PRIMER DİFFÜZ BÖBREK TUTULUMU ILE PREZENTE OLAN BİR MALT LENFOMA
Marjinal zon lenfomada (MZL) böbreğin tutulumu sık görülen bir durum değildir. Yetmiş yedi yaşında kadın hasta böbrek yetmezliği şikayeti ile kliniğe başvurdu. Böbrek biyopsisinde normal böbrek dokusunun yerini alan diffüz lenfoid infiltrasyon saptandı. İmmünohistokimyasal boyamada CD20, CD38, kappa, IgD pozitif ve CD3, lamda, siklin D1, CD5, CD23, CD43, lambda negatif bulundu. Ki-67 %10 pozitifti. Hastaya MALT tip MZL tanısı konuldu. Evreleme için yapılan vücut 18-Fluorodeoksiglukoz pozitron emisyon tomografi/bilgisayarlı tomografi (18F-FDG PET/CT) her iki böbrekte yaygın FDG tutulumu göstermekteydi, lenfadenopati saptanmadı. Kemik iliği aspirasyonu ve biyopsisi normaldi. Rituximab-bendamustin kemoterapi rejimi başlandı. Sonuç olarak, bu olgu böbreği diffüz olarak tutan ilk MALT lenfoma olgusudur ve böbrek fonksiyonlarının geri dönüşümsüz kaybını önlemek için hızlı tanı ve tedavi gerekmektedir.
A MALT LYMPHOMA PRESENTING WITH PRIMARY DIFFUSE RENAL INVOLVEMENT
The involvement of kidney in marginal zone lymphoma (MZL) is not a frequent condition. Seventy-seven year old female presented with renal failure. Renal biopsy revealed diffuse lymphoid infiltration replacing the normal renal tissue. Immunohistochemical staining was CD20, CD38, kappa, IgD positive and CD3, lamda, cyclin D1, CD5, CD23, CD43, lambda negative. Ki-67 was 10% positive. The patient was diagnosed as MALT type MZL. Body 18Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed for staging revealed diffuse FDG uptake in both kidneys and no lymphadenopathy was detected. Bone marrow aspiration and biopsy were normal. Rituximab-bendamustin chemotherpy regimen was started. In conclusion, this is the first case of MALT lymphoma involving kidney diffusely which requires rapid diagnosis and treatment to prevent irreversible loss of renal functions.
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