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Kidney Week

Abstract: FR-PO692

Primary Large B Cell Lymphoma Mimicking Renal Cell Carcinoma

Session Information

Category: Trainee Case Report

  • 1500 Onco-Nephrology


  • Reddy, Prashanth, Medical City Fort Worth, Fort Worth, Texas, United States
  • Viswanathan, Sahityan, Medical City Fort Worth, Fort Worth, Texas, United States

Primary renal lymphoma is extremely rare and accounts for less than 1% of all kidney tumors. The prognosis is poor and the median survival is less than a year. It is extremely difficult to differentiate between renal cell carcinoma and primary renal lymphoma on initial imaging without biopsy. Primary renal lymphoma is a debated topic due to the kidneys not containing any lymphatic tissue.[1] Here we present a 81 yo CF who presented with nonspecific abdominal finding and was eventually diagnosed with a rare primary diffuse large B-cell lymphoma on CT guided biopsy.

Case Description

An 81 year-old- CF with PMHx of HTN, HLD presented with insidious onset dull epigastric dull and right sided abdominal pain. The pain was nonradiating, and nothing made it better or worst. It was associated with nausea, dry heaving, loss of appetite and weight loss. Otherwise ROS were negative. Vital signs were within normal range. Physical exam was unremarkable except minimal tenderness on palpation in the epigastric area and the right abdomen. A CBC was unremarkable, CMP was suggestive of AKI. Persistent nagging abdominal pain resulted in a CT abdomen and pelvis with contrast that was suggestive of renal mass with encasement of the IVC. She underwent CT guided renal biopsy instead of resection due to high risk of surgical removal that came back positive for a rare primary diffuse non hodgkin's B cell lymphoma. Her metastasis workup was negative. Oncology and the surgical team were consulted for further management.


Primary Diffuse large B cell lymphoma of kidney is infrequent and management is completely different than RCC but needs renal biopsy to diagnose. With better technique and advancement in minimally invasive renal biopsy there is now a low complication rate. The use of percutaneous renal mass biopsy has expanded considerably in the last decade making it easier to differentiate between primary vs. secondary renal malignancy. We postulate that this advancement would stratify the malignant risk which could help in decreasing the number of needless extirpative therapies like nephrectomy.