T-Cell Lymphoblastic Leukemia as a Rare Cause of Bilateral Nephromegaly

Abstract

Bilateral renal enlargement is a very rare manifestation as the primary presenting feature of acute lymphoblastic leukemia (ALL). ALL is the most common malignancy in children, representing nearly one-third of all pediatric cancers. Although a small percentage of cases are associated with inherited genetic syndromes, the cause of ALL remains largely unknown ( 1 Dogan M. Bay A. Bora A. Acikgoz M. Oner A.F. Massively enlarged kidneys due to leukemic infiltration in a child. Eur J Gen Med. 2010; 7: 114-117 Google Scholar , 2 Sinnett D. Labuda D. Krajinovic M. Challenges identifying genetic determinants of pediatric cancers—the childhood leukemia experience. Fam Cancer. 2006; 5: 35-47 Crossref PubMed Scopus (25) Google Scholar ). The T-cell form accounts for 15–20% of all cases of ALL ( 3 Lanzkowsky P. Manual of pediatric hematology and oncology. 4th edn. Elsevier Academic Press, San Diego, CA2005 Google Scholar ). Most ALL patients present with anemia, neutropenia, bone pain, and arthralgia. Acute renal failure, nephromegaly, and lymphomatous infiltration of the kidneys are very rare manifestations of ALL in children ( 4 Han B.K. Babcoock D.S. Sonographic measurements and appearance of normal kidneys in children. AJR Am J Roentgenol. 1985; 145: 611-616 Crossref PubMed Scopus (215) Google Scholar , 5 Richmond J. Sherman R.S. Diamond H.D. Craver L.F. Renal lesions associated with malignant lymphomas. Am J Med. 1962; 32: 184-207 Abstract Full Text PDF PubMed Scopus (282) Google Scholar ).