Case Report

Limited Renal Intravascular Lymphoma: A Case Report and Review of the Literature

Table 1

Patients with intravascular large B-cell lymphoma.

CaseAge/genderYearClinical manifestationCT/PET-CTBone marrow biopsyRenal biopsyTreatmentOutcome

Niitsu et al. [11]52 (M)2008Edema of his lower extremities and mild renal dysfunction.Computed tomography (CT) revealed markedly enlarged bilateral kidneys but no lymphadenopathy. FDG-PET revealed no abnormal uptake of FDG.NAThe proliferating cells were phenotypically characterized to be CD3−, CD20+, CD5−, CD10−, BCL2+, BCL6+, and MUM-1+.R-CHOPCR

D’Agati et al. [12]62 (F)1989Fever, nausea, vomiting, nephritic syndrome.NANAMCD with lymphoma cells within glomerular capillaries, interstitial vessel, and interstitium.PrednisoneDeath

Axelsen et al. [13]60 (F)1991Fever, proteinuria, CNS involvement.NANAGlomerular capillary lumina with large lymphoma cells; CD20+, UCHL-1−, and CD43−.CAVPCR

Sekulic et al. [14]59 (M)2016Fever, albuminuria.PET-CT showed that this lesion had no increased FDG uptake.NormalThe lymphoma cells were positive for CD20, CD45, CD34, CD31, and immunoglobulin (Ig) M and were negative for cytokeratin, IgG, IgA, and CD56.R-CHOPCR

Hasegawa et al. [15]65 (F)2015Renal dysfunction, proteinuria.CT showed both kidneys were small with a long axis of 9 cm bilaterally.NAAtypical large lymphoid cells in the glomerular capillaries were positive for CD20 and CD79a but negative for CD3 and CD10. Lymphocytes in the tubulointerstitium were positive for CD3 but negative for CD20 and CD79a.R-CHOPRelapse

Bilgili et al. [16]56 (F)2013Anasarca edema, acute renal failure.CT showed hepatomegaly with 168 mm size and inguinal lymph nodes.NAThe immunohistochemical analysis was positive for CD20, factor-8, and leukocyte common antigen (LCA) (CD45) and negative for CD3, CD30, HMB45, S100, CD117, cytokeratin, CK7, CK20, CEA, and EMA.R-CHOPCR

Kamalanathan et al. [17]77 (F)2013Renal impairment, proteinuria, lethargy, weight loss.PET-CT showed diffuse marrow activity but no abnormal renal signal.NAAtypical CD20 positive B-lymphocytes filling the capillary lumens of nearly 50% of all glomeruli seen on the biopsy indicating large B-cell lymphoma of nongerminal centre immunophenotype.R-CHOPCR

Bai et al. [18]41 (F)2011Fever, bilateral lower limb fatigue.PET-CT shows foci with high signal intensity in bilateral kidneys, multiple vertebrae, bilateral sacrum, and ilium.41.5% immature cells of unknown origin.Atypical lymphoid cells were positive for B-cell markers CD20 and negative for CK, CD3, CD45RO, and CD10. They were positive for large B-cell lymphoma marker mum-1.CHOPCR

Kameoka et al. [19]40 (F)2006Proteinuria.PET-CT revealed no significant uptake of isotopes.NAThe atypical large lymphoid cells showed positive stainings for leukocyte common antigen CD45, BCL-2, BCL-6, B-cell-associated antigens including CD20, CD79a, and MUM1 and showed negative stainings for CD3, CD5, CD10, or CD56.R-CHOPCR

Current case56 (M)2016Fever, headache, dyspnea, arthralgia.PET-CT showed a focal hypermetabolic lesion in the colon and augmented signal in both spleen and bone marrow.NormalIntravascular B lymphoma (CD20+, CD5+, BCL2+ Y BCL6+, CD3-, GRANZYME-, MUM1- Y CD10- KI67 80%).R-CHOPCR

R-CHOP: rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone; CHOP: cyclophosphamide, doxorubicin, vincristine, and prednisolone; CAVP: cyclophosphamide, doxorubicin, vincristine, and prednisone; CR: complete response; NA: not available.