PMC7563074_01
PET-CT scan. Initial PET-CT. (a) Shows the hypermetabolic lesions, which can be seen in the descending colon, and the augmented signaling of the liver without renal compromise is documented. (b, c) PET-CT scans showing nonenhancement of the kidney signal.
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fig1
Kidney biopsy. (a) Hematoxylin-eosin staining of the kidney showing the presence of large atypical lymphocytes with an irregular nucleus in the glomerulus and tubules. (b) PAS staining of the kidney showing the presence of lymphocytes in the peritubular capillaries. (c) CD20 staining showing the presence of atypical B-lymphocytes. (d) CD3 staining. (e) KI67 staining showing a proliferation (80%). (f) CD5 staining was positive in this patient and associated with a poor prognosis in IVLBCL.
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fig2
A renal biopsy was performed; it was positive for monoclonal B-lymphocyte (CD20+, CD5+, BCL2+ and BCL6+, CD3-, GRANZYME-, MUM1-, and CD10- KI67 80%) infiltration inside the peritubular capillaries which is compatible with an intravascular large B-cell lymphoma (Figure 2).
Evolution of the main laboratory parameters. The patient showed improvement in albumin, lactate dehydrogenase, and hemoglobin levels after the chemotherapy treatment. (a) The albumin levels of the patient showed improvement as a result of the treatment. (b) The hemoglobin levels show improvement as a result of the treatment. (c) The lactate dehydrogenase levels decreased as a result of the treatment.
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fig3
This treatment resulted in improvements in his blood test (Figure 3).