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Journal of Pediatric Hematology/Oncology:
doi: 10.1097/MPH.0b013e318168e7b3
Clinical and Laboratory Observations

Bilateral Nephromegaly Simulating Wilms Tumor: A Rare Initial Manifestation of Acute Lymphoblastic Leukemia

Pradeep, Rudramurthy MD; Madhumathi, Davanam Satyanarayana MD; Lakshmidevi, Visweswariah MD; Premalata, Chennagiri Srinivasmurthy MD; Appaji, Lingappa MD, DM; Patil, Shekhar Akkamahadevi MD; Swapnil, Bhagat DMRD

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Abstract

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.

© 2008 Lippincott Williams & Wilkins, Inc.

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