Rare Presentation of Pediatric Acute Lymphoblastic Leukemia: Nephromegaly at Time of Diagnosis

  • Ela Erdem
  • Petek Kayıran
  • Gul Ozcelik
  • Alper Ozel
  • Z. Yildiz Yildirmak
Case Report

Abstract

Renal involvement is a fairly frequent development in children with acute lymphoblastic leukemia, but palpable renal enlargement at time of diagnosis is very unusual. We report the case of a young girl who presented with enlarged kidneys and was diagnosed with this form of leukemia. This case is of interest because of the rarity of this presentation. The importance of renal biopsy in identifying the etiology of this patient’s nephromegaly is emphasized.

Keywords

Leukemia Nephromegaly Child 

References

  1. 1.
    Pradeep R, Madhumathi DS, Lakshmidevi V, Premalata CS, Appaji L, Patil SA et al (2008) Bilateral nephromegaly simulating wilms tumor. J Pediatr Hematol Oncol 30:471–473CrossRefPubMedGoogle Scholar
  2. 2.
    Basker M, Scott JX, Ross B, Kirubakaran C (2002) Renal enlargement as primary presentation of acute lymphoblastic leukemia. Indian J Cancer 39:154–156PubMedGoogle Scholar
  3. 3.
    Ali SH, Yacoub FM, Al-Matar E (2008) Acute lymphoblastic leukemia presenting as bilateral enlargement in a child. Med Princ Pract 17:504–506CrossRefPubMedGoogle Scholar
  4. 4.
    Hann IM, Lees PD, Palmer MK, Gupta S, Morris JPH (1981) Renal size as a prognostic factor in childhood acute lymphoblastic leukaemia. Cancer 48:207–209CrossRefPubMedGoogle Scholar
  5. 5.
    Taccone A, De Bernardi B, Comelli A et al (1982) Renal changes in acute leukemia in children at onset. Incidence and prognostic value. Pediatr Med Chir 4:107–113PubMedGoogle Scholar
  6. 6.
    Rajantie J, Jaaskelainen J, Perkkio M, Siimes MA (1986) Kidneys very large at diagnosis are associated with poor prognosis in children with acute lymphoblastic leukemia. Am J Pediatr Hematol Oncol 8:87–90CrossRefPubMedGoogle Scholar
  7. 7.
    Hilmes MA, Dillman JR, Mody RJ, Strouse PJ (2008) Pediatric renal leukemia: spectrum of CT imaging findings. Pediatr Radiol 38:424–430CrossRefPubMedGoogle Scholar
  8. 8.
    Sullivan MP, Hrgovic CM (1973) Extramedullary leukaemia. In: Sutov WW, Vietti TJ, Fernbach DJ (eds) Clinical Pediatric Oncology. Mo Mosby, St. Louis, pp 227–251Google Scholar
  9. 9.
    Shapiro JH, Ramsey CG, Jacobson HG et al (1962) Renal involvement in lymphoma and leukaemia in adults. Am J Roentgenol 88:928–941Google Scholar
  10. 10.
    Banday KA, Sirwal IA, Reshi AR, Najar MA, Bhat MA, Wani MM (2004) Renal involvement in hematological malignancies. Indian J Nephrol 14:50–52Google Scholar
  11. 11.
    Richmond J, Sherman RS, Diamond HD et al (1962) Renal lesions associated with malignant lymphomas. Am J Med 32:184–207CrossRefPubMedGoogle Scholar
  12. 12.
    Amromin GP (1968) Pathology of leukaemia. Harper and Row, New York, pp 251–261Google Scholar
  13. 13.
    D′Angelo P, Mura R, Rizzari C et al (1995) Prognostic value of nephromegaly at diagnosis of childhood acute lymphoblastic leukemia. Acta Haematol 94:84–89CrossRefPubMedGoogle Scholar
  14. 14.
    Neglia JP, Day DL, Swanson TV et al (1988) Kidney size at diagnosis of childhood acute lymphocytic leukemia: lack of prognostic significance for outcome. Am J Pediatr Hematol Oncol 10:296–300CrossRefPubMedGoogle Scholar

Copyright information

© Indian Society of Haematology & Transfusion Medicine 2011

Authors and Affiliations

  • Ela Erdem
    • 1
  • Petek Kayıran
    • 1
  • Gul Ozcelik
    • 2
  • Alper Ozel
    • 3
  • Z. Yildiz Yildirmak
    • 4
  1. 1.Pediatric Clinic-Sisli Etfal Education and Research Hospital, IstanbulUskudar-IstanbulTurkey
  2. 2.Department of Pediatric NephrologyPediatric Clinic-Sisli Etfal Education and Research HospitalIstanbulTurkey
  3. 3.Department of RadiologySisli Etfal Education and Research HospitalIstanbulTurkey
  4. 4.Department of Pediatric HematologyPediatric Clinic-Sisli Etfal Education and Research HospitalIstanbulTurkey

Personalised recommendations