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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

Journal of Pediatric Hematology/Oncology: June 2008 - Volume 30 - Issue 6 - p 471-473
doi: 10.1097/MPH.0b013e318168e7b3
Clinical and Laboratory Observations

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

Disclaimers: No disclaimers.

This study has not been presented anywhere else.

No research was undertaken. It is a case report.

Reprints: Rudramurthy Pradeep, MD, 1905, South end ‘C’ road, 9th block, Jayanagar, Bangalore 560069, Karnataka, India (e-mail:

Received for publication July 22, 2007; accepted January 2, 2008

© 2008 Lippincott Williams & Wilkins, Inc.