China Oncology ›› 2017, Vol. 27 ›› Issue (7): 581-587.doi: 10.19401/j.cnki.1007-3639.2017.07.010

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Diagnosis and treatment of primary renal lymphoma: an analysis of 61 cases

LI Zeng, LIAO Hong, TAN Zheng, MAO Dun, WU Yi, XIAO Yingming, YANG Shengke, ZHONG Lei   

  1. Department of Urology, Sichuan Cancer Hospital, Chengdu 610041, Sichuan Province, China
  • Online:2017-07-30 Published:2017-08-16
  • Contact: LIAO Hong E-mail: liaohong131@163.com

Abstract: Background and purpose: Primary renal lymphoma (PRL) is rare in clinic, difficult to diagnose preoperatively and easily misdiagnosed as renal cancer. We investigated the clinical pathological characteristics and treatment as well as prognosis of PRL.. Methods: Clinical data from 61 cases of PRL domestic case reports (1981—2014) were obtained and analysed retrospectively. Results: Of the 61 patients, 34 cases (55.7%) were men, 27 cases (44.3%) were women, the ratio was 1.3∶1.0. The age of onset was between 3 and 84 years with high incidence among patients aged 50 to 70 years, and the average age was 52.3 years. Unilateral lesions were found in 53 cases (86.9%), of which the left kidney in 34 cases (64.2%), 19 cases (35.8%) of the right kidney. Bilateral lesions were found in 8 cases (13.1%). The signs and symptoms of PRL included back pain in 45 cases (73.8%), fever in 17 cases (27.9%), hematuria in 8 cases (13.1%), acute renal failure in 2 cases (3.3%). There were 58 cases (95.1%) of non-Hodgkin’s lymphoma (NHL), accounting for the vast majority, of which B cell lymphoma (BCL) in 48 cases (82.6%), T cell lymphoma (TCL) in 5 cases (8.7%), not clear in 5 cases (8.7%). Diffuse large B-cell lymphoma (DLBCL) was the most common type (28 cases, 58.3%). A total of 47 cases (77.0%) underwent surgery, 48 cases (78.7%) received chemotherapy (14 cases of simple chemotherapy, 34 cases of postoperative adjuvant chemotherapy), 9 cases (14.8%) underwent radiotherapy. One case (1.6%) was lost to follow-up, and prognosis was not mentioned in 3 cases (4.9%). There were 34 cases (55.7%) in stable condition and survival, 23 cases (37.7%) had recurrence and progression, 4 cases (6.6%) achieved remission after retreatment, and 19 cases (31.1%) died at last. Conclusion: PRL is a rare tumor with higher malignancy, poorer prognosis as well as easy to misdiagnosis. Radical nephrectomy among patients with early-stage PLR combined with postoperative chemotherapy and other comprehensive treatment, could help to reduce recurrence and improve the prognosis of the disease.

Key words: Kidney neoplasms, Lymphoma, Clinical characteristics, Retrospective studies