PMC4323911_01
Photomicrographs from the kidney biopsy specimen. (a) Diffuse interstitial infiltration by lymphomatous cells (H and E, x200), (b) Immunohistochemistry showing diffuse membranous positivity for CD20 of the lymphomatous cells
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F1
Histopathological examination revealed [Figure 1a] diffuse interstitial infiltration with lymphomatous cells with morphology suggestive of high-grade non-Hodgkin's lymphoma (NHL) and immunohistochemistry showed [Figure 1b] CD20 positivity of the lymphomatous cells, suggestive of diffuse large B-cell, non-Hodgkin's lymphoma (DLBCL).
Positron emission tomography - computed tomography imaging. (a) Increased flurodeoxy glucose (FDG) uptake (standardized uptake value [SUV] max 9.5) is noted in the right kidney with regular margins. Increased FDG uptake is also noted in left kidney (SUV max 18.5) with irregular margins. Note is made of 9 mm calculus in left kidney lower calyx with mild hydronephrosis. (b) Avid FDG uptake is noted in multiple lesions in liver with largest lesion (7.9 cm x 5.9 cm, SUV max 13.8) in left lobe
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F2
Avid FDG uptake was also seen in multiple hypodense areas in both lobes of liver (SUV max 13.8), largest being 7.9 cm x 5.5 cm in the left lobe [Figure 2] and intense patchy uptake in the bone marrow of multiple bones in axial and appendicular skeleton.