Light chain cast nephropathy caused by plasmablastic lymphoma of the bladder.

Clin Nephrol Case Stud

Department of Medicine, Division of Nephrology, Lehigh Valley Health Network, Allentown, PA.

Published: July 2021

Introduction: Plasmablastic lymphoma (PBL) is a rare form of B-cell lymphoma typically seen in patients with underlying immunosuppression such as HIV, autoimmune disease, and organ transplantation. PBL in HIV-positive patients usually originates from the gastrointestinal tract, with a predilection for the oral cavity. Bladder involvement by PBL is exceedingly rare, and cast nephropathy due to κ light chain-secreting PBL has not been reported previously.

Case Report: We report a patient who presented with acute kidney injury (AKI) in the setting of HIV, and was found to have a bladder tumor. Bladder pathology revealed a high-grade PBL with κ light chain restriction. Renal biopsy showed κ light chain cast nephropathy, presumably secondary to κ light chain-secreting PBL.

Conclusion: Although the prognosis of PBL is poor, our patient recovered from AKI, achieved complete hematologic remission with chemotherapy, and underwent successful autologous stem cell transplant.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259465PMC
http://dx.doi.org/10.5414/CNCS110339DOI Listing

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