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Lymphocytic Leukemia (CLL and SLL)

T. David Bourne, MD renal pathologist and neuropathologist at arkana laboratories
By David Bourne, MD

Jun 21, 2017

Lymphocytic Leukemia (CLL and SLL)

This renal biopsy was taken from an 82-year-old man with acute renal failure and nephrotic range proteinuria. His past medical history included chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The biopsy shows an involvement of the renal cortex by a monomorphic population of small lymphoid cells, the morphology and immunophenotype of which were diagnostic of CLL/SLL. In addition, glomeruli showed a diffuse membranoproliferative glomerulonephritis (MPGN) pattern of injury with associated immune deposits. In a study by Da’as et al., more than 10% of patients with non-Hodgkin lymphoma developed acute renal failure. More recent work by Kowalewska et al. describes the spectrum of glomerular injury in patients with renal involvement by lymphoid neoplasms, including paraprotein-related disease, membranous glomerulopathy, and MPGN-pattern glomerulonephritis, which was observed in this biopsy.

Da’as N, Polliack A, Cohen Y, Amir G, Darmon D, Kleinman Y, Goldfarb AW, Ben-Yehuda D. Kidney involvement and renal manifestations in non-Hodgkin’s lymphoma and lymphocytic leukemia: a retrospective study in 700 patients. Eur J Haematol. 2001 Sep;67(3):158-64.

Kowalewska J, Nicosia RF, Smith KD, Kats A, Alpers CE. Patterns of glomerular injury in kidneys infiltrated by lymphoplasmacytic neoplasms. Hum Pathol. 2011 Jun;42(6):896-903.



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