Acute Renal Failure and Osteolytic Lesions as Presenting Features of Non-Hodgkin’s Lymphoma in Infants
Bláhová K.1, Eckschlager T.2, Mališ M.2, Èumlivská E.3, Kodet R.4, Pýcha K.5, Mráèek J.6, Janda J.1
1st Pediatric Clinic1, Head Assist. Prof. J. Janda, CSc. Dept. of Pediatric Oncology2, Head Prof. J. Koutecký, DrSc. Dept. of Radiology3, Head Assist. Prof. J. Neuwirth, CSc. Dept. of Pathology4, Head Assist. Prof. R. Kodet, DrSc. Dept. of Pediatric Surgery5, Head Prof. J. Šnajdauf, DrSc. Dept. of Orthopedics6, Head Assist. Prof. T. Trè, CSc. 2nd Medical Faculty Charles University, Prague, Czech Republic |
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Summary:
Acute renal failure and multiple osteolytic lesions as first presenting features of Non-Hodgkin’s lymphoma (NHL) are extremely rare in children younger than the age of two. The two cases discussed below, show the clinical and histological features of lymphomas. The first patient, a twenty-month-old boy, had acute renal failure with bilateral nephromegaly due to NHL (Burkitt’s lymphoma) infiltration. In the second case, an eighteen-month-old boy, multiple osteolytic lesions of the left low extremity have been the first presentation of the disease. The diagnosis of lymphoblastic lymphoma pre-B has been established. In the first case immunophenotype was the of relatively mature B cell with typically expressed CD19, CD20. The patient was started on hemodialysis and chemotherapy, but despite the treatment his course continued to worsen. Renal necropsy did not reveal any NHL infiltration. In the second case the diagnosis of lymphoblastic lymphoma pre-B with expression of CD10, CD19, CD20 and aberrant expression of CD7 was established. The boy underwent chemotherapy and he is 5 months in remission.
Key words:
non-Hodkin’s lymphoma, infants
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