診斷及治療腎臟淋巴癌的臨床經驗
林祖鋒1、許炯明1,2、林炯森3、陳功深3、林文榮1,2、邱文祥1,2,4
馬偕紀念醫院 泌尿科1；馬偕醫學院2；馬偕紀念醫院 血液科3；陽明醫學院4
Clinical experience for diagnosis and treatment of renal lymphoma
Tsu-Feng Lin1, Jong-Ming Hsu1,2, Johnson Lin3, Caleb Gonshen Chen3, Wun-Rong Lin1,2, Allen W. Chiu1,2,4
1 Department of Urology, MacKay Memorial Hospital
2 Mackay Medical College
3Department of Hematology, Mackay Memorial Hospital
4 School of Medicine, National Yang-Ming University
Propose: Renal involvement with lymphoma was common in lymphoma patients but seldom in primary case. The common radiographic patterns in computed tomography were multiple distinct renal masses, and renal invasion from enlarged retroperitoneal lymph nodes. We present three renal lymphoma cases in our hospital.
Case presentation
Three renal lymphoma cases were reviewed. Two cases were primary, and one was secondary. Flank pain without hematuria happened in all three cases. CT showed huge heterogeneous enhancement mass infiltrated from kidney to pararenal space. All of them received CT-guide biopsy which pathologic report revealed diffuse large B-cell lymphoma, germinal center type in two primary cases and the other discovered marginal zone B-cell lymphoma. Primary renal lymphoma patients received chemotherapy with regiment of R-CHOP (Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone). Partial remission and complete remission was found after treatment. One of these patients died of tumor recurrence. Marginal zone B-cell lymphoma patient received primary lymphoma excision over axillary region. Follow up image over kidney showed stationary without tumor progression. She is alive at follow-up 32 months.
Conclusion:
Image finding on renal lymphoma were multiple renal mass, and enlargement retroperitoneal mass with renal invasion. Marginal zone B-cell lymphoma is more benign, and poor prognosis in high grade primary renal lymphoma, median survival time is only 8 months to 3 years