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Membranoproliferative glomerulonephritis, mantle cell lymphoma infiltration, and acute kidney injury.

Lubas A, Mróz A, Smoszna J, Niemczyk S - Int Urol Nephrol (2012)

Bottom Line: Mantle cell lymphoma (MCL) is a rare aggressive lymphoid neoplasm occurring in about 3-7 % of non-Hodgkin lymphomas in the United States and Europe.Although lymphomas infiltrations are recognized in about half of post-mortem studies, in available literature we found only eight cases of mantle cell lymphoma with renal involvement.We present the first case of a patient with the coexistence of renal mantle cell lymphoma infiltration, subacute membranoproliferative glomerulonephritis and acute kidney injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, ul. Szaserów 128, 04-141, Warsaw 44, Poland, alubas@wim.mil.pl.

ABSTRACT
Mantle cell lymphoma (MCL) is a rare aggressive lymphoid neoplasm occurring in about 3-7 % of non-Hodgkin lymphomas in the United States and Europe. Although lymphomas infiltrations are recognized in about half of post-mortem studies, in available literature we found only eight cases of mantle cell lymphoma with renal involvement. Five of them present MCL related glomerulonephritis, two show renal MCL infiltration with acute kidney injury and the last one describes MCL infiltration with acute tubulo-intrerstitial nephritis. We present the first case of a patient with the coexistence of renal mantle cell lymphoma infiltration, subacute membranoproliferative glomerulonephritis and acute kidney injury.

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Mantle cell lymphoma infiltration in renal cortex (HE, a ×100, b ×200)
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Fig1: Mantle cell lymphoma infiltration in renal cortex (HE, a ×100, b ×200)

Mentions: Renal core biopsy submitted for embedding contained 10 glomeruli and cortex parenchyma. On histological examination, several foci of dense lymphocytic infiltration were found. These foci concentrated mainly around glomeruli and consisted of medium-sized slightly atypic lymphocytes with sparse cytoplasm. The nuclei were of similar size and cytological features and stayed in close intimacy with each other without overt molding (Fig. 1). Immunohistochemical studies revealed expression of CD20, CD5 and cyclin D1 markers, while CD3 staining was positive only in non-neoplastic cells (Figs. 2, 3). The Ki-67 staining displayed a low mitotic activity with the expression in about 20 % nuclei (Fig. 4). These morphology and immunoprofile justified the diagnosis of mantle cell lymphoma invading renal parenchyma. In addition, the biopsy showed features of membranoproliferative glomerulonephritis including mesangial proliferation and basal membranes thickening and double contouring (Fig. 5). Segmental, cellular crescents were present in 2 of 10 glomeruli as signs of glomerular sclerosis were present in several glomeruli. A striking feature of Bowman’s capsule thickening mainly in glomeruli encircled by lymphoma infiltrations was clearly visible. Immunofluorescnece staining showed C3 deposits in the subendothelial capillary space. In addition, only sparse mononuclear inflammatory infiltration was present within renal parenchyma as well as slight tubular injury in the form of epithelial cell edema and degeneration. The cervical lymph node biopsy confirmed the diagnosis with the recognition of mantle cell lymphoma.Fig. 1


Membranoproliferative glomerulonephritis, mantle cell lymphoma infiltration, and acute kidney injury.

Lubas A, Mróz A, Smoszna J, Niemczyk S - Int Urol Nephrol (2012)

Mantle cell lymphoma infiltration in renal cortex (HE, a ×100, b ×200)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3824272&req=5

Fig1: Mantle cell lymphoma infiltration in renal cortex (HE, a ×100, b ×200)
Mentions: Renal core biopsy submitted for embedding contained 10 glomeruli and cortex parenchyma. On histological examination, several foci of dense lymphocytic infiltration were found. These foci concentrated mainly around glomeruli and consisted of medium-sized slightly atypic lymphocytes with sparse cytoplasm. The nuclei were of similar size and cytological features and stayed in close intimacy with each other without overt molding (Fig. 1). Immunohistochemical studies revealed expression of CD20, CD5 and cyclin D1 markers, while CD3 staining was positive only in non-neoplastic cells (Figs. 2, 3). The Ki-67 staining displayed a low mitotic activity with the expression in about 20 % nuclei (Fig. 4). These morphology and immunoprofile justified the diagnosis of mantle cell lymphoma invading renal parenchyma. In addition, the biopsy showed features of membranoproliferative glomerulonephritis including mesangial proliferation and basal membranes thickening and double contouring (Fig. 5). Segmental, cellular crescents were present in 2 of 10 glomeruli as signs of glomerular sclerosis were present in several glomeruli. A striking feature of Bowman’s capsule thickening mainly in glomeruli encircled by lymphoma infiltrations was clearly visible. Immunofluorescnece staining showed C3 deposits in the subendothelial capillary space. In addition, only sparse mononuclear inflammatory infiltration was present within renal parenchyma as well as slight tubular injury in the form of epithelial cell edema and degeneration. The cervical lymph node biopsy confirmed the diagnosis with the recognition of mantle cell lymphoma.Fig. 1

Bottom Line: Mantle cell lymphoma (MCL) is a rare aggressive lymphoid neoplasm occurring in about 3-7 % of non-Hodgkin lymphomas in the United States and Europe.Although lymphomas infiltrations are recognized in about half of post-mortem studies, in available literature we found only eight cases of mantle cell lymphoma with renal involvement.We present the first case of a patient with the coexistence of renal mantle cell lymphoma infiltration, subacute membranoproliferative glomerulonephritis and acute kidney injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, ul. Szaserów 128, 04-141, Warsaw 44, Poland, alubas@wim.mil.pl.

ABSTRACT
Mantle cell lymphoma (MCL) is a rare aggressive lymphoid neoplasm occurring in about 3-7 % of non-Hodgkin lymphomas in the United States and Europe. Although lymphomas infiltrations are recognized in about half of post-mortem studies, in available literature we found only eight cases of mantle cell lymphoma with renal involvement. Five of them present MCL related glomerulonephritis, two show renal MCL infiltration with acute kidney injury and the last one describes MCL infiltration with acute tubulo-intrerstitial nephritis. We present the first case of a patient with the coexistence of renal mantle cell lymphoma infiltration, subacute membranoproliferative glomerulonephritis and acute kidney injury.

Show MeSH
Related in: MedlinePlus