Eur J Pediatr Surg 2009; 19(5): 332-334
DOI: 10.1055/s-2008-1039191
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© Georg Thieme Verlag KG Stuttgart · New York

Massive Bilateral Nephromegaly in Acute Lymphoblastic Leukemia: A Case Report

P. Aguayo1 , J. D. Fraser1 , S. D. St. Peter1 , T. Spilde1 , J. M. Gatti2 , C. L. Snyder1 , D. J. Ostlie1
  • 1Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, MO, USA
  • 2Department of Pediatric Urology, Children's Mercy Hospital, Kansas City, MO, USA
Further Information

Publication History

Publication Date:
17 February 2009 (online)

Introduction

Acute leukemia is the most common childhood malignancy, accounting for about one-third of all pediatric cancers. Acute lymphoblastic leukemia (ALL) constitutes about 75 % of childhood leukemias [11]. The disease involves the bone marrow and blood but occasionally presents with nodal or extranodal sites including renal involvement.

The most common sites of extramedullary involvement in ALL are the liver, spleen or lymph nodes; however, as many as 30 % of patients presenting with ALL in one study had renal involvement and about 10 % presented with bilateral nephromegaly. We report a rare case of a 15-month-old child with massive bilateral nephromegaly and pre-B cell ALL.

References

  • 1 Ali A A, Flombaum C D, Brochstein J A. et al . Lactic acidosis and renal enlargement at diagnosis and relapse of acute lymphoblastic leukemia.  J Pediatr. 1994;  125 584-586
  • 2 Araki T. Leukemic involvement of the kidney in children: CT features.  J Comput Assist Tomogr. 1982;  6 781-784
  • 3 Barakat A Y, Mnaymneh L G. Acute lymphoblastic leukemia diagnosed by renal biopsy.  J Urol. 1977;  118 103-104
  • 4 Bunchman T E, Gale G B, O'Connor D M. et al . Renal biopsy diagnosis of acute lymphocytic leukemia.  Clin Nephrol. 1992;  38 142-144
  • 5 D'Angelo P, Mura R, Rizzari C. et al . Prognostic value of nephromegaly at diagnosis of childhood acute lymphoblastic leukemia.  Acta Haematol. 1995;  94 84-89
  • 6 Gupta S, Keane S. Renal enlargement as a primary presentation of acute lymphoblastic leukemia.  Br J Radiol. 1985;  58 893-895
  • 7 Lai R. Pathologic diagnosis of acute lymphocytic leukemia.  Hematol Oncol Clin North Am. 2000;  14 1209-1235
  • 8 Nizze H, Prall F, Wigger M. et al . Primary renal manifestations in malignant lymphomas and leukemia.  Pathologe. 2003;  24 460-465
  • 9 Pizzo P A, Poplack D G eds. Principles and practice of pediatric oncology. 4th ed. Philadelphia, PA; Lippincott, Williams & Wilkins 2002
  • 10 Pui C H, Ribiero R C. International collaboration on childhood leukemia.  Int J Hematol. 2003;  78 383-389
  • 11 Samuel E D, Sakamoto K M. Topics in pediatric leukemia-acute lymphoblastic leukemia.  Med Gen Med. 2005;  7 23

Dr. M.D. Pablo Aguayo

Department of Surgery
Children's Mercy Hospital

2401 Gillham Road

Kansas City, MO 64108

USA

Email: paguayo@cmh.edu