title: Acute renal failure due to lymphomatous infiltration: an unusual presentation.
abstract: Renal lymphoma occurs most often as a part of a multi-systemic disseminated lymphoma or as a recurrence of the tumor. Renal involvement usually occurs late in the course of the disease and is clinically silent. Acute renal failure (ARF) from lymphomatous infiltration has been described but is quite rare. We report a 50-year-old Caucasian woman, who presented with features of ARF. Physical examination showed that her arterial blood pressure was 190/100 mm Hg with no lymphadenopathy or hepatosplenomegaly. Her urine output was about 100 ml/day, and urinanalysis revealed + proteinuria and microscopic hematuria. Biochemical findings revealed severely impaired renal function with a serum creatinine of 693 micromol/L. The patient's lactate dehydrogenase was elevated at 632 U/L. An abdominal ultrasound showed bilateral, large non-obstructed kidneys and a hypoechoic mass arising in the right lobe of the liver. An ultrasound-guided percutaneous liver biopsy showed typical features of B-cell lymphoblastic lymphoma. The patient expired two days later, even before any specific treatment could be started.
authors.affiliation: Military Hospital of Tunis, Tunis, Tunisia. harzallakais@yahoo.fr
authors.forename: Kais
authors.initials: K
authors.lastname: Harzallah
authors.forename: Jannet
authors.initials: J
authors.lastname: Laadidi
authors.forename: Kais
authors.initials: K
authors.lastname: Chatti
authors.forename: Imed
authors.initials: I
authors.lastname: Hlel
authors.forename: Fethi
authors.initials: F
authors.lastname: Bougrine
authors.forename: Ammar
authors.initials: A
authors.lastname: Bouziani
authors.forename: Nejib
authors.initials: N
authors.lastname: Ben Abdallah
authors.forename: Bassam
authors.initials: B
authors.lastname: Louzir
authors.forename: Salah
authors.initials: S
authors.lastname: Othmani
authors.forename: Ezzedine
authors.initials: E
authors.lastname: Boussema
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology*; D001706:Biopsy; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D014057:Tomography, X-Ray Computed