title: Spectrum of renal involvement in hematolymphoid neoplasms: Renal biopsy findings of 12 cases.
abstract: Spectrum of causes for renal dysfunction in patients with hematolymphoid malignancy (excluding plasma cell dyscrasia) is varied. A retrospective evaluation of "native" renal biopsies referred to our institute during the period from January 2010 to December 2013 revealed 12 cases. Age ranged between 7 and 69 (median 54.5) years. All patients were males. The neoplasms included non-Hodgkin lymphoma, chronic lymphocytic leukemia, acute lymphoblastic leukemia, Burkitt's lymphoma, intravascular lymphoma, Hodgkin lymphoma and chronic myeloid leukemia. Proteinuria was noted in 66% of the patients (nephrotic range in 5, subnephrotic range in 3). Renal insufficiency was noted in 100% patients. Malignancy-related kidney injury was noted in 75% of the cases. Renal histology showed lymphomatous infiltration (8), membranoproliferative glomerulonephritis (MPGN) (3), intracapillary monoclonal deposit disease (1) and intravascular lymphoma (1). Distribution of lymphomatous infiltration was diffuse in 50% and focal in 50%. We observed that renal dysfunction was predominantly a direct effect, that is, lymphomatous invasion. Paraneoplastic glomerulopathic changes occur in the form of MPGN. Proteinuria of >2 g/day correlated with glomerular disease.
authors.affiliation: Department of Pathology, Manipal Hospital, Bengaluru, Karnataka, India.
authors.forename: M
authors.initials: M
authors.lastname: Vankalakunti
authors.affiliation: Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India.
authors.forename: A
authors.initials: A
authors.lastname: Rohan
authors.affiliation: Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India.
authors.forename: S
authors.initials: S
authors.lastname: Vishwanath
authors.affiliation: Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India.
authors.forename: S
authors.initials: S
authors.lastname: Rampure
authors.affiliation: Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India.
authors.forename: R
authors.initials: R
authors.lastname: Bonu
authors.affiliation: Department of Pathology, Manipal Hospital, Bengaluru, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Babu
authors.affiliation: Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India.
authors.forename: H S
authors.initials: HS
authors.lastname: Ballal
keywords: Hematolymphoid malignancy; intravascular lymphoma; lymphoma infiltration; paraneoplastic glomerulopathy; renal biopsy