Renal Lymphomas
Yimin Ge, MD
Jun Zhang, MD, MS
Key Facts
Clinical Issues
PRL accounts for 0.7% of all extranodal lymphomas, including Hodgkin and non-Hodgkin lymphomas
SRL is 30x more common than PRL
Cytopathology
Hypercellular aspirate
Dispersed and uniform population of lymphocytes with scant cytoplasm
Nuclear atypia varies with lymphoma types
Lymphoglandular bodies in background
Top Differential Diagnoses
Infection and inflammation
Primary or metastatic tumors
Diagnostic Checklist
Key to correct diagnosis is to recognize individual atypical lymphocytes and lymphoglandular bodies
Specimen should be prioritized for flow cytometry
 (A) Diff-Quik-stained fine-needle aspiration of a renal follicular lymphoma shows medium-sized cells with irregular or cleaved nuclei  and lymphoglandular bodies in the background  . (B) Pap-stained small lymphocytic lymphoma shows monotonous population of slightly enlarged lymphocytes with coarse chromatin. (C) Diff-Quik-stained diffuse large B-cell lymphoma demonstrates large lymphocytes with pronounced nuclear irregularity  and pleomorphism. (D) Immunostain for cyclin-D1 shows diffuse nuclear stain in a renal mantle cell lymphoma on cell block. |
CLINICAL ISSUES
Epidemiology
Incidence
Primary renal lymphoma (PRL) accounts for 1% of all renal lesions and 0.7% of all extranodal lymphomas
< 100 cases of PRL were reported, including Hodgkin and non-Hodgkin lymphomas
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