Paraneoplastic glomerulonephritis and kidney infiltration by mantle cell lymphoma: A diagnostic challenge.

IF 0.6 4区医学 Q4 HEMATOLOGY

Journal of Hematopathology Pub Date : 2024-07-20 DOI:10.1007/s12308-024-00596-5

Ana Lerma-Verdejo, Maribel Monroy-Condori, Xavier E Guerra-Torres, Nahir Daniela Moreno Paredes, Anastasio Serrano Egea, Francisco Díaz, Jorge L Morales-Montoya, Jacobo Galán Vega, Iván Arenas-Moncaleano, Fernando Solano Ramos

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Abstract

Mantle cell lymphoma (MCL) is a rare and aggressive type of lymphoma that can affect the kidneys. The disease can lead to kidney impairment, and glomerulonephritis (GN) is a rare but serious complication of MCL. We report a case of MCL with kidney interstitial infiltration and membranoproliferative glomerulonephritis with focal and segmental glomerulosclerosis. A 75-year-old man presented recurrent acute kidney failure and worsening of nephrotic syndrome. Kidney biopsy revealed membranoproliferative glomerulonephritis presented immunoglobulin and complement deposition, focal and segmental glomerulosclerosis of not otherwise specified type, and infiltration by mantle cell lymphoma. Bone marrow biopsy and PET/CT scan confirmed the diagnosis of mantle cell lymphoma. The patient was treated with R-CHOP21 chemotherapy with cyclophosphamide dose adjustment for nephroprotection. He achieved complete remission with normalization of hematological parameters, improvement of kidney function, and reduction of proteinuria and albuminuria. This case shows the importance of considering alternative diagnoses in patients with recurrent chronic kidney disease and worsening nephrotic syndrome. Early diagnosis and treatment of mantle cell lymphoma can lead to favorable outcomes.

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副肿瘤性肾小球肾炎和套细胞淋巴瘤的肾脏浸润：诊断难题。

套细胞淋巴瘤（MCL）是一种罕见的侵袭性淋巴瘤，可影响肾脏。该病可导致肾功能损害，肾小球肾炎（GN）是 MCL 罕见但严重的并发症。我们报告了一例伴有肾间质浸润和膜增生性肾小球肾炎及局灶性和节段性肾小球硬化的 MCL 病例。一名 75 岁的男性反复出现急性肾衰竭和肾病综合征恶化。肾活检显示，膜增生性肾小球肾炎伴有免疫球蛋白和补体沉积、局灶性和节段性非特异性肾小球硬化以及套细胞淋巴瘤浸润。骨髓活检和 PET/CT 扫描证实了套细胞淋巴瘤的诊断。患者接受了 R-CHOP21 化疗，并调整了环磷酰胺的剂量以保护肾脏。他的病情完全缓解，血液学指标正常，肾功能改善，蛋白尿和白蛋白尿减少。该病例表明，对于慢性肾病反复发作和肾病综合征恶化的患者，考虑其他诊断非常重要。套细胞淋巴瘤的早期诊断和治疗可带来良好的预后。

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来源期刊

Journal of Hematopathology HEMATOLOGYPATHOLOGY-PATHOLOGY

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： The Journal of Hematopathology aims at providing pathologists with a special interest in hematopathology with all the information needed to perform modern pathology in evaluating lymphoid tissues and bone marrow. To this end the journal publishes reviews, editorials, comments, original papers, guidelines and protocols, papers on ancillary techniques, and occasional case reports in the fields of the pathology, molecular biology, and clinical features of diseases of the hematopoietic system. The journal is the unique reference point for all pathologists with an interest in hematopathology. Molecular biologists involved in the expanding field of molecular diagnostics and research on lymphomas and leukemia benefit from the journal, too. Furthermore, the journal is of major interest for hematologists dealing with patients suffering from lymphomas, leukemias, and other diseases. The journal is unique in its true international character. Especially in the field of hematopathology it is clear that there are huge geographical variations in incidence of diseases. This is not only locally relevant, but due to globalization, relevant for all those involved in the management of patients.