Extranodal Marginal Zone Lymphoma Presenting as Acute Kidney Injury due to Cast Nephropathy: A Case Report

Acute kidney injury (AKI) in non-Hodgkin lymphoma has diverse etiologies. We report a case in which AKI due to light chain cast nephropathy was the initial manifestation of extranodal marginal zone lymphoma, occurring without systemic symptoms. A 64-year-old male presented with severe AKI without ot...

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Main Authors: Naphasorn Naruemon, Piriyaporn Iamsai, Piyapong Ounpanyo, Boonyarit Cheunsuchon, Thanawat Vongchaiudomchoke
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Canadian Journal of Kidney Health and Disease
Online Access:https://doi.org/10.1177/20543581251338434
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author Naphasorn Naruemon
Piriyaporn Iamsai
Piyapong Ounpanyo
Boonyarit Cheunsuchon
Thanawat Vongchaiudomchoke
author_facet Naphasorn Naruemon
Piriyaporn Iamsai
Piyapong Ounpanyo
Boonyarit Cheunsuchon
Thanawat Vongchaiudomchoke
author_sort Naphasorn Naruemon
collection DOAJ
description Acute kidney injury (AKI) in non-Hodgkin lymphoma has diverse etiologies. We report a case in which AKI due to light chain cast nephropathy was the initial manifestation of extranodal marginal zone lymphoma, occurring without systemic symptoms. A 64-year-old male presented with severe AKI without other symptoms. His physical examination and renal ultrasound were unremarkable. Renal biopsy revealed light chain cast nephropathy, and a subsequent bone marrow biopsy confirmed marginal zone lymphoma. The patient received R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) for a total of six cycles. The patient had a partial response to lymphoma. However, his renal function did not improve, and ultimately he progressed to end-stage kidney disease, requiring maintenance hemodialysis. This case highlights extranodal marginal zone lymphoma presenting as AKI, emphasizing its unique renal-limited manifestation in the absence of systemic symptoms and the critical role of renal biopsy in diagnosing unexplained AKI.
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institution Kabale University
issn 2054-3581
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publishDate 2025-06-01
publisher SAGE Publishing
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series Canadian Journal of Kidney Health and Disease
spelling doaj-art-afdaea65da014ee19f9b831c8162bd402025-08-20T03:24:59ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812025-06-011210.1177/20543581251338434Extranodal Marginal Zone Lymphoma Presenting as Acute Kidney Injury due to Cast Nephropathy: A Case ReportNaphasorn Naruemon0Piriyaporn Iamsai1Piyapong Ounpanyo2Boonyarit Cheunsuchon3Thanawat Vongchaiudomchoke4Department of Internal Medicine, Lampang Hospital, Lampang, ThailandDepartment of Internal Medicine, Lampang Hospital, Lampang, ThailandDepartment of Anatomical Pathology, Lampang Hospital, Lampang, ThailandDivision of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Internal Medicine, Lampang Hospital, Lampang, ThailandAcute kidney injury (AKI) in non-Hodgkin lymphoma has diverse etiologies. We report a case in which AKI due to light chain cast nephropathy was the initial manifestation of extranodal marginal zone lymphoma, occurring without systemic symptoms. A 64-year-old male presented with severe AKI without other symptoms. His physical examination and renal ultrasound were unremarkable. Renal biopsy revealed light chain cast nephropathy, and a subsequent bone marrow biopsy confirmed marginal zone lymphoma. The patient received R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) for a total of six cycles. The patient had a partial response to lymphoma. However, his renal function did not improve, and ultimately he progressed to end-stage kidney disease, requiring maintenance hemodialysis. This case highlights extranodal marginal zone lymphoma presenting as AKI, emphasizing its unique renal-limited manifestation in the absence of systemic symptoms and the critical role of renal biopsy in diagnosing unexplained AKI.https://doi.org/10.1177/20543581251338434
spellingShingle Naphasorn Naruemon
Piriyaporn Iamsai
Piyapong Ounpanyo
Boonyarit Cheunsuchon
Thanawat Vongchaiudomchoke
Extranodal Marginal Zone Lymphoma Presenting as Acute Kidney Injury due to Cast Nephropathy: A Case Report
Canadian Journal of Kidney Health and Disease
title Extranodal Marginal Zone Lymphoma Presenting as Acute Kidney Injury due to Cast Nephropathy: A Case Report
title_full Extranodal Marginal Zone Lymphoma Presenting as Acute Kidney Injury due to Cast Nephropathy: A Case Report
title_fullStr Extranodal Marginal Zone Lymphoma Presenting as Acute Kidney Injury due to Cast Nephropathy: A Case Report
title_full_unstemmed Extranodal Marginal Zone Lymphoma Presenting as Acute Kidney Injury due to Cast Nephropathy: A Case Report
title_short Extranodal Marginal Zone Lymphoma Presenting as Acute Kidney Injury due to Cast Nephropathy: A Case Report
title_sort extranodal marginal zone lymphoma presenting as acute kidney injury due to cast nephropathy a case report
url https://doi.org/10.1177/20543581251338434
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