Diagnostic histologique de lymphome intravasculaire guidé par une hyperfixation corticale rénale à la tomographie par émission de positons : à propos d’un cas |
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| Institution: | 1. Service de néphrologie et médecine interne, centre hospitalier de Valenciennes, avenue Désandrouin, 59322 Valenciennes cedex, France;2. Service d’anatomie et cytopathologie, centre hospitalier régional et universitaire de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France;3. Service de médecine nucléaire, centre hospitalier de Valenciennes, avenue Désandrouin, 59322 Valenciennes cedex, France;4. Service d’hématologie, centre hospitalier de Valenciennes, avenue Désandrouin, 59322 Valenciennes cedex, France;1. Service de pneumologie, hôpital Louis-Pradel, hospices civils de Lyon, Centre national de référence des maladies pulmonaires rares, université Claude-Bernard – Lyon 1, 28, avenue Doyen-Lepine, 69677 Lyon, France;2. Laboratoire d’immunologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France;3. Cabinet de pneumologie, 60, avenue de Jasseron, 01000 Bourg-en-Bresse, France;1. Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast;2. Free University of Brussels, Brussels, Belgium;3. Free University of Tunis, Charles Nicolle Hospital, Tunis, Tunisia;4. Novartis Pharmaceuticals, Regional Office, Abidjan, Ivory Coast;1. Laboratoire d’anatomie et de cytologie pathologiques de l’hôpital Aristide-Le-Dantec, pavillon Bichat, avenue Pasteur, BP 3001, Dakar, Sénégal;2. Service d’ORL et de CCF de l’hôpital régional de Ziguinchor, BP 535, Ziguinchor, Sénégal;3. Laboratoire d’anatomie et de cytologie pathologiques de l’hôpital régional de Troyes, hôpital général de Troyes, 101, avenue Anatole-France, 10000 Troyes, France;1. Service de dermatologie, clinique dermatologique, hôpital Civil, CHU, hôpitaux universitaires de Strasbourg, 1, place de l’Hôpital, 67091 Strasbourg cedex, France;2. Cabinet de dermatologie, 87, avenue des Vosges, 67000 Strasbourg, France;1. Pôle de gérontologie clinique, hôpital Xavier-Arnozan, CHU de Bordeaux, avenue du Haut-Lévêque, 33000 Bordeaux, France;2. Association pour l’utilisation du rein artificiel à domicile (AURAD) d’Aquitaine, 2, allée des Demoiselles, 33170 Gradignan, France;3. Département de néphrologie, transplantation, dialyse, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France |
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| Abstract: | Intravascular large B cell lymphoma is a rare non-Hodgkin large B cell lymphoma disease, with heterogeneous clinical manifestation and difficult pathological diagnosis. Positron emission tomography may be helpfull in this context and has already been reported. A 45-year-old woman was admitted for persistent high fever, inflammatory syndrome and unexplained haemophagocytic syndrome. Bilateral cortical renal hypermetabolism at positron emission tomography initially misled to pyelonephritis diagnosis and secondarily led to kidney biopsy, which showed intravascular large B cell lymphoma. Renal involvement in intravascular large B cell lymphoma is rare and is usually characterized by acute renal failure and proteinuria. Global hypermetabolism at positron emission tomography has already been described in this context, but cortical hypermetabolism has never been associated with pathological findings. In front of persistent high fever without etiology, this positron emission tomography feature must lead to intravascular large B cell lymphoma suspicion and to kidney biopsy to obtain pathological proof. |
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| Keywords: | Acute renal failure Intravascular lymphoma disease PET-scanner |
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