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Case Reports
. 2013 Jul 22:14:158.
doi: 10.1186/1471-2369-14-158.

An unusual case of glomerulonephritis in a patient with non-Hodgkin mucosal associated lymphoid tissue (MALT) B-cell lymphoma

See Cheng Yeo  1 , Khoon Leong Chuah, Hwei Yee Lee, Adrian Liew
Affiliations
Case Reports

An unusual case of glomerulonephritis in a patient with non-Hodgkin mucosal associated lymphoid tissue (MALT) B-cell lymphoma

See Cheng Yeo et al. BMC Nephrol. .

Abstract

Background: Kidney involvement in non-Hodgkin lymphoma is well recognized and glomerulonephritis, when present, has been commonly reported to be associated with a membranoproliferative pattern.

Case presentation: We report a case of a 58-year-old lady with a recurrence of non-Hodgkin MALT B-cell lymphoma, presenting with acute kidney injury, nephrotic range proteinuria and a cellular urinalysis. She underwent a renal biopsy that showed a severe diffuse proliferative and exudative lupus-like glomerulonephritis, which is likely paraneoplastic in nature. We discuss the differential diagnosis and possible pathogenesis of glomerular injury in lymphoma-related proliferative glomerulonephritis.

Conclusion: Differentiating between true lupus nephritis and a paraneoplastic glomerulonephritis is important, as it would have significant implications on treatment and clinical course.

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Figures

Figure 1
Figure 1
A glomerulus showing hyperlobulation and global narrowing/occlusion of the glomerular capillary lumina with deposits and infiltrating mononuclear leukocytes and occasional neutrophils (periodic acid-Schiff stain; original magnification, ×400).
Figure 2
Figure 2
Immunofluorescence photographs showing global positivity in the distribution of the glomerular intraluminal and endothelial deposits for IgG (2+), IgA (2+), IgM (1+), C3 (2+), C4 (1+), C1q (2+), kappa (2+) and lambda (1+) (original magnification, ×400).
Figure 3
Figure 3
Electron micrograph showing abundant subendothelial electron dense deposits with intraluminal narrowing. This appearance corresponds to the global narrowing/occlusion of glomerular capillary lumina by massive eosinophilic deposits together with infiltrating mononuclear leukocytes and neutrophils seen on light microscopy (original magnification × 5000).
Figure 4
Figure 4
An electron micrograph shows the electron dense deposits with randomly oriented thin fibrils (original magnification, ×40,000).
See this image and copyright information in PMC

References

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