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Objective: To present the clinicalpicture of acute renal failure in patients withmycosis fungoides (MF) and renal lymphomatousinfiltrates. To analyze the pathogenesis ofrenal failure.Methods:Correlation of clinicalpicture, urinary findings, imaging reports andautopsy findings in two patients withlong-standing MF who died with renal failure.Case summaries:Both subjects hadsustained oliguria in the last 2 weeks. Onepatient had persistent hypotension, normalurinalysis, normal renal sonogram, and scarceinterstitial lymphomatous infiltrates withpreservation of renal parenchymal architecture. He was thought to have ischemic acute renalfailure not directly linked to the lymphomatousinfiltrates. The second patient developedhypertension one month prior to death, and hadmoderate proteinuria, hematuria, pyuria,grossly enlarged kidneys with hypoechoicmasses, and extensive replacement of the renalparenchyma by lymphomatous infiltrates. Thispicture is typical of renal failure secondaryto lymphomatous replacement of the kidneys.Conclusions:The development of oliguricrenal failure in MF with renal lymphomatousinfiltrates may have varying clinical andimaging manifestations and pathogeneses. Potentially reversible pathogenic mechanismsshould be systematically investigated,particularly if the overall clinical picture isnot characteristic of renal failure secondaryto lymphomatous replacement of theparenchyma.