Wednesday, January 12, 2011


What is the most prevalent renal lesion in systemic lymphomas? Here is what you all said: 
Minimal Change Disease  27%
Lymphamatous Infiltration 11%
Immunotactoid GN 3%

Amyloidosis 9%
Fibrillary GN 5%
Membranous GN 41%

Hmm.. tough question I guess. Associations of lot of glomerular diseases have been seen with cancer. Cancer can be solid tumors or blood tumors like lymphomas and leukemias. In the largest autopsy case series performed on lymphoma patients, 34% showed parenchymal involvement hence lymphoma in the kidney making choice number 2 the most correct answer.  Surprisingly, we only diagnosed it 14% of the time before death.  This might be due to lack of physical findings, proteinuria or any signs or clues to point towards that.  Bilateral enlargement of the kidneys and enhancement on US might be a clue and proteinuria can be seen.
If you had to pick a glomerular disease most associated with lymphoma:- it is Minimal change disease, in about 40% of the cases, primarily Hodgkin's Lymphoma( perhaps a permeability factor that is paraneoplastic in nature)
Monoclonal Immunoglobulin Deposition ( light or heavy chain), amyloidosis and Immunotactoid GN are rare but follow next in autopsy series of cases.
Membranous GN is less common in lymphomatous GN but more common in solid malignancies.  There are cases of Membranous GN and MPGN but rare case reports in Lymphomas.  

A nice review is listed below:

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