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Research
Suxia Wang
Peking University First Hospital
Corresponding Author
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Background
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is rare in Asians, and patients with CLL/SLL seldomly undergo kidney biopsy. The histopathological features and clinical relevance of tubulointerstitial injury in CLL/SLL have not been extensively charaterized. Hence, we attempted to describe the clinical characteristics, renal pathology and clinical outcome of a well-characterized population of CLL/SLL patients with CLL cell infiltration in the renal interstitium from a large single center in China.
Methods
Between January 1st, 2010 and September 31st, 2020, 31946 renal biopsy pathologies were performed at Peking University First Hospital, and 10 CLL/SLL patients with CLL cell infiltration in the renal interstitium were included. Complete clinical data were collected from these 10 patients, and renal specimens were examined by routine light microscopy, immunofluorescence and electron microscopy.
Results
The extent of the infiltrating CLL cells in patients with CLL/SLL varied among different patients and ranged from 10–90% of kidney parenchyma. Six (60%) of 10 patients presented with an extent of infiltrating CLL cells ≥ 50%. Interestingly, we found that three patients (3/10, 30%) expressed monoclonal immunoglobulins in the infiltrating CLL cells, and special cytoplasmic crystalline structures were found in two of the three patients by electron micriscopy for the first time. Severe renal insufficiency (Scr ≥ 200 µmol/L ) was associated with ≥ 50% interstitial infiltration of CLL cells in the renal interstitium.
Conclusions
The findings confirmed that CLL cells infiltrating the renal interstitium can directly secrete monoclonal immunoglobulins, indicating that the interstitial infiltrating CLL cells probably cause renal injuriy directly by secreting monoclonal immunoglobulins in situ. This finding may prove a new clue to elucidate the pathogenetic mechanism of renal injury involved with CLL/SLL .
Keywords
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), infiltrating CLL cells, monoclonal immunoglobulins, pathological features, tubulointerstitial injury
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Reviewer #4 agreed
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Received 05 Apr, 2021
Reviewer #2 agreed
On 22 Mar, 2021
Review #1 received
Received 21 Mar, 2021
Reviewer #1 agreed
On 11 Mar, 2021
Reviewers invited
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On 07 Mar, 2021
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A new preprint design is coming!
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This preprint is under consideration at Diagnostic Pathology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Suxia Wang
Peking University First Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 16 Mar, 2021
No community comments so far
Reviewer #4 agreed
On 05 Apr, 2021
Reviewer #3 agreed
On 05 Apr, 2021
Review #2 received
Received 05 Apr, 2021
Reviewer #2 agreed
On 22 Mar, 2021
Review #1 received
Received 21 Mar, 2021
Reviewer #1 agreed
On 11 Mar, 2021
Reviewers invited
Invitations sent on 08 Mar, 2021
Editor assigned
On 07 Mar, 2021
Submission checks complete
On 07 Mar, 2021
Editor invited
On 07 Mar, 2021
First submitted
On 03 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is rare in Asians, and patients with CLL/SLL seldomly undergo kidney biopsy. The histopathological features and clinical relevance of tubulointerstitial injury in CLL/SLL have not been extensively charaterized. Hence, we attempted to describe the clinical characteristics, renal pathology and clinical outcome of a well-characterized population of CLL/SLL patients with CLL cell infiltration in the renal interstitium from a large single center in China.
Methods
Between January 1st, 2010 and September 31st, 2020, 31946 renal biopsy pathologies were performed at Peking University First Hospital, and 10 CLL/SLL patients with CLL cell infiltration in the renal interstitium were included. Complete clinical data were collected from these 10 patients, and renal specimens were examined by routine light microscopy, immunofluorescence and electron microscopy.
Results
The extent of the infiltrating CLL cells in patients with CLL/SLL varied among different patients and ranged from 10–90% of kidney parenchyma. Six (60%) of 10 patients presented with an extent of infiltrating CLL cells ≥ 50%. Interestingly, we found that three patients (3/10, 30%) expressed monoclonal immunoglobulins in the infiltrating CLL cells, and special cytoplasmic crystalline structures were found in two of the three patients by electron micriscopy for the first time. Severe renal insufficiency (Scr ≥ 200 µmol/L ) was associated with ≥ 50% interstitial infiltration of CLL cells in the renal interstitium.
Conclusions
The findings confirmed that CLL cells infiltrating the renal interstitium can directly secrete monoclonal immunoglobulins, indicating that the interstitial infiltrating CLL cells probably cause renal injuriy directly by secreting monoclonal immunoglobulins in situ. This finding may prove a new clue to elucidate the pathogenetic mechanism of renal injury involved with CLL/SLL .
Figure 1
Figure 2
Figure 3
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