Skip to main content

Advertisement

SpringerLink
Log in

Abdominal pain in a 5-year-old girl with bilateral nephromegaly: Answers

  • Clinical Quiz
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Renal involvement in non-Hodgkin lymphoma is a recognized development, but it mostly follows a diagnosis of lymphoma. We describe a rare case of a T-cell-type non-Hodgkin lymphoma that first presents as nephromegaly in a 5-year-old girl admitted to the emergency department with abdominal pain. Further investigation revealed bilateral nephromegaly, but the results of blood tests, imaging studies, and bone marrow aspiration were inconclusive. During the second week of hospitalization, significant physical examination revealed an enlarged lymph node in the anterior cervical chains, confirming a diagnosis of Non-Hodgkin’s lymphoma. This case illustrates that it is important to have a high degree of suspicion in any patient presenting with unexplained enlarged kidneys without any identifiable cause because it could be the first presentation of a hematologic malignancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Seidemann K, Tiemann M, Schrappe M, Yakisan E, Simonitsch I, Janka-Schaub G, Dörffel W, Zimmermann M, Mann G, Gadner H, Parwaresch R, Riehm H, Reiter A (2001) Short-pulse B-non-Hodgkin lymphoma-type chemotherapy is efficacious treatment for pediatric anaplastic large cell lymphoma: a report of the berlin-Frankfurt-Münster group trial NHL-BFM 90. Blood 97:3699–3706

    Article  CAS  PubMed  Google Scholar 

  2. Buyukpamukcu M, Varan A, Aydin B, Kale G, Akata D, Yalçin B, Akyuz C, Kutluk T (2005) Renal involvement of non-Hodgkin’s lymphoma and its prognostic effect in childhood. Nephron Clin Pract 100:86–91

    Article  Google Scholar 

  3. Truong LD, Soroka S, Sheth AV, Kessler M, Mattioli C, Suki W (1987) Primary renal lymphoma presenting as acute renal failure. Am J Kidney Dis 9:502–506

    Article  CAS  PubMed  Google Scholar 

  4. Ferry JA, Harris NL, Papanicolaou N, Young RH (1995) Lymphoma of the kidney: a report of 11 cases. Am J Surg Pathol 19:134–144

    Article  CAS  PubMed  Google Scholar 

  5. Brouland JP, Meeus F, Rossert J, Hernigou A, Gentric D, Jacquot C, Diebold J, Nochy D (1994) Primary bilateral B-cell renal lymphoma: a case report and review of the literature. Am J Kidney Dis 24:586–589

    Article  CAS  PubMed  Google Scholar 

  6. Malbrain ML, Lambrecht GL, Daelemans R, Lins RL, Hermans P, Zachée P (1994) Acute renal failure due to bilateral lymphomatous infiltrates. Primary extranodal non-Hodgkin’s lymphoma (p-EN-NHL) of the kidneys: does it really exist? Clin Nephrol 42:163–169

    CAS  PubMed  Google Scholar 

  7. Kiely JM, Wagoner RD, Holley KE (1969) Renal complications of lymphoma. Ann Intern Med 71:1159–1175

    Article  CAS  PubMed  Google Scholar 

  8. Da’as N, Polliack A, Cohen Y, Amir G, Darmon D, Kleinman Y, Goldfarb AW, Ben-Yehuda D (2001) Kidney involvement and renal manifestations in non Hodgkin’s lymphoma and lymphocytic leukemia: a retrospective study in 700 patients. Eur J Haematol 67:158–164

    Article  PubMed  Google Scholar 

  9. Lewi HJE, Stewart ID, Seywright M, Fleming S, Deane RF, Kyle KF (1986) Urinary tract lymphoma. Br J Urol 58:16–18

    Article  CAS  PubMed  Google Scholar 

  10. Richmond J, Sherman RS, Diamond HD, Craver LF (1962) Renal lesions associated with malignant lymphomas. Am J Med 32:184–207

    Article  CAS  PubMed  Google Scholar 

  11. Cohen LJ, Rennke HG, Laubach JP, Humphreys BD (2010) The spectrum of kidney involvement in lymphoma: a case report and review of the literature. Am J Kidney Dis 56:1191–1196

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rault R, Holley JL, Banner BF, el-Shahawy M (1992) Glomerulonephritis and non-Hodgkin’s lymphoma: a report of two cases and review of the literature. Am J Kidney Dis 20:84–89

    Article  CAS  PubMed  Google Scholar 

  13. Stokes MB, Wood B, Alpers CE (2002) Membranoproliferative glomerulonephritis associated with low-grade B cell lymphoma presenting in the kidney. Clin Nephrol 57:303–309

    Article  CAS  PubMed  Google Scholar 

  14. Miyake JS, Fitterer S, Houghton DC (1990) Diagnosis and characterization of non-Hodgkin’s lymphoma in a patient with acute renal failure. Am J Kidney Dis 16:262–263

    Article  CAS  PubMed  Google Scholar 

  15. Ellman L, Davis J, Lichtenstein NS (1974) Uremia due to occult lymphomatous infiltration of the kidneys. Cancer 33:203–205

    Article  CAS  PubMed  Google Scholar 

  16. Kowalewska J, Nicosia RF, Smith KD, Kats A, Alpers CE (2011) Patterns of glomerular injury in kidneys infiltrated by lymphoplasmacytic neoplasms. Hum Pathol 42:896–903

    Article  PubMed  Google Scholar 

  17. Shi SF, Zhou FD, Zou WZ, Wang HY (2012) Acute kidney injury and bilateral symmetrical enlargement of the kidneys as first presentation of B-cell lymphoblastic lymphoma. Am J Kidney Dis 60:1044–1048

    Article  PubMed  Google Scholar 

  18. Yeo SC, Chuah KL, Lee HY, Liew A (2013) An unusual case of glomerulonephritis in a patient with non-Hodgkin mucosal associated lymphoid tissue (MALT) B-cell lymphoma. BMC Nephrol 14:158

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ng YY, Healy JC, Vincent JM, Kingston JE, Armstrong P, Reznek RH (1994) The radiology of non-Hodgkin’s lymphoma in childhood: a review of 80 cases. Clin Radiol 49:594–600

    Article  CAS  PubMed  Google Scholar 

  20. Mora J, Filippa DA, Thaler HT, Polyak T, Cranor ML, Wollner N (2000) Large cell non-Hodgkin lymphoma of childhood: analysis of 78 consecutive patients enrolled in 2 consecutive protocols at the memorial Sloan Kettering Cancer center. Cancer 88:186–197

    Article  CAS  PubMed  Google Scholar 

  21. Attard-Montalto SP, Saha V, Norton AJ, Kingston JE, Eden OB (1993) Anaplastic large cell lymphoma in childhood. Med Pediatr Oncol 21:665–669

    Article  CAS  PubMed  Google Scholar 

  22. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, Delsol G, De Wolf-Peeters C, Falini B, Gatter KC (1994) A revised European-American classification of lymphoid neoplasms: a proposal from the international lymphoma study group. Blood 84:1361

    CAS  PubMed  Google Scholar 

  23. Falini B, Pileri S, Zinzani PL, Carbone A, Zagonel V, Wolf-Peeters C, Verhoef G, Menestrina F, Todeschini G, Paulli M, Lazzarino M, Giardini R, Aiello A, Foss HD, Araujo I, Fizzotti M, Pelicci PG, Flenghi L, Martelli MF, Santucci A (1999) ALK1 lymphoma: clinico-pathological findings and outcome. Blood 93:2697

    CAS  PubMed  Google Scholar 

  24. Filippa DA, Ladanyi M, Wollner N, Straus DJ, O’Brien JP, Portlock C, Gangi M, Sun M (1996) CD30 (Ki-1)-positive malignant lymphomas: clinical, immunophenotypic, histologic, and genetic characteristics and differences with Hodgkin’s disease. Blood 87:2905

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Nephrology Department, Kayseri Education and Research Hospital, Kocasinan, Kayseri, Kayseri Province, Turkey

    Hulya Nalcacioglu, Sibel Yel & Funda Bastug

  2. Pediatric Hematology-Oncology Department, Kayseri Education and Research Hospital, Kayseri, Turkey

    Meriban Karadogan, Fatma Turkan Mutlu & Yasemin Altuner Torun

Authors
  1. Hulya Nalcacioglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sibel Yel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Meriban Karadogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fatma Turkan Mutlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Funda Bastug
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yasemin Altuner Torun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hulya Nalcacioglu.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest and financial assistance.

Informed consent

Informed consent was obtained for the patient’s parents.

Additional information

This refers to the article that can be found at http://dx.doi.org/10.1007/s00467-017-3689-1.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nalcacioglu, H., Yel, S., Karadogan, M. et al. Abdominal pain in a 5-year-old girl with bilateral nephromegaly: Answers. Pediatr Nephrol 33, 423–426 (2018). https://doi.org/10.1007/s00467-017-3696-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-017-3696-2

Keywords

Search

Navigation