A case of precursor B-cell lymphoblastic lymphoma with bilateral multiple nodular renal and multiple spinal involvements

Abstract

Malignant lymphoma sometimes infiltrates kidneys. We report the case of an 11-year-old boy with fever and unbearable lumbar backache 5 days before admission. He was diagnosed as having multiple nodular renal and multiple spinal involvements on the basis of enhanced CT and MRI findings. His renal function was spared and blood test showed no anemia, thrombocytopenia, or blasts in contrast to high urine acid and LDH levels. We performed bone marrow examination, and he was diagnosed as having precursor B-cell lymphoblastic lymphoma (stage IV) on the basis of the findings of cell surface markers and 10.8% blasts of all nucleated cells. He was treated following the ALB-NHL03 protocols of the Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG), and he attained and maintained remission. There are many differential diagnoses of renal hypovascular lesions. Renal infiltration of malignant lymphoma is one of the differential diagnoses that we should be concerned of.