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      Renal Involvement of Non-Hodgkin’s Lymphoma and Its Prognostic Effect in Childhood

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          Objective: To evaluate renal involvement in childhood lymphoma and define its prognostic effects. Patients and Methods: One hundred and four patients with non-Hodgkin’s lymphoma and renal involvement on admission to a single center between 1972 and 2003 were evaluated retrospectively. Blood urea nitrogen, serum creatinine, uric acid, electrolytes, and lactate dehydrogenase levels, as well as urinalysis, were evaluated. One or more of the following imaging methods were performed: intravenous urogram, ultrasound, computed tomography, and magnetic resonance imaging. The χ<sup>2</sup> test was used to compare the groups. The Kaplan-Meier survival method was used to calculate survival rates, and the log-rank test was used to compare groups with respect to survival. Survival rates were also compared in two different time periods (before 1991 and after 1991). Results: There were 76 boys and 28 girls with a median age of 6 (0.9–16) years. The renal infiltration pattern was nodular in 62 patients (59.6%) and diffuse in 40 patients (38.5%). Two patients had tumoral masses that originated from their kidneys (1.9%). Renal involvement was bilateral in 75 patients (72.1%); the remaining 29 patients had unilateral involvement. The overall survival rate was 42.5% with a median follow-up of 64 months. The factors that had a statistically significant impact on survival were high creatinine (p = 0.00001) and blood urea nitrogen levels (p = 0.0001), the onset of tumor lysis syndrome (p = 0.01), and the need for dialysis (p = 0.009). The survival rate was higher in the time period after 1991 (p = 0.01). Conclusion: Impaired renal function is a poor prognostic factor for non-Hodgkin’s lymphoma. Renal function should therefore be monitored closely. Renal dysfunction caused by direct tumoral involvement may complicate therapy and shorten survival.

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          Most cited references 13

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          Renal lesions associated with malignant lymphomas.

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            Acute tumor lysis syndrome.

             A. Altman (2001)
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              Malignant lymphoma of the kidney.

               T Miki,  K Aozasa,  Y Hoshida (1997)
              Primary renal lymphoma (PRL) is a rare disease, making information including etiologic factors for PRL extremely limited. Clinical and pathologic findings of PRL in Japan are presented and compared with those from Western countries. The presence of Epstein-Barr virus (EBV) genomes in the tumor was also evaluated. Eight cases of PRL were collected from a review of the "Annual of the Pathological Autopsy Cases in Japan (1976-1992)". These cases fulfilled the following criteria: (1) presence of renal mass without extrarenal lymphomatous involvement at admission and (2) absence of a leukemic blood picture. For histologic and immunohistochemical studies, 10% formalin-fixed and paraffin-embedded histologic specimens were used. Presence of Epstein-Barr virus (EBV) genome was examined by polymerase chain reaction (PCR) and in situ hybridization (ISH). There were five males and three females; age at admission ranged from 15 to 79 years (median 57 yr). Abdominal and/or flank pain were the most common presenting symptoms. No particular past history was present in any of the patients. Histologically, tumor cells in all cases showed a diffuse pattern of proliferation: large cell type in six cases, mixed cell type and small lymphocytic type in 1 each. Immunohistochemistry revealed B-cell nature of lymphoma cells in all cases. Neither PCR nor ISH showed the presence of EBV genome in any cases. PRL is non-Hodgkin's lymphoma of predominantly large cell type with a B-cell immunophenotype. EBV etiology is unlikely in PRL.

                Author and article information

                Nephron Clin Pract
                Nephron Clinical Practice
                S. Karger AG
                July 2005
                15 April 2005
                : 100
                : 3
                : c86-c91
                aDepartment of Pediatric Oncology, Hacettepe University, Institute of Oncology; Departments of bPediatric Pathology and cRadiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
                85053 Nephron Clin Pract 2005;100:c86–c91
                © 2005 S. Karger AG, Basel

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