Glomerular lesions in lymphomas and leukemias.

Area of Science:

• Nephrology
• Hematology
• Oncology

Background:

• Renal lesions in lymphoid malignancies are rare but diverse.
• Minimal-change nephrotic syndrome is the most common renal manifestation.
• Other renal diseases are associated with specific lymphoid disorders.

Purpose of the Study:

• To review the spectrum of renal lesions in lymphoid malignancies.
• To discuss the proposed pathogenetic mechanisms.

Main Methods:

• Literature review of renal lesions in Hodgkin's disease, non-Hodgkin's lymphomas, and leukemias.
• Analysis of reported cases associated with atypical lymphoid proliferations.

Main Results:

• Minimal-change lesion observed in 0.4% of Hodgkin's disease patients; amyloidosis in 0.1%.
• Minimal-change nephrotic syndrome is frequent in non-Hodgkin's lymphomas and leukemias.
• Rare renal diseases reported with angioimmunoblastic lymphadenopathy, giant lymph node hyperplasia, and AIDS.

Conclusions:

• Pathogenesis of renal disease in lymphoid malignancies is complex and multifactorial.
• Proposed mechanisms include immune complex deposition, viral antigens, and T cell dysfunction.
• Further research is needed due to the rarity and sporadic nature of reported cases.