Renal lymphoma

From Dog
Renal lymphoma, a slow-growing renal disease[1]

Primary renal lymphoma is a relatively uncommon variant of canine lymphoma characterized by primary renal neoplasm, usually involving T-cells[2].

Renal lymphomas usually occur bilaterally and are commonly seen as secondary metastases from other organs[3] but primary tumors have been reported[4].

These tumors are usually confined to the kidney but can invade local retroperitoneal tissues such as the vena cava[5] and metastasize distally to the ovary, heart, pancreas[6] and brain[7].

Clinically affected dogs typically present with signs of chronic renal disease such as renal pain, hematuria, weight loss, vomiting and anorexia[8].

A presumptive diagnosis can be established on clinical history, blood tests and urinalysis. Hematology may reveal polycythemia (due to inappropriate erythropoietin production)[9] and paraneoplastic hypercalcemia[10].

Supportive evidence can be obtained from radiographic, ultrasonographic and CT imaging studies which show irregular-shaped renomegaly.

A definitive diagnosis requires fine-needle biopsy and histological examination of tissue samples.

A differential diagnosis would include pyelonephritis, renal carcinoma[11], renal amyloidosis[12], hydronephrosis due to other causes, multicentric lymphoma and renal parasites (e.g. Leptospira spp, Dioctophyme renale and Pearsonema plica).

Unilateral renal lymphoma can be treated with ureteronephrectomy.

Chemotherapy may include lomustine[13] or high-dose cyclophosphamide, vincristine and prednisolone[14].

References

  1. Dog Health Guide
  2. Durno AS et al (2011) Polycythemia and inappropriate erythropoietin concentrations in two dogs with renal T-cell lymphoma. J Am Anim Hosp Assoc 47(2):122-128
  3. Lane LV et al (2012) Canine intravascular lymphoma with overt leukemia. Vet Clin Pathol 41(1):84-91
  4. Osborne CA et al (1971) Renal lymphoma in the dog and cat. J Am Vet Med Assoc 158(12):2058-2070
  5. Lascelles BD et al (2003) Surgical treatment of right-sided renal lymphoma with invasion of the caudal vena cava. J Small Anim Pract 44(3):135-138
  6. Zhao D et al (1993) Bilateral renal lymphosarcoma in a dog. J Vet Med Sci 55(4):657-659
  7. Lane EP & Lobetti RG (2002) Renal T-cell lymphoma with cerebral metastasis in a dog with chronic canine ehrlichiosis. J S Afr Vet Assoc 73(2):83-85
  8. Breshears MA et al (2011) Pathology in practice. Renal lymphoma. J Am Vet Med Assoc 238(2):167-169
  9. Nelson RW et al (1983) Renal lymphosarcoma with inappropriate erythropoietin production in a dog. J Am Vet Med Assoc 182(12):1396-1397
  10. Bergman PJ (2012) Paraneoplastic hypercalcemia. Top Companion Anim Med 27(4):156-158
  11. Haers H et al (2010) Contrast harmonic ultrasonographic appearance of focal space-occupying renal lesions. Vet Radiol Ultrasound 51(5):516-522
  12. Mason NJ & Day MJ (1992) Renal amyloidosis in related English foxhounds. J Small Anim Pract 37(6):255-260
  13. Heading KL et al (2011) CCNU (lomustine) toxicity in dogs: a retrospective study (2002-07). Aust Vet J 89(4):109-116
  14. Batchelor DJ et al (2006) Long-term survival after combination chemotherapy for bilateral renal malignant lymphoma in a dog. N Z Vet J 54(3):147-150