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Case Reports
. 2020 May-Jun;30(3):192-195.
doi: 10.4103/ijn.IJN_160_19. Epub 2020 Feb 11.

Lymphomatous Interstitial Nephritis Coexistent with Paraneoplastic Crescentic Membranoproliferative Glomerulonephritis in a Case of Mantle Cell Lymphoma

Praveen Kumar Etta  1 , M V Rao  2 , Sujeet Reddy  2 , Swarnalata Gowrishankar  3 , Neha Agarwal  3
Affiliations
Case Reports

Lymphomatous Interstitial Nephritis Coexistent with Paraneoplastic Crescentic Membranoproliferative Glomerulonephritis in a Case of Mantle Cell Lymphoma

Praveen Kumar Etta et al. Indian J Nephrol. 2020 May-Jun.

Abstract

Mantle cell lymphoma (MCL) is a rare aggressive lymphoproliferative disorders (LPD) of B-cell lymphoma, which usually presents in advanced stages at initial diagnosis. Renal involvement in MCL is very rare, especially the combined presence of both glomerular and interstitial disease. We report on a patient with lymphomatous interstitial nephritis (LIN) coexistent with paraneoplastic crescentic membranoproliferative glomerulonephritis (MPGN), subsequently diagnosed to have disseminated MCL with bone marrow and lymph nodal infiltration. He was treated with rituximab-based chemotherapy and went into complete renal remission at 6-months of follow up.

Keywords: Crescentic membranoproliferative glomerulonephritis; lymphomatous interstitial nephritis; mantle cell lymphoma; paraneoplastic glomerulonephritis; renal lymphoma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Renal biopsy showing patchy dense nodular lymphoid infiltrate in the interstitium (Panel a - periodic acid-Schiff (PAS), ×40). High power view of the infiltrate showing monomorphic lymphoid cells (Panel b - hematoxylin-eosin, ×400)
Figure 2
Figure 2
Glomerulus showing an MPGN pattern glomerulonephritis with mesangial and endocapillary proliferation and segmental duplication of the basement membrane (Panel a – PAS, ×400; Panel b - Jones silver, ×400). Direct immunofluorescence stains showing significant peripheral deposits of IgG (Panel c, ×400) and C3c (Panel d, ×400)
Figure 3
Figure 3
Composite image of the panel of immunohistochemical markers of the lymphoid infiltrate. There is diffuse strong positivity for CD20, cyclin D1, and BCL-2. The intervening small lymphocytes are CD3 and CD5 positive. The MIB1 index is low averaging 5%. CD10, BCL-6, and CD23 are essentially negative
See this image and copyright information in PMC

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