To investigate the clinical characteristics, pathology, imaging features, and prognosis of primary renal lymphoma (PRL), a rare malignancy.

We conducted a retrospective review of 14 PRL cases diagnosed between January 2009 and January 2022, with follow-up data collected from medical records.

The study included 14 patients (7 males, 7 females), with a mean age of 60.4 years. All cases were unilateral, with 6 involving the left kidney and 8 the right. Eleven patients underwent radical nephrectomy, and two had partial nephrectomy. Pathological subtypes included 8 cases of diffuse large B-cell lymphoma (DLBCL), 5 of extranodal marginal zone B-cell lymphoma (MZBL), and 1 of extranodal NK/T-cell lymphoma. Nine patients received 4-6 cycles of adjuvant chemotherapy: 4 with the R-CHOP regimen, 4 with CHOP, and 1 with COP-L combined with chidamide for extranodal NK/T-cell lymphoma. By June 2022, 7 patients were alive, while 7 had died, 5 of whom did not receive adjuvant chemotherapy. The median progression-free survival (PFS) was 33 months, and the median overall survival (OS) was 38 months.

PRL is a rare lymphoma, with diffuse large B-cell lymphoma (DLBCL) being the most common subtype. Nephrectomy followed by R-CHOP chemotherapy is recommended as the treatment approach, and early diagnosis is essential for improving patient outcomes.