Acute kidney injury and cardiac arrhythmia as the presenting features of widespread diffuse large B-cell lymphoma

Diffuse Large B-cell Lymphoma, the most common adult non-Hodgkin lymphoma, is a proliferative neoplasm of enlarged B cells. Patients may be asymptomatic on presentation, but if present, symptoms often correlate with direct organ dysfunction resulting from the site of involvement. While the gastrointestinal system is the most common site of extranodal involvement, virtually any part of the body can be infiltrated by malignant lymphocytes. Here, we present an unusual case of cardiac and bilateral renal involvement by Diffuse Large B-cell Lymphoma in a 78-year-old male with a relatively unremarkable medical history. This combination of organ involvement and the resulting clinical symptoms are uncommonly described in the literature. The patient was treated for his symptoms prior to death, but the underlying cause that explained his presentation was not identified until performance of an autopsy. As such, this case demonstrates the utility of the medical autopsy, a gold standard in diagnostic medicine that can provide a variety of benefits in today's healthcare system.