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Renal Failure Incident to Reticulum Cell Sarcoma of the Kidneys
Response to Radiotherapy
- DONALD ARMSTRONG, M.D.; and
- W. P. L. MYERS, M.D., F.A.C.P.
- Requests for reprints should be addressed to Donald Armstrong, M.D., Microbiology Laboratory, Memorial Hospital for Cancer and Allied Diseases, New York, N. Y. 10021.
Excerpt
Malignant lymphomas commonly involve the kidneys (1), occurring on histological examination in approximately one half of the cases studied (2-5). However, only 3.3% of a large series of lymphosarcomas (2) showed clinical involvement of the genitourinary tract, and much less frequently lymphomas are associated with gross impairment of renal function (2, 6-11). Even more rarely uremia is responsible for the presenting symptoms of a lymphomatous disease (12). Renal functional impairment may occur via three mechanisms: [1] Diffuse infiltration of the kidneys (6-12); [2] bilateral ureteral obstruction secondary to nodal or retroperitoneal involvement (5, 10, 11, 13) or to associated periureteral
Summario in Interlingua
Es reportate le caso de un juvene femina qui se presentava con un syndrome de vena cave superior secundari al formation de un massa mediastinal e in qui le symptomas clinic e le signos roentgenologic respondeva favorabilemente al radiotherapia. Le tractamento esseva empiric proque le effortios initial de establir un diagnose histologic non succedeva. Post un mense e medie le patiente retornava con un massa sinistro-abdominal, hematuria, e un concentration de nitrogeno del urea sanguinee de 35 mg per 100 ml. Rapidemente illa disveloppava uremia progressive e esseva tractate con mustarda de nitrogeno. Isto culminava in un valor de 450 mg per 100 ml pro nitrogeno de urea sanguinee e de 9,25 mEq/L pro le kalium seral, lo que—in le presentia de un relativemente leve acidosis reflectite in mesurationes de pH, pCO2, e CO2—se explicava le melio per le hypothese que un carga extra-ordinari de productos nitrogenose esseva presentate al renes in consequentia del decomposition de un grande massa de cellulas tumoric per le previemente administrate mustarda de nitrogeno. Un prompte responsa normalisatori del alterationes electrocardiographic esseva notate post le therapia medical, durante que le concentration de kalium declinava plus lentemente. Esseva opinate que le relativemente leve grado de acidosis esseva responsabile pro le rapiditate del responsa electrocardiographic, proque alteremente un tal responsa non haberea potite esser expectate in le presentia del observate nivellos seral de kalium.
Le responsa del patiente a mesuras de supporto e al radiotherapia renal esseva spectacular, e le melioration general justificava le dimission del patiente ab le hospital. Tamen, intra duo menses illa succumbeva a intractabile sanguination supero-gastrointestinal. Le necropsia revelava que su renes esseva virtualmente reimplaciate per sarcoma de cellulas reticular. Isto esseva etiam trovate extensemente in varie partes del corpore incluse le vias gastrointesinal ubi un ulcerate tumore gastric habeva essite le cause del sanguination.
Es delineate le diagnose differential e le methodologias diagnostic pro dysfunction renal associate con lymphoma. Le therapia del complicationes renal de iste morbos es commentate.
Article and Author Information
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From the Departments of Medicine, Memorial Hospital for Cancer and Allied Diseases and James Ewing Hospital (of the City of New York), and Cornell University Medical College, New York, N. Y.
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- Received January 21, 1966.
- Accepted March 8, 1966.
