A Case of Angiotropic Large Cell Lymphoma Manifesting Nephrotic Syndrome and Treated Successfully with Combination Chemotherapy

Abstract

A 52-year-old female had a nephrotic syndrome without neurological or dermatological manifestations. Renal biopsy revealed that glomeruli were filled with tumor cells which bore leukocyte common antigen and pan B cell marker. These cells occupied the capillary lumen and invaded into the mesangial area. Morphological alteration of endothelial cells and glomerular basement membrane were also noticed. The interstitium was well preserved. After five cycles of a combination chemotherapy, CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone), the second biopsy revealed that tumor cells disappeared from glomeruli showing mild sclerosis. Proteinuria became absent. This is the first report of an angiotropic large cell lymphoma manifesting a nephrotic syndrome and treated successfully by CHOP therapy.

Renal Intravascular Large B-cell Lymphoma Localized Only within Peritubular Capillaries Report of a Case

“…reported the first case of IVLBCL in kidney tissue after a percutaneous biopsy in 1981, 12 additional case presentations have been published (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). All of these cases had malignant lymphoid cells localized only within the intraglomerular capillaries.…”

True identity of endocapillary proliferation: a case of intravascular large B cell lymphoma diagnosed with immunohistochemical study of kidney biopsy and literature review

“…Several additional cases have been reported since then. Table 2 is the first attempt to summarize relevant renal and extra-renal findings of the previously reported IVLBCL cases proven with kidney biopsy [4,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23], except for one case of IVLBCL complicated with renal cell carcinoma reported in 2001 [24] and two cases of IVLBCL showing intracapillary proliferation only within peritubular capillaries reported in 2007 and 2011 [25,26]. The table shows wide individual variations in renal laboratory findings and LM findings of kidney specimens.…”

Long-term remission after autologous peripheral blood stem cell transplantation for relapsed intravascular lymphoma

“…6,7 We describe the long-term follow-up of a case we have previously reported as having angiotropic large-cell lymphoma which presented as nephrotic syndrome. 8 To our knowledge, this is the first report dealing with long-term follow-up of an IVL patient following auto-PBSCT.…”

“…The precise clinical and pathological findings have been previously reported. 8 Bone marrow examination revealed a normal distribution of cells. She achieved a complete remission (CR) after five courses of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) therapy.…”