Malignant lymphoma is a malignant tumor that usually originates in the lymphoid tissues and lymph nodes but can affect almost any organ of the body. Although lymphomatous infiltration of the kidneys is a common finding at autopsy and has been
reported
in up to 53% of patients with lymphoma, it generally does not cause functional impairment but rarely cause acute renal failure as the initial manifestation. In patients with lymphoma, acute renal failure occur the cons3equence of urteral
obstruction due
to retroperitoneal nodal enlargement, hypercalcemia, hyperuricemia, and amyloidosis. However acute renal failure due to lymphomatous infiltration of the kidney is less common.
A33-year-old man was admitted to the hospital with high fever, bilateral flank pain, and oliguria of 3-day duration. On admission he was febrile with a blood pressure of 160/100 mmHg, and his conjunctiva was injected but cervical lymph nodes were
not
palpated. His breathing sound was decreased over the left lower lung field and his bilateal costovertebral areas were lung field and his bilateal costovertebral areas were tender. Laboratordy examination revealed WBC 21,900/㎣, Hb 12.0 g/dl Hct
34.9%,
and platelet 282,000/㎣. Serum Na was 144 mEq/L, K 6.3 mEq/L, Cl 100 mEq/L, Ca 7.9 mg/dl, BUN 73mg/dl, and creatinine 10.2 mg/dl. Urinalysis showed S. G of 1.010, occult blood 2+, glucose 1+, RBC many;/HPF, and WBC 7~10/HPF. Liver function test
was
normal except that total protein was 5.2 g/dl and albumin 2.3 g/dl. ?Cryoglobulin, RA factor, FANF, and AB to leptospira, HFRS, and scrup typhus were negative. The viral markers reveasled HBsAg negative, HBsAb positive, and Anti-HCV negative. The
chest
x-ray showed pleural effusion at the left lower lung field. The CT scan of the abdomen demonstrated bilateral enlarged kidneys and retroperitoneal lymphadenopathy without evidence of obstruction. A kidney biopsy revealed infiltration of the
parenchyma
by small, rounded lymphomatous cells. We report one case of malignant lymphoma presenting as acute renal failure in 33-year-old male patients with review of literature.
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