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Non-accidental Trauma - Abdominal Manifestations
Joseph Junewick, MD FACR
over 4 years ago
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Leukemic Renal Infiltration

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: US CT MRI
Activities:
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History

3 year old with 6 week history of increasing abdominal distention.


Case Images


Diagnosis

Leukemia

Clinical Notes

CBC: WBC 6.6k, Hgb 13.4 g, Hct 40.9, plt 206k

Recent streptococcal throat infection.

Findings

CT – Massive nephromegaly with striated nephrogram.

MR – Axial and coronal images demonstrate massive nephromegaly.

US – Massive nephromegaly with normal color Doppler flow.

Discussion

Acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), and juvenile myelomonocytic leukemia are common forms of leukemia in children. Extramedullary involvement is often seen in T-cell ALL and the M4 and M5 subtypes of AML.

Nephromegaly is a common manifestation of leukemic infiltration; nephromegaly may be mild or marked. Peripheral wedge shaped, round and ill-defined defects can also be seen. Despite renal involvement, function is usually not compromised.

Other visceral infiltration can be seen including brain, liver, bone, spleen, lymph nodes, and thymus.

Reference

Gore RM and Shkolnik A. Abdominal manifestations of pediatric leukemias: Ultrasound assessment. Radiology 1982; 143:207-210.

Donaldson JS and Shkolnik A. Pediatric renal masses. Sem Roentgenology 1988; 23(3):194-204.

Hilmes MA, Dillman JR, Mody RJ, Strouse P. Pediatric renal leukemia: spectrum of CT imaging findings. Pediatric Radiol (2008); 38:424-430.



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