Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520-8023, USA.
Am J Kidney Dis. 2010 Nov;56(5):1001-5. doi: 10.1053/j.ajkd.2010.03.029.
We report the case of a 14-year-old boy who presented with hematuria and decreased kidney function as initial manifestations of acute lymphoblastic leukemia (ALL). Computed tomography of the abdomen showed extensive retroperitoneal lymphadenopathy and bilateral nephromegaly. The patient's kidney biopsy specimen showed a dense monomorphous interstitial infiltrate of small round blue cells with significant nuclear atypia. Immunohistochemical workup showed positive staining for CD20, CD10, and terminal deoxynucleotidyl transferase (TdT), consistent with ALL. The patient underwent induction chemotherapy, attained remission 4 weeks after induction, and presently is stable in the consolidation phase of chemotherapy. This is an unusual case of ALL involving both kidneys with initial presenting signs of hematuria and decreased kidney function.
我们报告了一例 14 岁男孩的病例，其最初表现为血尿和肾功能下降，诊断为急性淋巴细胞白血病（ALL）。腹部计算机断层扫描显示广泛的腹膜后淋巴结病和双侧肾肿大。患者的肾活检标本显示弥漫性单一形态的小圆形蓝色细胞间质浸润，细胞核异型性明显。免疫组织化学检查显示 CD20、CD10 和末端脱氧核苷酸转移酶（TdT）阳性染色，符合 ALL。患者接受了诱导化疗，诱导后 4 周达到缓解，目前处于化疗巩固阶段。这是一例不常见的累及双侧肾脏的 ALL，最初表现为血尿和肾功能下降。
