CD20-negative diffuse large B-cell lymphoma presenting with anuria: a case report

CD20-negative diffuse large B-cell lymphoma (DLBCL) is a rare novel subtype of non-Hodgkin lymphoma. Herein, we report a case of CD20-negative DLBCL in a 54-year-old male who had suffered with anuria for 5 days. Positron emission tomography/computed tomography (PET/CT) revealed lymphadenopathy, and biopsy of the right inguinal lymph node was performed. Lymph node sections revealed a 2 × 2 × 2-cm solid mass histopathologically suggestive of DLBCL. Immunohistochemical (IHC) analysis revealed the patient’s lymphoid cells were CD10(+), CD21(+), CD79a(+), CD99(+), LCA(+), Myc(+), P53(+), PAX5(+), ALK(-), BCL-2(-), BCL-6(-), CD3(-), CD20(-), Mum1(-), and TDT(-). Approximately 90% of his tested lymphoid cells reacted positively to Ki-67 antibody. A diagnosis of CD20-negative DLBCL (not otherwise specified) was made, and the patient was treated with seven courses of CHOP (cyclophosphamide, doxorubicin, vincristine, and dexamethasone) and one course of EPOCH (etoposide, cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy. However, the treatment outcome was unsuccessful. To the best of our knowledge, this is the first reported case of CD20-negative DLBCL-induced acute renal failure presenting as anuria. Formulation of an optimized therapeutic strategy for this rare and aggressive disorder is urgently required.