A patient with a solitary renal mass as the only manifest lesion of B-cell lymphoma was reported. The surgical specimen revealed that the lesion was histologically limited to the renal parenchyma. Liver dysfunction prevented him from receiving systemic chemotherapy. Mediastinal and mesenteric lymph node involvements developed 6 months later. Fortunately, the patient survived without recurrence for 18 months after the surgical removal of these tumors and intensive chemotherapy. Systemic chemotherapy is recommended on patients with renal lymphoma even if the tumor seems to be limited to the organ.