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Kidney-limited intravascular large B cell lymphoma: a distinct variant of IVLBCL?

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Abstract

Intravascular large B cell lymphoma (IVLBCL) is a rare type of non-Hodgkin lymphoma characterized by a disseminated intravascular proliferation of tumor cells in the lumina of small vessels. Although the kidney is one of the target organs of IVLBCL, it is extremely rare that lymphoma cells are localized only in the kidney. We report here a Japanese patient with kidney-limited IVLBCL. The patient presented with mild proteinuria and a good performance status without B symptoms at presentation. A renal biopsy showed large B cell neoplastic lymphocytes in the glomerular capillary lumina. Extensive systemic examinations showed no other organ involvement. The patient responded well to rituximab and anthracycline-based chemotherapy. A follow-up renal biopsy showed the disappearance of intraglomerular lymphoma cells with restoration of glomerular architecture. Within 20 months past the discontinuation of chemotherapy, no evidence of recurrence was observed. Although IVLBCL is commonly a fatal disease, favorable clinical courses were reported in some cases of IVLBCL, such as the cutaneous variant. To our knowledge, there are 8 reported cases of kidney-limited IVLBCL in the English literature. All 4 patients treated with intensive chemotherapy responded well to the treatment as our patient. We suggest that kidney-limited IVLBCL might be a distinct variant of IVLBCL.

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Acknowledgments

The authors are grateful to Dr. Kazuhiro Nishikawa (Aichi Medical University), Dr. Tetsuro Kusaba (Nantan Hospital), and Dr. Naoki Sawa (Toranomon Hospital) for providing information about their patients.

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Authors and Affiliations

  1. Third Department of Internal Medicine, Akita University School of Medicine, 1-1-1 Hondo, Akita City, Akita, 010-8543, Japan

    Yoshihiro Kameoka, Naoto Takahashi, Atsushi Komatsuda, Hiroyuki Tagawa, Makoto Hirokawa, Hideki Wakui & Ken-ichi Sawada

  2. Department of Internal Medicine, Nakadori General Hospital, Akita, Japan

    Keiko Hamai

  3. Department of Hematopathology, Tohoku University Graduate School of Medicine, Sendai, Japan

    Ryo Ichinohasama

Authors
  1. Yoshihiro Kameoka
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  2. Naoto Takahashi
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  3. Atsushi Komatsuda
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  4. Hiroyuki Tagawa
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  5. Keiko Hamai
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  6. Makoto Hirokawa
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  7. Hideki Wakui
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  8. Ryo Ichinohasama
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  9. Ken-ichi Sawada
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Correspondence to Yoshihiro Kameoka.

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Kameoka, Y., Takahashi, N., Komatsuda, A. et al. Kidney-limited intravascular large B cell lymphoma: a distinct variant of IVLBCL?. Int J Hematol 89, 533–537 (2009). https://doi.org/10.1007/s12185-009-0294-5

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  • DOI: https://doi.org/10.1007/s12185-009-0294-5

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