Primary renal diffuse large B cell lymphoma misdiagnosed as renal cell carcinoma
Xintong Li, Jia Li, Shijie Sun, Pintong HuangRationale:
Primary renal lymphoma (PRL) is a rare malignant lymphoma characterized by an extranodal presentation with limited or absent involvement of lymphatic channels. Its nonspecific clinical manifestations often make differentiation from renal cell carcinoma (RCC) challenging. This report describes a case of non-Hodgkin lymphoma initially diagnosed as RCC and subsequently confirmed as primary diffuse large B-cell lymphoma (DLBCL).
Patient concerns:
A 78-year-old man presented with right flank pain radiating to the abdomen for 2 weeks. Physical examination revealed no significant abnormalities.
Diagnoses:
Laboratory tests showed a mild elevation of lactate dehydrogenase (LDH) and positive urine occult blood. Imaging evaluations, including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), were suggestive of RCC. Contrast-enhanced ultrasonography further supported this initial impression.
Interventions:
Based on the suspicion of RCC, an ultrasound-guided renal needle biopsy was performed to establish the diagnosis.
Outcomes:
Histological Pathology: Histopathological analysis of the ultrasound-guided biopsy confirmed primary renal DLBCL.
Lessons:
This case underscores the importance of accurate diagnostic methods in oncology, particularly in distinguishing PRL from RCC, which can be challenging based on imaging alone. The findings demonstrate the utility of ultrasound-guided biopsy as a reliable diagnostic tool for primary renal lymphoma.