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Currently filtering by tag: Intravascular lymphoma

A Case of an Unlucky Strike

ANCA Disease, LECT2 Amyloid, IgG4-Related Disease, AL amyloidosis, ANCA, digging deeper, Dr. Messias, Arkana Laboratories, pathology diseases
This biopsy was from a 57-year-old African American female patient. She presented with a gradual increase in serum creatinine over the course of 5 months. Initially, her baseline serum creatinine was 1.3 mg/dl but two months later it increased to 2.0 mg/dl. And, at the time of the biopsy, an additional 3 months later, her serum creatinine was as high as 4.4 mg/dl. During her workup, she was found to have nephrotic syndrome with proteinuria quantified at 8 gm/24hr, a serum albumin of 1.3 g/dL, and ascites.  Concerning previous medical history, the patient had a diagnosis of stage II colon...

Pushing Glass (March 13, 2018)

intravascular diffuse large B-cell lymphoma, arkana laboratories, pushing glass, renal pathology
A 65-year-old male presents with mild proteinuria and a sudden increase in creatinine. He was recently diagnosed with widely metastatic gastric carcinoma and has received 4 rounds of chemotherapy. During treatment with chemotherapy, his creatinine increased to 3.5 and has remained at that level despite fluid resuscitation. A kidney biopsy is performed. What is the best diagnosis? A. Membranoproliferative Glomerulonephritis B. Metastatic Gastric Carcinoma C. Intravascular Diffuse Large B-Cell Lymphoma D. Thrombotic Microangiopathy The best answer is C – Intravascular Diffuse Large B-Cell Lymphoma This is a very difficult case due to the proliferative nature of the glomeruli. At first...

Intravascular Large B Cell Lymphoma

Intravascular Large B Cell Lymphoma, stained positive for CD20
A 75-year-old woman presented for her annual checkup with no complaints. She had a past medical history of hypertension and her blood pressure at this visit was 160/80. Laboratory findings were significant for an elevated serum creatinine at 2.1 mg/dL (baseline 1.0 mg/dL) as well as proteinuria of 855 mg/24 hr. All serologies, including proteinase-3, myeloperoxidase, and anti-nuclear antibodies were negative. A kidney biopsy was performed to evaluate the decreased kidney function and proteinuria. It revealed a total of five glomeruli were present, three of which showed a global endocapillary proliferation of large atypical cells with frequent mitotic figures (Photomicrographs...