Monday, May 18, 2015

NK cell leukemia and lymphomas and renal disease

NK cell neoplasms have a wide range of clinical, morphologic, and immunophenotypic characteristics. Aggressive NK cell leukemia usually affects young patients in their 20-30s with equal sex incidence and shows a rapidly progressive clinical course.  Often they don’t respond well to chemotherapy and prognosis is poor.

Kidney involvement in these cancers is rare but here is what I found?
One case report of a collapsing FSGS published in AJKD in 2011. Initially, in this case, the first biopsy was read as FSGS NOS and then a repeat one had collapsing glomerulopathy.
Another recent case series describes cases of renal diseases seen with all types of non-Hodgkin’s lymphoma.  They describe 20 cases. T/NK cell lymphoma was in 4 cases. 2 of the 4 cases had crescentic GN, 1 had minimal change disease and 1 had infiltrative disease

A very early description of minimal change disease has been described in a case report in 1980s of a large granular cell lymphoma.

So in summary, NK cell neoplasms likely are related to cause some glomerular involvement-likely podocytopathies such as minimal change to FSGS. Cases of crescentic GN have also been described.

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