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논문분류	춘계학술대회 초록집
제목	Clinicopathological spectrum of patients with renal lesions associated with lymphoma from a single Chinese center
저자	Xiaojuan Zhu
출판정보	2024; 2024(1):
키워드
초록	Objectives: The renal involvement in lymphoma is a rare disorder, which revealed heterogenous clinical and pathological manifestation, leading to diagnostic challenges. Hence,we attempted to describe the clinicopathological characteristics and outcome of this entity. Methods: Between January 1, 2008 and September 30 ,2023, 47,093 renal biopsies were performed at Peking University First Hospital. 36 (36/47093,0.076%) patients with interstitial infiltration of lymphoma were enrolled, including 26 patients with low-intermediate grade B cell lymphoma (chronic lymphocytic leukemia/ small lymphocytic lymphoma, low-grade B-cell lymphoma, marginal zone lymphoma, mantle cell lymphoma and Wadenström macroglobulinemia), 7 patients with high grade B-cell lymphoma (diffuse large B-cell lymphoma, B lymphoblastic lymphoma) and 3 patients with T-cell lymphoma (T-cell large granular lymphocytic leukemia, angioimmunoblastic T-cell lymphoma).Clinical and pathological data were collected at the time of renal biopsy. Results: In low-intermediate grade B-cell lymphoma, the extent of infiltrating neoplastic cells in renal interstitium was diverse, from 10 to 90% and vaguely nodular pattern can be seen. Coexisting glomerular diseases were identified in 23 cases, including 7 monoclonal immunoglobulin-associated diseases and 16 non-monoclonal immunoglobulin-associated diseases. In 5 patients, tubular basement membranes deposits were found by electron microscopy, and these patients had worsen renal survival than those without (p =.02). In high grade B-cell lymphoma, diffuse interstitial infiltration of neoplastic cells was prominent, resulting in acute kidney injury (AKI, 100%), and there were no significant glomerular abnormalities. In T -cell lymphoma, one (1/3) showed coexistent glomerular capillary infiltration. Univariate analysis showed that low-intermediate grade B-cell lymphoma had better renal survival than the other two types of lymphoma (p＜.001). Conclusions: Renal lesions associated with lymphoma included both of lymphomatous interstitial infiltration and paraneoplastic glomerulopathy, which manifested a diverse spectrum that depended on the pathological patterns of lymphoma. Renal biopsy is the best way to confirm this entity and required for early diagnosis to improve patient prognosis.
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