|Year : 2022 | Volume
| Issue : 3 | Page : 299-300
A rare case of massive bilateral renomegaly due to primary involvement by mantle cell lymphoma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography
Ritanshu Solanki1, Anwin Joseph Kavanal1, Harmandeep Singh1, Rajender Kumar1, Gaurav Prakash2
1 Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Clinical Hematology and Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
|Date of Submission||04-Mar-2022|
|Date of Acceptance||04-Apr-2022|
|Date of Web Publication||02-Nov-2022|
Dr. Rajender Kumar
Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Mantle cell lymphoma (MCL) is a rare subtype of B-cell non-Hodgkin's lymphoma with an annual incidence of 5%, common in men with a median age of 60–70 years. Renal involvement is seen in about 0.7% of the extranodal lymphomas. The bilateral presentation is seen in 10%–20% of cases. There have been many case reports of MCL with renal involvement; however, primary renal involvement by MCL is extremely rare. We hereby describe the 18F-fluorodeoxyglucose positron emission tomography/computed tomographic findings in primary MCL involving the bilateral kidneys.
Keywords: 18F-Fluorodeoxyglucose positron emission tomography/computed tomography, Mantle cell lymphoma, renal involvement
|How to cite this article:|
Solanki R, Kavanal AJ, Singh H, Kumar R, Prakash G. A rare case of massive bilateral renomegaly due to primary involvement by mantle cell lymphoma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Indian J Nucl Med 2022;37:299-300
|How to cite this URL:|
Solanki R, Kavanal AJ, Singh H, Kumar R, Prakash G. A rare case of massive bilateral renomegaly due to primary involvement by mantle cell lymphoma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Indian J Nucl Med [serial online] 2022 [cited 2022 Nov 29];37:299-300. Available from: https://www.ijnm.in/text.asp?2022/37/3/299/360262
A 62-year-old man was found to have raised serum urea and creatinine levels on a routine check-up. On further clinical examination, he had enlarged cervical and inguinal lymph nodes. In view of raised serum urea and creatine levels, ultrasonography (USG) of the abdomen was done, which demonstrated grossly enlarged bilateral kidneys. A USG-guided core needle biopsy from the kidney revealed Mantle cell lymphoma (MCL), which was diffusely positive for CD20, SOX11, cyclin D1, and Ki67 (5%–10%) and correlated with (11;14) translocation CCND1 expression.
He underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging workup. The maximum intensity projection image [Figure 1]a, coronal fused PET/CT image [Figure 1]b, and coronal CT image [Figure 1]c revealed FDG avid lymph nodes on both sides of the diaphragm [dashed arrows in [Figure 1]a] and FDG avid bilateral grossly enlarged kidneys [solid arrows in [Figure 1]a] showing FDG uptake in the massively enlarged kidneys (right kidney ~21.5 cm × 11.9 cm, maximum standard uptake value [SUV max] 5.5 and left kidney ~20.5 cm × 12.0 cm, SUV max 5.9).
|Figure 1: The maximum intensity projection image of FDG PET/CT (a), coronal fused PET/CT image (b) and coronal CT image (c) revealed FDG avid lymph nodes on both sides of the diaphragm (dashed arrows in [Figure 1]a) and FDG avid bilateral grossly enlarged kidneys (solid arrows in [Figure 1]a) showing FDG uptake in the massively enlarged kidneys (right kidney ~21.5 x 11.9 cm, SUV max 5.5 and left kidney~20.5 x 12.0 cm, SUV max 5.9)|
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MCL is a rare subtype of B-cell non-Hodgkin's lymphoma, having an incidence of 5% with renal involvement of 0.7% and the bilateral presentation of 10%–20% of the cases. MCL is a rare disease arising from mature B-lymphocytes and generally involves lymph nodes with common extranodal involvement, bone marrow, spleen, gastrointestinal tract, and Waldeyer ring. Renal involvement of MCL is very rare and usually presents as acute kidney injury due to proliferative glomerulonephritis, focal segmental glomerulosclerosis, or tubulointerstitial nephritis with mildly enlarged kidneys.,,, The usefulness of FDG/PET in MCL was well established in the literature, with pretreatment PET scans being positive in 94%–100%., The positivity for SOX11, a specific MCL marker, correlates with (11;14) translocation, CCND1 expression, and an adverse prognosis. Primary MCL involving bilateral kidneys is extremely rare. The present case highlights the 18F-FDG-PET/CT findings in a rare case of primary MCL involvement of bilateral kidneys.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
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