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Abstract：
Primary renal lymphoma (PRL) is a rare non-Hodgkin\'s lymphoma (NHL) involving the kidneys without evidence of extra-renal involvement. We describe a 66-year-old female who presented with bilateral pleural effusions, and acute renal failure and was diagnosed with primary renal diffuse large B-cell lymphoma (DLBCL). She presented with shortness of breath due to bilateral pleural effusions and acute renal failure. Computed tomography (CT) of the chest reported bilateral pleural effusions. Thoracocentesis and subsequent fluid analysis reported non-malignant effusion. Her kidney function worsened during her hospital stay, requiring dialysis. Nonspecific findings such as bilateral renal enlargement on imaging prompted a renal biopsy. Histopathology reported mixed tubulointerstitial atypical lymphocytic CD 20 and BCL-6 positive cell infiltrates, confirming non-Hodgkin diffuse large B-cell lymphoma. Whole-body positron emission tomography/CT (PET/CT) and brain magnetic resonance imaging (MRI) ruled out the involvement of any other organs or lymph nodes, confirming our diagnosis of PRL. She was treated with six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Her kidney function recovered fully and remained normal at the one-year follow-up. We highlight the importance of recognizing PRL as an underlying cause of renal failure and its association with autoimmune diseases. Prompt investigation with timely diagnosis and treatment can result in improved morbidity and mortality in these patients.
摘要：
原发性肾淋巴瘤（PRL）是一种罕见的非霍奇金淋巴瘤（NHL），涉及肾脏，没有肾外受累的证据。我们描述了一名66岁的女性，她出现了双侧胸腔积液，和急性肾功能衰竭，并被诊断为原发性肾脏弥漫性大B细胞淋巴瘤（DLBCL）。由于双侧胸腔积液和急性肾功能衰竭，她表现为呼吸急促。胸部计算机断层扫描（CT）报告双侧胸腔积液。胸腔穿刺术和随后的液体分析报告非恶性积液。她住院期间肾功能恶化,需要透析.非特异性发现，例如影像学上的双侧肾脏肿大提示肾活检。组织病理学报告混合肾小管间质非典型淋巴细胞CD20和BCL-6阳性细胞浸润，确认非霍奇金弥漫性大B细胞淋巴瘤。全身正电子发射断层扫描/CT（PET/CT）和脑磁共振成像（MRI）排除了任何其他器官或淋巴结的参与，确认我们对PRL的诊断。她接受了六个周期的利妥昔单抗治疗，环磷酰胺,阿霉素,长春新碱,和泼尼松（R-CHOP）。在一年的随访中，她的肾功能完全恢复并保持正常。我们强调认识到PRL是肾衰竭的潜在原因及其与自身免疫性疾病的关联的重要性。及时的诊断和治疗可以提高这些患者的发病率和死亡率。
