PMC5457928_01
Kidney CT before (A) and after (B) 8 cycles of chemotherapy. CT at diagnosis showed marked bilateral kidney hypertrophy (A) which subsided after 8 cycles of anthracycline-containing chemotherapy associated with rituximab (B).
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A whole-body CT scan was unremarkable, except for bilateral kidney hypertrophy (Fig. 1A). The patient received 8 cycles of anthracycline-containing chemotherapy associated with rituximab (R-CHOP) and complete remission was achieved, as assessed by kidney CT (Fig. 1B) and FDG PET-CT (Fig. 2B).
Maximum intensity projection PET images before (A) and after (B) 8 cycles of chemotherapy. PET at diagnosis showed intense tracer uptake in both kidneys with a standard uptake value of 5.5 (A). After 8 cycles of treatment, complete remission was achieved (B). PET: positron emission tomography
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No other abnormality was found (Fig. 2A).
Renal biopsy findings. A: Glomerular capillary lumens containing lymphomatous cells (arrows). Hematoxylin and Eosin (H&E) staining (left). CD31 staining marking the endothelium (upper right-hand corner). CD20 staining marking lymphomatous cells (lower right-hand corner). Magnification 40x. B: Lymphomatous cells occluding the peritubular capillaries (arrows). H&E staining (left). CD31 staining (upper right-hand corner). CD20 staining (lower right-hand corner). Magnification 60x.
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A histological examination of a renal biopsy (Fig. 3) showed infiltration of the renal parenchyma by abnormally large lymphoid cells with prominent nucleoli, consistent with lymphoma.