Marginal zone lymphoma with acute kidney injury as the initial clinical manifestation: a case report
10.3760/cma.j.cn441217-20240819-00817
- VernacularTitle:以急性肾损伤为初发临床表现的边缘区淋巴瘤1例
- Author:
Hui GUO
1
;
Jing YANG
;
Fuhua CHEN
;
Yonglan WANG
;
Linlin SUN
;
Lan LIN
;
Ligen LIU
;
Xiaoxia WANG
Author Information
1. 上海交通大学医学院附属同仁医院肾内科，上海 200336
- Publication Type:Journal Article
- Keywords:
Acute kidney injury;
Lymphoma, non-Hodgkin;
Lymphoma, B cell, marginal zone;
Renal biopsy
- From:
Chinese Journal of Nephrology
2025;41(8):620-623
- CountryChina
- Language:Chinese
-
Abstract:
The paper presents a case of 69-year-old male with marginal zone lymphoma (MZL) manifesting as acute kidney injury (AKI) requiring emergency hemodialysis. The patient presented with fever, fatigue and rapidly progressive renal dysfunction, and serum creatinine was 1 105 μmol/L. Emergency central venous catheterization and hemodialysis were performed. Serum immunofixation electrophoresis revealed monoclonal IgM and λ light chain positivity. Autoantibody testing showed positivity for both anti-SSA and anti-SSB antibodies. Renal biopsy demonstrated interstitial infiltration by atypical B lymphocytes with λ light chain restriction. The diagnosis of MZL was confirmed by bone marrow biopsy. Following hemodialysis and chemotherapy with bendamustine plus rituximab, renal function significantly improved and remained stable during follow-up. This case highlights that AKI may serve as the initial manifestation of lymphoma, underscoring the importance of considering hematologic malignancies in the differential diagnosis of unexplained renal failure.
