미만성대형 B세포림프종의 좌측 신동맥 압박에 의한 급성 신부전 1예
A case of acute renal failure caused by extrinsic compression of the left renal artery in lymphoma
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미만성대형 B세포 림프종에 의한 급성 신부전으로, 복막강내 임파절에 의한 양측성 요관 폐쇄, 요도 및 콩팥 깔때기의 종양 침범, 종양 용해 증후군, 급성 세뇨관 괴사 혹은 림프종의 신침범 등이 종종 보고되어지고 있는데, 덩이 효과에 의한 신동맥의 직접적 압박으로 인한 급성신부전은 매우 드문 경우이다. 이에 저자들은 미만성대형 B세포 림프종이 진행됨에 따라 동반된 급성 신부전의 진단 및 치료 경과를 문헌과 같이 보고하는 바이다.
Abstract
Malignant lymphomas can involve any organ, but rarely cause acute renal failure as an initial manifestation. Impaired renal function secondary to renal arterial compression by a tumor mass has not been reported. A 50-year-old man was admitted with low back pain, weight loss, and a palpable abdominal mass. He developed non-oliguric acute renal failure secondary to extrinsic compression of the left renal artery by enlarged lymph nodes in the posterior wall of the pelvic cavity. Abdominal computed tomography (CT) showed the complete absence of perfusion of the left kidney due to extrinsic compression of the left renal artery by a huge diffuse large B cell lymphoma (stage IVa, International Prognostic Index score 3). We report a case of malignant lymphoma presenting as acute renal failure due to extrinsic compression of the left renal artery; this was treated successfully with systemic combination chemotherapy.
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