Pediatric renal leukemia: spectrum of CT imaging findings.
BACKGROUND
The kidneys are a site of extramedullary leukemic disease that can be readily detected by CT.


OBJECTIVE
To demonstrate the spectrum of CT findings in children with renal leukemic involvement.


METHODS
Twelve children were identified retrospectively as having renal leukemic involvement by contrast-enhanced CT of the abdomen. Contrast-enhanced CT images through the kidneys of each patient were reviewed by two pediatric radiologists. Pertinent imaging findings and renal lengths were documented. The electronic medical record was accessed to obtain relevant clinical and pathologic information.


RESULTS
Five patients with renal leukemic involvement presented with multiple bilateral low-attenuation masses, while three patients demonstrated large areas of wedge-shaped and geographic low attenuation. Four other patients presented with unique imaging findings, including a solitary unilateral low-attenuation mass, solitary bilateral low-attenuation masses, multiple bilateral low-attenuation masses including unilateral large conglomerate masses, and bilateral areas of ill-defined parenchymal low attenuation. Two patients showed unilateral nephromegaly, while eight other patients showed bilateral nephromegaly. Two patients had normal size kidneys. Two patients had elevated serum creatinine concentrations at the time of imaging.


CONCLUSIONS
Renal leukemic involvement in children can present with a variety of CT imaging findings. Focal renal abnormalities as well as nephromegaly are frequently observed. Most commonly, renal leukemic involvement does not appear to impair renal function.
Hilmes
Melissa A
MA
Section of Pediatric Radiology, University of Michigan Health System, C.S. Mott Children's Hospital, Ann Arbor, MI, USA.
Dillman
Jonathan R
JR
Mody
Rajen J
RJ
Strouse
Peter J
PJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006801:Humans; D007223:Infant; D007472:Iohexol / Q000031:analogs & derivatives; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D007938:Leukemia / Q000000981:diagnostic imaging*; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide