary renal lymphoma mimicking a subcapsular hematoma: a case report

Primary renal lymphoma (PRL) is a rare entity with a history of controversy regarding its existence. Lymphomatous involvement of the kidney is more commonly seen secondarily to spread from an adjacent lymphomatous mass, rather than arising primarily from the kidney. PRL can mimic other renal lesions such as renal cell carcinoma, renal abscess, and metastasis; therefore, an early diagnosis is crucial to guide treatment and properly assess prognosis. We present a rare case of a 77 year-old male who presented with hematuria and PRL mimicking a subcapsular hematoma.