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. 2013 Apr 16:7:105.
doi: 10.1186/1752-1947-7-105.

Mantle cell lymphoma presenting as a pelvi-ureteric junction obstruction: a case report

Ishvar Naranji  1 , Rhana H Zakri, Thomas Liston
Affiliations

Mantle cell lymphoma presenting as a pelvi-ureteric junction obstruction: a case report

Ishvar Naranji et al. J Med Case Rep. .

Abstract

Introduction: Mantle cell lymphoma is one of the several subtypes of non-Hodgkin's lymphoma. Mantle cell lymphoma is the rarest of the subtypes, accounting for about 6% of all non-Hodgkin's lymphoma cases in the United States and Europe. Lymphoid neoplasms of the urinary tract and male genital organs are relatively rare, accounting for less than 5% of extranodal lymphomas. We present a rare case of mantle cell lymphoma infiltrating the ureter causing pelvi-ureteric junction obstruction on tissue diagnosis.

Case presentation: A 78-year-old Caucasian woman was referred to our department with right flank pain, pyrexia and features of a urinary tract infection. A nephrostogram revealed a grossly distended right pelvicalyceal system in a pelvi-ureteric junction obstruction pattern. She underwent an elective pyeloplasty after her acute management and the results of histological examination revealed mantle cell lymphoma.

Conclusion: We describe a rare presentation of mantle cell lymphoma as a pelvi-ureteric junction obstruction. To the best of our knowledge, there has not been any previously published report of the above finding. Our patient had a history of a previous lymphoma but the aim of this manuscript is to highlight a possible presentation rather than determining whether the mantle cell lymphoma was de novo or a transformation from her previous splenic lymphoma with villous lymphocytes.

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Figures

Figure 1
Figure 1
Ultrasound demonstrating hydronephrosis.
Figure 2
Figure 2
Ultrasound with hydronephrosis and dilated pelvis.
Figure 3
Figure 3
Persisting hydronephrosis on ultrasound with debris.
Figure 4
Figure 4
Nephrostogram showing the pelvi-ureteric junction obstruction pattern pattern.
Figure 5
Figure 5
Histology slides: Mantle cell lymphoma, CD20, CyclinD and CD5 staining.
Figure 6
Figure 6
Computed tomography scan with persisting right PUJO and minor lymphadenopathy.
See this image and copyright information in PMC

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