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Secondary renal involvement in advanced non-Hodgkin’s lymphomas is quite common, but primaryrenal lymphoma (PRL) is a rare disease. It accountsfor 0.7% of all extra-nodal lymphomas in NorthAmerica and 0.1% in Japan, and 65 cases have beenreported in the worldwide literature. PRL is also adebated disease because kidneys do not containlymphatic tissue [1,2]. General agreement exists aboutthe criteria needed to dene the diagnosis of PRL: (i)renal failure as the rst presentation in the absence ofother causes of renal impairment; (ii) rapid improve-ment of renal function following therapy; (iii) increaseof the kidneys’ size without any urinary tract obstruc-tion; (iv) absence of other nodal or extra-nodalinvolvement; and (v) denite diagnosis made by histo-logical examination.The medianageat PRL diagnosis is 64years, andthediseaseismorefrequentinmalesthaninfemales. Acuterenalfailure,ankpainanddetectionofarenalmassarethe most frequent manifestations [3]. Renal failure mayresult from a large variety of causes, such as lympho-matousinltrationofrenaltissueorhypercalcaemia[4].Histological examination is mandatory, as clinical andradiological ndings often evoke renal carcinoma [5].The prognosis is poor, but long-term survivors havebeen reported occasionally after surgical resection andcombination chemotherapy, in unilateral renal lym-phoma [2]. Bilateral renal involvement has a prevalenceof 43% [6]: in this case, the prognosis is very severe andchemotherapy is the usual proposed treatment becausesurgery has never been described (Table 1).We report a case of bilateral PRL successfullytreated by surgical resection leading to a three-quartersablation of native renal mass followed by combinationchemotherapy.

Bilateral primary renal lymphoma treated by surgery and chemotherapy