Skip to main content
SpringerLink
Log in

Pathoanatomical features of the kidney in myelomonocytic and chronic lymphocytic leukemia

  • Published:
Virchows Archiv A Aims and scope Submit manuscript

Summary

The kidneys of 18 autopsy cases of myelomonocytic leukemia (MML) were examined for MML-specific features. Nine cases of chronic lymphocytic leukemia (CLL) served as controls.

The kidneys of the cases of MML showed macroscopically detectable sings of hemorrhagic diathesis and secondary uric acid diathesis more often than those of CLL. In the MML group most of the kidneys weighed more than the normal average for the corresponding age group, but the average renal weights for the 2 groups were about the same. Renal weight and grade of leukemic infiltration, particularly in MML, revealed no significant positive correlation.

In most of the cases of MML there were unevenly distributed poorly defined leukemic, infiltrates in the renal cortex and medulla. The histology resembled that of pyelonephritis. In CLL, on the other hand, the leukemic infiltrates were usually sharply defined and localized in foci in the outer cortex and the corticomedullary border region.

Renal dysfunction in cases of MML has been attributed by others to hyperlysozymemia. It was found occasionally but there was no MML-typical morphological substrate in our material. Hyaline droplet change of the tubular epithelium was more frequent and more pronounced in MML than in CLL. However, we also determined that it was nonspecific and that it was not a parameter of cell damage. Tubular hyaline droplet change and the morphological criteria of acute renal failure were not positively correlated with the degree of leukemic infiltration of the kidneys or with the leukemic proliferation as a whole. Instead, they were considered to be signs and symptoms of accompanying or secondary diseases which complicated the leukemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ballard, H. S., Marcus, A. J.: Hypercalcemia in chronic myelogenous leukemia. New Engl. J. Med. 282, 663–665 (1970)

    Google Scholar 

  • Bohle, A.: Zur Pathomorphologie der akuten, perakuten und chronischen Abstoßung von Nierentransplantaten. Verh. dtsch. Ges. Path. 54, 136–145 (1970)

    Google Scholar 

  • Catovsky, D., Galton, D. A. G., Griffin, Ch., Hoffbrand, A. V., Szur, L.: The significance of lysozyme estimates in acute myeloid and chronic monocytic leukemia. Brit. J. Haemat. 21, 565–580 (1971)

    Google Scholar 

  • Ellman, L., Davis, J., Lichtenstein, N. S.: Uremia due to occult lymphomatous infiltration of the kidneys. Cancer (Philad.) 33, 203–205 (1974)

    Google Scholar 

  • Finch, S. C., Gnabasik, F. J., Rogoway, W.: Lysozyme and leukopoiesis. In: Third International Symposium on Flemings's Lysozyme, 1–5. Milan: Cesano Boscone 1964

    Google Scholar 

  • Frei, E., III., Fritz, R. D., Price, E., Moore, E. W., Thomas, L. B.: Renal and hepatic enlargement in acute leukemia. Cancer (Philad.) 16, 1089–1092 (1963)

    Google Scholar 

  • Greul, W., Lozano-Tonkin, C.: Hypercalcämische Krise als Erstmanifestation einer akuten Leukämie im Erwachsenenalter. Dtsch. med. Wschr. 99, 287–290 (1974)

    Google Scholar 

  • Haskell, C. M., DeVita, V. T., Canellos, G. P.: Hypercalcemia in chronic granulocytic leukemia. Cancer (Philad.) 27, 872–880 (1971)

    Google Scholar 

  • Klockars, M.: Distribution of lysozyme in the serum, urine, and kidneys of AKR mice during the pathogenesis of lymphocytic leukemia. Acta path. microbiol. scand. Sect. A, 82, 665–674 (1974)

    Google Scholar 

  • Klockars, M., Azar, H. A., Hermida, R., Isobe, T., Hsu, C. C. S., Ansari, H., Osserman, E. F.: The relationship of lysozyme to the nephropathy in chloroleukemia rats and effects of lysozyme loading on normal rat kidneys. Cancer Res. 34, 47–60 (1974)

    Google Scholar 

  • Leder, L. D.: Über die selektive fermentcytochemische Darstellung von neutrophilen myeloischen Zellen und Gewebsmastzellen im Paraffinschnitt. Klin. Wschr. 42, 553 (1964)

    Google Scholar 

  • Lusted, L. B., Besse, B. E., Fritz, R.: The intravenous urogram in acute leukemia. Amer. J. Roentgenol. 80, 608–610 (1958)

    Google Scholar 

  • Mir, M. A., Delamore, I. W.: Hypourioaemia and proximal renal tubular dysfunction in acute myeloid leukemia. Brit. med. J. 3, 775–777 (1974)

    Google Scholar 

  • Noble, R. E., Fudenberg, H. H.: Leukocyte lysozyme activity in myelocytic leukemia. Blood 30, 465–473 (1967)

    Google Scholar 

  • Norris, H. J., Wiener, J.: The renal lesions in leukemia. Amer. J. med. Sci. 514, 140–145 (1961)

    Google Scholar 

  • Osserman, E. F., Azar, H. A.: Renal tubular lesions secondary to lysozyme in human and rat monocytic leukemia. Fed. Proc. 28, 619 (1969)

    Google Scholar 

  • Osserman, E. F., Lawlor, D. P.: Serum and urinary lysozyme (muramidase) in monocytic and myelomonocytic leukemia. J. exp. Med. 124, 921–952 (1966)

    Google Scholar 

  • Palva, J. P., Salokannel, S. J.: Hypercalcaemia in acute leukemia. Blut 24, 209–214 (1972)

    Google Scholar 

  • Pruzanski, W., Platts, M. E.: Serum and urinary proteins, lysozyme (muramidase), and renal dysfunction in mono- and myelomonocytic leukemia. J. clin. Invest. 49, 1694–1708 (1970)

    Google Scholar 

  • Randerath, E., Bohle, A.: Morphologische Grundlagen akuter extrarenal bedingter Nierenfunktionsstörungen. Verh. dtsch. Ges. inn. Med. 65, 250–269 (1959)

    Google Scholar 

  • Richmond, J., Sherman, R. S., Diamond, H. D., Craver, L. F.: Renal lesions associated with malignant lymphomas. Amer. J. Med. 32, 184–207 (1962)

    Google Scholar 

  • Roessle, R., Roulet, F.: Maß und Zahl in der Pathologie. In: Pathologie und Klinik in Einzeldarstellungen (Hrsg. Aschoff, L., Elias, H., Eppinger, H., Sternberg, C., and Wenckebach, K. F.), Bd. V, S. 63–66. Berlin and Wien: J. Springer 1932

    Google Scholar 

  • Schubert, G. E.: Die pathologische Anatomie des akuten Nierenversagens. In: Ergebnisse der Allgemeinen Pathologie und Pathologischen Anatomie (Hrsg. Cohrs, P., Giese, W., Meesen, H., and Stoerk, H. C.), 49, 1–112 (1968)

  • Sternby, N. H.: Studies on enlargement of leukemic kidneys. Acta haemat. (Basel) 14, 354–362 (1955)

    Google Scholar 

  • Tischendorf, F. W., Ledderose, G., Müller, D., Orywall, D., Wilmanns, W.: Chronische Myelose mit massiver Lysozymurie unter Milzbestrahlung. Klin. Wschr. 50, 250–257 (1972)

    Google Scholar 

  • Wentzel, R. A., Berkheiser, S. W.: Malignant lymphomatosis of the kidneys. J. Urol. (Baltimore) 74, 177–185 (1955)

    Google Scholar 

  • Zollinger, H. U.: Die chronische Pyelonephritis. Kompressiver Typ der Glomerulumveränderung. In: Niere und ableitende Harnwege. In: Spezielle pathologische Anatomie (Hrsg. Doerr, W., and Uehlinger, E.), 446. Berlin-Heidelberg-New York: Springer 1966

    Google Scholar 

  • Zollinger, H. U.: Die Nephrosen. Die hyalintropfige Veränderung der Nieren. 189–195. In: Niere und ableitende Harnwege. In: Spezielle pathologische Anatomie (Hrsg. Doerr, W., and Uehlinger, E.), Berlin-Heidelberg-New Uork: Springer 1966

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, University of Kiel, Federal Republic of Germany

    E. -W. Schwarze

Authors
  1. E. -W. Schwarze
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

The author is grateful to Mr. K.-H. Tedsen for his excellent technical assistance and to Mrs. M. Soehring for translation and secretarial help.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schwarze, E.W. Pathoanatomical features of the kidney in myelomonocytic and chronic lymphocytic leukemia. Virchows Arch. A Path. Anat. and Histol. 368, 243–251 (1975). https://doi.org/10.1007/BF00432526

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00432526

Key words

Search

Navigation