Editing Non-RCC Renal Malignancies (section)

== Renal lymphoma and leukemia ==

* Renal involvement with hematologic malignancies, which include the lymphomas and leukemias, is common
** '''The most common hematologic malignancy to involve the kidney is lymphoma'''
* '''Renal lymphoma should be suspected in patients with (4):'''
*# '''Infiltrative renal lesions'''
*# '''Splenomegaly'''
*# '''Lymphadenopathy that is out of proportion to the renal primary'''
*# '''Lymphadenopathy in other regions of the body or atypical regions within the retroperitoneum'''
*#* '''Lymphadenopathy centered outside of the main landing zones (see above) should raise suspicion for lymphoma'''
* '''The radiographic patterns manifested by renal lymphoma are diverse and can be difficult to differentiate from RCC'''
* '''Any patient with a prior history of lymphoma and a renal mass should also be evaluated for renal recurrence rather than for RCC'''.

* '''Renal involvement related to leukemia is more common in children'''
* Renal lymphoma and leukemia are commonly silent but can be associated with hematuria, flank pain, or progressive renal failure. Fever, weight loss, and fatigue, the so-called B symptoms of lymphoma, are much more common
* '''If lymphoma or leukemic renal involvement is suspected, consideration should be given to percutaneous biopsy or aspiration to obtain a pathologic diagnosis'''
* '''Extirpative surgery should be avoided if renal lymphoma and leukemia are suspected because the primary treatment of these processes is systemic chemotherapy with or without radiation therapy'''
** Nephrectomy is seldom indicated except in patients with severe symptoms, such as uncontrollable hemorrhage.
** The other notable exception is the extremely rare patient with primary renal lymphoma in whom a combination of nephrectomy and systemic chemotherapy may represent optimal therapy