Prilozi, Odd. biol. med. nauki, MANU, XXXIII, 2, s. 231–238 (2012) Contributions, Sec. Biol. Med. Sci., MASA, XXXIII, 2, p. 231–238 (2012) ISSN 0351–3254 UDK: 616.61-006.441:616.61-008.64 CASE REPORT ACUTE RENAL FAILURE IN A PATIENT WITH DIFFUSE LARGE B-CELL LYMPHOMA: CASE REPORT Domazetovski I¹, Jovanovic R¹, Kostadinova-Kunovska S¹, Duganovska S¹, Labachevski B¹, Nikolov I², Ivanovski N², Sikole A², Petrushevska G¹ ¹Institute of Pathology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, R. Macedonia ²University Clinic of Nephrology, Medical Faculty, Skopje, R. Macedonia Abstract: Introduction: Renal parenchymal involvement is common in syste- mic lymphomas. In almost all cases, renal involvement appears to be a secondary pro- cess, either by direct extension from a retroperitoneal mass or via haematogenous spread in the setting of disseminated disease. Secondary renal involvement in systemic lympho- mas is generally presented as multiple masses, but also as a solitary nodule. Acute renal failure by a lymphoma infiltration of the kidney is extremely rare. Primary renal non- Hodgkin’s lymphoma is even more uncommon and it is a debated issue because of the absence of lymphoid tissue in normal kidneys. Case presentation: We report on the case of a 62-year old woman, who had melena, abdominal pain, malaise and fever. She was hospitalized at the Nephrology Clinic due to severe anemia and signs of acute renal failure. The peripheral blood smear showed the presence of dysplastic erythroblasts and hypo-granular neutrophils. Ultrasound was performed, which showed enlarged kidneys with signs of urinary obstruction of the first degree, with swollen, hypoechogenic parenchyma. After not responding to the condu- cted treatment, the patient died from heart failure. An autopsy was performed and Non- Hodgkin’s, diffuse large B-cell lymphoma infiltrating multiple parenchymal organs was determined as the main cause of death. Conclusion: Diffuse large B-cell lymphoma with multiple organ affection and secondary renal involvement, presented as an acute renal failure is a rare case. We report on this case to update the literature concerning this topic and highlight the impor- tance of renal biopsy in the diagnostics. Key words: non-Hodgkin’s lymphoma, primary, secondary, acute renal failure, biopsy.