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Characteristics of Intravascular Large B-Cell Lymphoma Limited to the Glomerular Capillaries: A Case Report.

Hasegawa J, Hoshino J, Suwabe T, Hayami N, Sumida K, Mise K, Ueno T, Sawa N, Wake A, Ohashi K, Fujii T, Honda K, Takaichi K, Ubara Y - Case Rep Nephrol Dial (2015)

Bottom Line: Kidney-limited intravascular large B-cell lymphoma (IVL) localized to the glomerular capillaries was diagnosed because the intraglomerular cells were positive for CD20 and CD79a, while there was no positivity in the extraglomerular kidney and extrarenal organs.Treatment with rituximab, cyclophosphamide, hydroxydaunomycin, vincristine, and prednisolone was started, and the patient has since been doing well.When IVL is limited to the intraglomerular capillaries, CRP may not be elevated.

View Article: PubMed Central - PubMed

Affiliation: Nephrology Center, Toranomon Hospital, Tokyo, Japan ; Department of Nephrology, Ohkubo Hospital, Tokyo, Japan.

ABSTRACT
A 65-year-old woman was admitted to our hospital for the evaluation of rapidly progressive renal dysfunction with serum creatinine of 2.7 mg/dl and urinary protein of 1.5 g daily. C-reactive protein (CRP) was 0.1 mg/dl. Kidney-limited intravascular large B-cell lymphoma (IVL) localized to the glomerular capillaries was diagnosed because the intraglomerular cells were positive for CD20 and CD79a, while there was no positivity in the extraglomerular kidney and extrarenal organs. Treatment with rituximab, cyclophosphamide, hydroxydaunomycin, vincristine, and prednisolone was started, and the patient has since been doing well. When IVL is limited to the intraglomerular capillaries, CRP may not be elevated.

No MeSH data available.


Related in: MedlinePlus

Electron microscopy showed an increase in atypical cells with large nuclei (arrows), large nucleoli, masses of chromatin in the outer nuclear zone, and abundant endoplasmic reticulum in the cytoplasm.
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Figure 4: Electron microscopy showed an increase in atypical cells with large nuclei (arrows), large nucleoli, masses of chromatin in the outer nuclear zone, and abundant endoplasmic reticulum in the cytoplasm.

Mentions: Renal biopsy was performed. Light microscopy of a specimen containing 12 glomeruli revealed global sclerosis in 2. There was mild fibrosis and atrophy, as well as very slight cellular infiltration, in the tubulointerstitial region (fig. 2a). Six of the 12 glomeruli were enlarged (fig. 2b), and the glomerular capillaries were filled with large atypical cells that had atypical nucleoi (fig. 2c). There was no increase in the mesangial matrix or mesangial cell proliferation. Immunohistochemical staining detected atypical large lymphoid cells in the glomerular capillaries that were positive for CD20 (fig. 3a) and CD79a (fig. 3b), but negative for CD3 (fig. 3c) and CD10. Lymphocytes in the tubulointerstitium were positive for CD3, but negative for CD20 and CD79a. Immunostaining was negative for IgG, IgA, IgM, and C3. Electron microscopy revealed numerous atypical cells with large nuclei, large nucleoli, masses of chromatin in the outer zones of the nuclei, and an abundance of endoplasmic reticulum (fig. 4). No deposits of immunoglobulins/complement components were detected. Bone marrow aspiration and flow cytometric analysis did not detect any abnormal cell populations. Endoscopy of the upper and lower gastrointestinal tract showed no abnormal findings. Based on these findings, kidney-limited IVL localized to the glomerular capillaries was diagnosed.


Characteristics of Intravascular Large B-Cell Lymphoma Limited to the Glomerular Capillaries: A Case Report.

Hasegawa J, Hoshino J, Suwabe T, Hayami N, Sumida K, Mise K, Ueno T, Sawa N, Wake A, Ohashi K, Fujii T, Honda K, Takaichi K, Ubara Y - Case Rep Nephrol Dial (2015)

Electron microscopy showed an increase in atypical cells with large nuclei (arrows), large nucleoli, masses of chromatin in the outer nuclear zone, and abundant endoplasmic reticulum in the cytoplasm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555212&req=5

Figure 4: Electron microscopy showed an increase in atypical cells with large nuclei (arrows), large nucleoli, masses of chromatin in the outer nuclear zone, and abundant endoplasmic reticulum in the cytoplasm.
Mentions: Renal biopsy was performed. Light microscopy of a specimen containing 12 glomeruli revealed global sclerosis in 2. There was mild fibrosis and atrophy, as well as very slight cellular infiltration, in the tubulointerstitial region (fig. 2a). Six of the 12 glomeruli were enlarged (fig. 2b), and the glomerular capillaries were filled with large atypical cells that had atypical nucleoi (fig. 2c). There was no increase in the mesangial matrix or mesangial cell proliferation. Immunohistochemical staining detected atypical large lymphoid cells in the glomerular capillaries that were positive for CD20 (fig. 3a) and CD79a (fig. 3b), but negative for CD3 (fig. 3c) and CD10. Lymphocytes in the tubulointerstitium were positive for CD3, but negative for CD20 and CD79a. Immunostaining was negative for IgG, IgA, IgM, and C3. Electron microscopy revealed numerous atypical cells with large nuclei, large nucleoli, masses of chromatin in the outer zones of the nuclei, and an abundance of endoplasmic reticulum (fig. 4). No deposits of immunoglobulins/complement components were detected. Bone marrow aspiration and flow cytometric analysis did not detect any abnormal cell populations. Endoscopy of the upper and lower gastrointestinal tract showed no abnormal findings. Based on these findings, kidney-limited IVL localized to the glomerular capillaries was diagnosed.

Bottom Line: Kidney-limited intravascular large B-cell lymphoma (IVL) localized to the glomerular capillaries was diagnosed because the intraglomerular cells were positive for CD20 and CD79a, while there was no positivity in the extraglomerular kidney and extrarenal organs.Treatment with rituximab, cyclophosphamide, hydroxydaunomycin, vincristine, and prednisolone was started, and the patient has since been doing well.When IVL is limited to the intraglomerular capillaries, CRP may not be elevated.

View Article: PubMed Central - PubMed

Affiliation: Nephrology Center, Toranomon Hospital, Tokyo, Japan ; Department of Nephrology, Ohkubo Hospital, Tokyo, Japan.

ABSTRACT
A 65-year-old woman was admitted to our hospital for the evaluation of rapidly progressive renal dysfunction with serum creatinine of 2.7 mg/dl and urinary protein of 1.5 g daily. C-reactive protein (CRP) was 0.1 mg/dl. Kidney-limited intravascular large B-cell lymphoma (IVL) localized to the glomerular capillaries was diagnosed because the intraglomerular cells were positive for CD20 and CD79a, while there was no positivity in the extraglomerular kidney and extrarenal organs. Treatment with rituximab, cyclophosphamide, hydroxydaunomycin, vincristine, and prednisolone was started, and the patient has since been doing well. When IVL is limited to the intraglomerular capillaries, CRP may not be elevated.

No MeSH data available.


Related in: MedlinePlus