Abstract
Renal involvement in lymphoma is not very uncommon but primary renal lymphoma is very rare and prognosis is poor. A 20 years male presented with localized, dull, constant pain and progressive swelling in left upper abdomen. He also gave history of significant weight loss. Examination findings revealed that he was anaemic, left kidney was hugely enlarged and hepatomegaly. Initially it seemed to be a case of renal cell carcinoma. But after doing invasive investigations it was proved to be a case of lymphoma, which considering all clinical and laboratory findings was diagnosed as a case of primary renal lymphoma. Keywords: Young man, Primary, Renal mass, Lymphoma DOI: http://dx.doi.org/10.3329/jom.v12i2.8424 JOM 2011; 12(2): 174-176
Highlights
Renal involvement in lymphoma is not very uncommon
The patient presented with very short history and initially considering all the clinical features it seemed to be a case of renal cell carcinoma with metastases to liver and paraaortic lymph node
We considered disseminated tuberculosis and lymphoma as differential diagnoses
Summary
Renal involvement in lymphoma is not very uncommon. Probably the exact incidence of the condition is underestimated as most cases are asymptomatic and less sensitive to conventional investigations like ultrasonography or intravenous urography. Some investigators believe that lymphoma in non lymphoid organ arise in the setting of an inflammatory disease with a lymphoplasmacytic infiltrate.[9] such explanation has not been applied for kidney It usually occurs in middle aged people and has slight male predominance.[6] Clinical presentation includes flank pain, symptoms of renal insufficiency due to obstruction, haematuria and fever.[3,10,11] In the series studied by Dimopoulos et al, all of 6 patients presented with urinary symptom without any peripheral lymph node enlargement.[3] It disseminate rapidly from their renal origin.[12] CHOP regimen is the standard treatment and rituximab may be added.[8] Survival is extremely poor, 75% of patients die in less than 1 year.[12,13] Early detection of disease and initiation of systemic chemotherapy may improve survival.
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