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INTRODUCTION. Primary renal non-Hodgkin’s lymphoma is a very uncommon pathology. Less than 100 cases described in medical literature. Its existence has been discussed because the presence of lymphatic tissue in the kidney is uncommon.
CASE REPORT. The patient is a 64 year old male who initiated with costolumbar bilateral colic-type pain, with an intensity of 5/10, irradiated to both abdomen flanks associated with numbness in both lower limbs since approximately 10 months. Subsequently he referred weight loss, fatigue, weakness, anorexia; 5/10 intensity permanent somatic pain located in pelvis, sacral and lumbar spine, as well as lower limb weakness. Abdominopelvic computed tomography showed a unique, homogeneous solid mass, of 8x7x7 cm in the left kidney with spleen and liver metastasis, as well as bone infiltration. Histopathological examination reported diffuse large B-cell lymphoma.
DISCUSSION. The patient presented a sudden onset of symptoms associated with a renal mass which was confirmed radiologically, compromising liver, spleen and paraaortic nodules, suggesting that the left kidney is the primary affected organ. A possible diagnosis of renal cell carcinoma with liver, paraaortic nodes, spleen and bone metastasis was initially considered due to the findings and epidemiology. Patient underwent a left radical nephrectomy. Nonetheless, histopathological and immunohistochemical studies revealed a diffuse, large, stage IV B B-cell lymphoma.
