KIDNEY involvement is common in non-Hodgkin＇s lymphoma （NHL） with incidence up to 30%-40% in autopsy studies. However, it us- ually occurs late in the course of the diseaseand is clinically silent. Clinically overt...KIDNEY involvement is common in non-Hodgkin＇s lymphoma （NHL） with incidence up to 30%-40% in autopsy studies. However, it us- ually occurs late in the course of the diseaseand is clinically silent. Clinically overt renal disease including acute kidney injury （AKI） as its primary manifestation is rarely reported, moreover, Fanconi syndrome （FS） is extremely rare as the main manifestation in NHL. In this report, we presented a case of NHL primarily presenting with FS and AKI due to diffuse interstitial infiltration of NHL cells and emphasized the important role of renal biopsy, especially renal immunohistochemical analysis in the diagnosis of renal diffuse lymphoma.展开更多
Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma （MM）, it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that req...Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma （MM）, it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stageⅡB. Thalidomide and dexamethasone were initiated. The patient developed a continuous increase in bilirubin that led to severe cholestasis. A liver biopsy revealed plasma cell infiltration. He then rapidly progressed to liver failure and died. Treatment options are limited in MM with significant liver dysfunction. Despite new drug therapies in MM, those patients with rapidly progressive liver failure appear to have a dismal outcome.展开更多
Objective To study the significance and distribution of renal infiltrating cells, including monocytes (CD68+ cells), proliferative cell nuclear antigen positive cells (PCNA+ cells), CD4+ and CD8+ cells in diffuse cres...Objective To study the significance and distribution of renal infiltrating cells, including monocytes (CD68+ cells), proliferative cell nuclear antigen positive cells (PCNA+ cells), CD4+ and CD8+ cells in diffuse crescent glomerulonephritis (DCGN). Methods Fifty-six patients with DCGN were studied, including 10 cases of anti-glomerular basement membrane (GBM)-type Ⅰ DCGN, 26 immune complex-type Ⅱ DCGN, and 20 cases of pauci-immune-type Ⅲ DCGN. Glomerular and interstitial infiltrates of CD68+ and PCNA+ cells, and interstitial infiltrates of CD4+ and CD8+ cells were detected by using four-layer PAP methods. Results There was a significant increase of renal infiltrating CD68+, PCNA+, CD4+ and CD8+ cells in patients with DCGN compared with that in normal controls. In patients with type Ⅰ DCGN, there was a higher number of renal infiltrating CD68+ and PCNA+ cells than that in patients with type Ⅱ and Ⅲ DCGN. A glomerular infiltrates of CD68+ and PCNA+ cells correlated with the interstitial infiltrates of CD4+ cells in type Ⅰ or Ⅲ DCGN patients. In lupus DCGN patients, the numbers of renal infiltrating CD68+ and PCNA+ cells were similar to vasculitis or type Ⅲ DCGN patients.Conclusion These findings demonstrate that the renal infiltrates of CD68+ and PCNA+ cells play an important role in patients with DCGN, that the infiltrates of CD4+ cells correlate with the infiltrates of CD68+ and PCNA+ cells may be an active marker of DCGN, and that cell-mediated immunity may contribute to crescent formation in lupus DCGN patients.展开更多
文摘KIDNEY involvement is common in non-Hodgkin＇s lymphoma （NHL） with incidence up to 30%-40% in autopsy studies. However, it us- ually occurs late in the course of the diseaseand is clinically silent. Clinically overt renal disease including acute kidney injury （AKI） as its primary manifestation is rarely reported, moreover, Fanconi syndrome （FS） is extremely rare as the main manifestation in NHL. In this report, we presented a case of NHL primarily presenting with FS and AKI due to diffuse interstitial infiltration of NHL cells and emphasized the important role of renal biopsy, especially renal immunohistochemical analysis in the diagnosis of renal diffuse lymphoma.
文摘Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma （MM）, it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stageⅡB. Thalidomide and dexamethasone were initiated. The patient developed a continuous increase in bilirubin that led to severe cholestasis. A liver biopsy revealed plasma cell infiltration. He then rapidly progressed to liver failure and died. Treatment options are limited in MM with significant liver dysfunction. Despite new drug therapies in MM, those patients with rapidly progressive liver failure appear to have a dismal outcome.
文摘Objective To study the significance and distribution of renal infiltrating cells, including monocytes (CD68+ cells), proliferative cell nuclear antigen positive cells (PCNA+ cells), CD4+ and CD8+ cells in diffuse crescent glomerulonephritis (DCGN). Methods Fifty-six patients with DCGN were studied, including 10 cases of anti-glomerular basement membrane (GBM)-type Ⅰ DCGN, 26 immune complex-type Ⅱ DCGN, and 20 cases of pauci-immune-type Ⅲ DCGN. Glomerular and interstitial infiltrates of CD68+ and PCNA+ cells, and interstitial infiltrates of CD4+ and CD8+ cells were detected by using four-layer PAP methods. Results There was a significant increase of renal infiltrating CD68+, PCNA+, CD4+ and CD8+ cells in patients with DCGN compared with that in normal controls. In patients with type Ⅰ DCGN, there was a higher number of renal infiltrating CD68+ and PCNA+ cells than that in patients with type Ⅱ and Ⅲ DCGN. A glomerular infiltrates of CD68+ and PCNA+ cells correlated with the interstitial infiltrates of CD4+ cells in type Ⅰ or Ⅲ DCGN patients. In lupus DCGN patients, the numbers of renal infiltrating CD68+ and PCNA+ cells were similar to vasculitis or type Ⅲ DCGN patients.Conclusion These findings demonstrate that the renal infiltrates of CD68+ and PCNA+ cells play an important role in patients with DCGN, that the infiltrates of CD4+ cells correlate with the infiltrates of CD68+ and PCNA+ cells may be an active marker of DCGN, and that cell-mediated immunity may contribute to crescent formation in lupus DCGN patients.
