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Nefrología (Madrid)
versão On-line ISSN 1989-2284versão impressa ISSN 0211-6995
Resumo
PECES, R. et al. MALT B cell lymphoma with kidney damage and monoclonal gammopathy: A case study and literature review. Nefrología (Madr.) [online]. 2010, vol.30, n.6, pp.681-686. ISSN 1989-2284.
We report a case of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) involving the left kidney and simultaneous onset of a monoclonal gammopathy IgM kappa. No predisposing local inflammatory condition was identified. Following left nephrectomy, the renal specimen showed the centrocyte like cells and lymphoid cells in the lymphoepithelial lesions were positive for CD20 and CD79 alfa. The neoplastic cells expressed monotypic cytoplasmic IgM kappa. The demonstration of bone marrow cells of B-lineage expressing the same monoclonal protein as the tumor suggested bone marrow involvement, even in the absence of identical morphology. Despite chemotherapy and rituximab treatment, clinical follow-up showed right kidney extension with high-grade transformation, and finally systemic dissemination. This case illustrates that the kidney is among the sites that may be involved by MALT B-cell lymphomas in a primary or secondary fashion, and the need for expanded investigation of the possible dissemination. We review the literature on this unusual extranodal lymphoma.
Palavras-chave : B-cell lymphoma; IgM kappa; Kidney; Monoclonal gammopathy; Mucosa-associated lymphoid tissue (MALT).