Renal involvement in non-Hodgkin's lymphoma: the Shaukat Khanum experience

Primary lymphoma of genitourinary system is rare as these organs do not contain lymphoid tissue, however secondary involvement often occurs. The most commonly affected genitourinary organ is the kidney.

Medical records of 901 patients with documented NHL seen at Shaukat Khanum Memorial Cancer Hospital & Research Center during 1995-2003 were studied for the incidence, histopathological, clinical and radiological correlation of renal involvement in NHL.

19(2.1%) patients had renal involvement. Male to female ratio was 3.75:1. Histology was diffuse large cell lymphoma in 12(63%) patients. IPI was High, High intermediate and Low intermediate in 17(89.5%) patients. Radiologically, 5(26.5%) patients had the disease above the diaphragm, 2(10.5%) patients had disease below the diaphragm while 12(63%) had disease on both sides of the diaphragm. 11(58%) showed complete response, 1(5.5%) showed partial response while 7(36.8%) showed progressive disease.

Majority of patients with renal involvement had low intermediate or higher IPI compatible with significant progression rate. The findings and disease behavior in our population is comparable to those quoted in English literature. Radiological tools have made it easier to monitor disease response and renal biopsy is seldom required.