Primary renal lymphoma in a uremic patient

Primary renal lymphoma is a rare renal malignancy, and its occurrence in patients undergoing maintenance haemodialysis is even more uncommon. Herein, we report the case of a 57-year-old woman undergoing maintenance haemodialysis, presenting with gross haematuria. After performing enhanced magnetic resonance imaging, positron emission tomography-computed tomography, and a kidney biopsy, a diffuse large B-cell lymphoma was detected. She was subsequently treated with five cycles of a modified R-CHOP regimen consisting of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, and achieved partial remission, as evidenced by an abdominal computed tomography scan. At the 15-month follow-up, no further enlargement or metastasis of the residual tumour was evident. We emphasize that the clinical manifestations of primary renal lymphoma (PRL) resemble those of renal cell carcinoma, necessitating an imaging and biopsy-based differential diagnosis to avoid misdiagnosis. Although PRL has a highly aggressive phenotype and is associated with high mortality, early diagnosis and appropriate treatment can improve patient outcomes.