PMC4706393_01
MRI showing kidney enlargement and bilateral renal multiple tumors, with low intensity on T1- and T2-weighted images.
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T1- and T2-weighted images (Fig. 1). The serum soluble interleukin-2 receptor was elevated to 870 U/mL (normal range 145-519 U/mL).
Clinical course of the patient's Cr levels after admission.
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After hospitalization, the AKI worsened rapidly and the patient underwent hemodialysis (Fig. 2). 18F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography) FDG-PET/CT showed intense uptake in bilateral kidneys, a para-aortic lymph node, and the right atrial appendage. After the open renal biopsy, the AKI was unexpectedly getting better and the patient was withdrawn from hemodialysis (Fig. 2).
Histopathologic examination. (A) Renal biopsy showed diffuse interstitial infiltration by lymphocytes (hematoxylin-eosin stains [HE] x100), (B) diffuse immunoreactivity of lymphocytes to CD10, (C) no immunoreactivity of lymphocytes to CD3 (HE x200).
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The third tissue specimen enabled the diagnosis: non-Hodgkin's lymphoma (diffuse large B-cell lymphoma/Barkitt lymphoma) (Fig. 3).