Bilateral nephromegaly simulating wilms tumor: a rare initial manifestation of acute lymphoblastic leukemia.
A 7-year-old boy was referred with a provisional diagnosis of bilateral Wilms tumor. Peripheral smear revealed elevated leukocyte count with 90% blasts. Bone marrow aspiration and biopsy were hypercellular with sheets of blasts. Immunohistochemistry on paraffin sections showed a pre-B phenotype of acute lymphoblastic leukemia. Computerized tomographic scan of the abdomen showed moderate bilateral renal enlargement. Ultrasound-guided fine needle aspiration cytology of both kidneys showed blasts similar to those seen in the bone marrow. Finally, a diagnosis of pre-B acute lymphoblastic leukemia infiltrating both the kidneys was made. This case is being presented because of its rarity.
Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India. docpradi@rediffmail.com
Rudramurthy
R
Pradeep
Davanam Satyanarayana
DS
Madhumathi
Visweswariah
V
Lakshmidevi
Chennagiri Srinivasmurthy
CS
Premalata
Lingappa
L
Appaji
Shekhar Akkamahadevi
SA
Patil
Bhagat
B
Swapnil
D044963:Biopsy, Fine-Needle; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D014057:Tomography, X-Ray Computed; D009396:Wilms Tumor / Q000473:pathology*