Renal collapse: A window into an underlying high-grade hematological malignancy – A case report

Kidney disease is prevalent in patients with hematologic malignancies, particularly multiple myeloma (MM) and acute leukemias. These conditions can directly infiltrate the kidneys or disrupt renal function through metabolic and immunological mechanisms. Renal failure is a significant complication, often the second leading cause of mortality in MM patients. Over 50% of multiple myeloma patients experience renal impairment, commonly identified as "myeloma kidney." Occasionally, blastoid morphology of some plasma cells can lead to diagnostic confusion, necessitating the use of immunohistochemistry to distinguish plasma cell leukemia (PCL) from other types of leukemias and lymphomas. Accurate diagnosis of renal disease can also reveal underlying hematologic malignancies, as demonstrated in our case where a kidney biopsy diagnosed a high-grade malignancy, facilitating timely and correct management.