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CASE 60 (February 2011)
Clinical information
A 23-year-old man was hospitalized for
acute renal failure, severe hypercalcemia and dehydration. On physical
examination was found with multiple lymphadenopathy and hepatosplenomegaly.
He also had signs of metabolic encephalopathy. Lymph node biopsy documented
peripheral high grade T-cell lymphoma. The patient required hemodialysis.
Serum creatinine: 3.5 mg/dL, BUN: 110
mg/dL; serum calcium: 18.9 mg/dL; Mg: 2.3 mg/dL, K: 4.6 meq/L; paratohormone:
5.3 ng/L.
The patient developed severe multisystem
organ failure and died before any treatment for the neoplasm. Th autopsy
showed diffuse pulmonary interstitial involvement by lymphoma.
The following images correspond to histologic
sections of the kidneys.
What is the most relevant finding?

Figure 1.
H&E, X100.

Figure 2.
H&E, X100.

Figure 3.
H&E, X200.

Figure 4.
H&E,
X100.

Figure 5.
H&E,
X200.

Figure 6.
H&E, X200.

Figure 7.
H&E, X200..
What is your diagnosis?
See
diagnosis and discussion
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