Renal Lymphoma: Treatment and Prognosis

This entry looks renal lymphoma, also known as primary renal lymphoma (PRL), one of the subtypes of lymphoma. 'Lymphoma' is an umbrella term that loosely refers to several dozen independent categorical types and subtypes of cancers of the lymphatic system.

What is Renal Lymphoma?

Renal lymphoma is defined as:

a non-Hodgkin's lymphoma arising primarily in the functional areas of the kidney (renal parenchyma), not resulting from invasion of an adjacent node or lymphomatous mass.

It is usually a B-cell lymphoma. If the lymphoma were a result of invasion from the adjacent nodes, we would call it lymphoma with renal involvement, or secondary renal lymphoma. But when it is clear that the lymphoma is originating as a kidney tumor, then it is called primary renal lymphoma (PRL).

It is much more common for kidneys to be an involved extra-nodal organ site in other lymphomas; perhaps just 3 to 8 percent of the time that the kidney is involved in lymphomas, it is a PRL.

In lymphoma circles, PRL is considered a controversial disease, meaning that not everyone agrees that it exists, since the kidneys are not lymphoid organs. In most cases, renal cell carcinoma is much more likely. Nonetheless, cases of PRL continue to be reported, although the disease is extremely, extremely rare.

What are the Symptoms of Renal Lymphoma?

Signs and symptoms of PRL are generally non-specific, meaning they could indicate many things, not just PRL. A person could experience flank pain or kidney pain as well as poor kidney functioning. Additionally, it's possible for a person with PRL to experience so-called B symptoms, such as unexplained weight loss, fatigue, and drenching night sweats, to name just a couple.

Treatment and Prognosis for Renal Lymphoma

PRL has been documented as a very aggressive disease, and in many cases, the mean survival time from diagnosis comes out to around a year. In other words, in the rare instances when PRL is diagnosed, it requires immediate therapeutic intervention, which is generally CHOP combination chemotherapy. The efficacy of Rituxan remains under investigation.

Sources

• Pervez H et al. Uncommon Presentations of Non-Hodgkin's Lymphoma. Case 3. PRL JCO vol. 21no. 3 567-569.
• Pinggera GM et al. A possible case of primary renal lymphoma: a case report. Cases Journal, 2:6233

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