Article Figures & Data
Figures
- Figure 1
- Lymphoma of the kidney. A) Section of renal mass biopsy showing diffuse large B-cell lymphoma (DLBL) composed of diffuse infiltration of large lymphoid cells ddestroying renal parenchyma (hematoxylin and eosin, 200×). B) Higher power of the same case; reveal large lymphoma cells surrounding renal tubules (hematoxylin and eosin, 400×). C) DLBL expressing CD20 (immunohistochemistry stain, 200×). D) DLBL with negative staining for CD3, which highlighted reactive T-cells (immunohistochemistry stain, 200×). E) Section of renal mass biopsy showing Burkitt’s lymphoma composed of monomorphic intermediate sized lymphoid cells with starry sky appearance showing tangible body macrophages and surrounding glomerulus (hematoxylin and eosin, 400×). F) Burkitt’s lymphoma expressing Ki-67 in almost 100% of tumor cells (immunohistochemistry stain, 400×).
- Figure 1
- Lymphoma of the kidney. G) Burkitt’s lymphoma expressing CD20 (immunohistochemistry stain, 200×). H) Burkitt’s lymphoma expressing CD10 (immunohistochemistry stain, 200×). I) Post-transplant lymphoproliferative disorder composed of large atypical lymphoid cells with areas of necrosis (not shown). (Immunohistochemistry stain, 400×). J) Post-transplant lymphoproliferative disorder, Epstein-Barr virus stain showing positive staining in proliferating cells (immunohistochemistry stain, 400×).
Tables
- Table 1
- Summary of the primary renal lymphoma cases from 2 tertiary hospitals in the Western regions of Saudi Arabia.
Patient no. Age/gender Specimen Site Clinical presentation Diagnosis Bone marrow Radiological findings 1 50/M Biopsy Left kid Palpable mass and hematuria DLBCL -ve CT: hypodense lesion in the left kid. The spleen and liver are normal. No significantly enlarged LNs. 2 56/M Biopsy Right kid Hematuria, flank pain DLBCL -ve US: hypoechoic tumor with enlarged retrocaval lymph nodes. The spleen and liver are normal. 3 59/F Biopsy, referral Right kid Hematuria, weight loss DLBCL Not carried out CT: hypodense lesion in the right kid (3.4x3.2x3 cm). No enlarged lymph nodes. Normal spleen and liver 4 61/M Biopsy, referral Left kid Palpable mass and hematuria DLBCL -ve CT: enhancing mass involving left kid There are enlarged lymph nodes in paracaval region. The spleen and liver are normal. 5 63/F Biopsy Left kid Flank pain DLBCL Not available Not available 6 23/M Biopsy Left kid Abdominopelvic pain Burkitt’s lymphoma -ve CT: multiple hypodense lesions involving left kid. No enlarged lymph nodes. Normal spleen and liver 7 24/M Biopsy Right kid Flank pain and mild renal impairment DLBCL -ve US: swollen right kid with paraaortic lymph node enlargement. 8 39/M Biopsy Kid, bilateral Chronic renal failure, bilaterally enlarged kid suggestive of glomerulonephritis Burkitt’s lymphoma -ve CT: both kids enlarged with multiple hypodense lesions. No enlarged lymph nodes. Normal spleen and liver 9 53/M Biopsy Right kid Hematuria, loss weight for 2 months, known hypothyroid and chronic renal failure DLBCL -ve CT: hypodense lesion in the right kid. The spleen and liver are normal. No significantly enlarged LNs. 10 4/M Biopsy Kid, bilateral Bilateral renal enlargement with hepatomegaly Burkitt’s lymphoma -ve CT: both kids are enlarged with no defined focal lesions. There are a few periaortic lymph nodes. Enlarged spleen with no focal lesion. Normal liver.
CT of orbits: this is involvement of both orbits and both maxillary sinuses.11 36/F Biopsy Kid, bilateral Epistaxis, abdominal pain, vomiting, and bilateral enlarged kid DLBCL -ve CT: significant intraabdominal lymphomatous infiltrative disease involving the abdominal organs namely both kids, liver, gallbladder, pancreas, adrenals, and intraabdominal and pelvic lymph nodes. 12 52/F Biopsy Left kid Left renal mass DLBCL -ve CT: perinephric soft tissue lesion is seen involving the right kid (2.8x0.8 cm). No enlarged lymph nodes. The left kid is atrophic. Liver, spleen, and pancreas adrenal glands are normal. 13 76/F Biopsy Left kid Left renal mass, hematuria DLBCL -ve CT: hypodense lesion in the left kid (3.6x4.3x3.4 cm). Similar lesion infiltrating focally the mid-portion of descending colon measuring (2.0x3.5 cm). There are multifocal hypodense splenic lesions. The pelvic organs are unremarkable. 14 41/M Radical nephrectomy Right kid Right kid mass with enlarged paraaortic lymph node DLBCL -ve CT: hypodense lesion with enlarged lymph nodes in paracaval region just below the level of renal vein measuring 2.3 cm. 15 53/F Biopsy Right kid Right renal mass and flank pain DLBCL -ve CT: enhanced lesion in the right kid (4.6x3.9 cm). It shows slightly more extension towards the renal hilum. The left kid, liver, and spleen are unremarkable. 16 61/M Biopsy Transplanted kid Renal mass, flank pain PTLD, monomorphic, monoclonal, and EBV associated-B cell/DLBCL Not carried out CT: large enhancing retroperitoneal mass encasing and involving transplanted kid. There are multiple retroperitoneal, retrocaval, and bilateral inguinal lymph node enlargement. 17 44/M Biopsy Transplanted kid Renal mass PTLD, monomorphic, monoclonal, and EBV associated-B cell/DLBCL -ve CT: enhancing mass involving transplanted kid associated with enlarged retrocaval lymph nodes. Kid: kidney, M: male, F: female, DLBCL: diffuse large B-cell lymphoma, PTLD: post-transplant lymphoproliferative disorder, EBV: Epstein-Barr virus, -ve: negative, LNs: lymphoid neoplasms, CT: computed tomography, US: ultrasound
References Age/gender Site Clinical presentation Diagnosis Omer et al6 21/F Bilateral Fever, weight loss, abdominal pain, and masses Non-Hodgkin lymphoma Hugosson et al9 4/M Right kidney Abdominal distension, pain, and vomiting Lymphoblastic lymphoma Al Mulhim et al10 45/F Right kidney Right flank pain and hematuria Diffuse large B-cell lymphoma F: female, M: male
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