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Case Reports
. 2019 Jun 12;12(6):e229359.
doi: 10.1136/bcr-2019-229359.

Nephrotic syndrome without kidney injury revealing intravascular large B cell lymphoma

Lucie Pothen  1 , Selda Aydin  2 , Alessandra Camboni  2 , Philippe Hainaut  1
Affiliations
Case Reports

Nephrotic syndrome without kidney injury revealing intravascular large B cell lymphoma

Lucie Pothen et al. BMJ Case Rep. .

Abstract

We describe the case of a 64-year-old woman admitted for fever of unknown origin, who developed nephrotic syndrome during hospitalisation and pulmonary infiltrates. Renal biopsy disclosed intracapillary glomerular invasion by intravascular large B cell lymphoma. Clinical and biological evolution was favourable after rituximab, cyclophosphamide, doxorubicine, vincristine and prednisone (R-CHOP) treatment and autologous stem cell transplant. Two years after diagnosis the patient was considered in remission.

Keywords: haematology (incl blood transfusion); nephrotic syndrome.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Renal biopsy shows large atypical lymphomatous cells filling the glomerular capillary lumina. Note the presence of mitosis (arrows) (A), (haematoxylin eosin staining; magnification: ×40). Intracapillary large lymphomatous cells are CD20+ (B), BCL2+ (C), MUM1+ (D); lymphomatous cells show a high Ki67 proliferation index (E) (immunoperoxydase haematoxylin counterstain; magnification: a ×40 and C–E, ×20).
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