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Transient opacification of the urinary pathways by amorphous debris in children with leukemia
1Department of Radiology, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Dense urinary tract opacities were observed in two pediatric patients with acute lymphatic leukemia. This material resolved spontaneously in both cases, highlighting a transient phenomenon in leukemia patients.
Area of Science:
- Pediatric Nephrology
- Hematology-Oncology
- Diagnostic Imaging
Background:
- Acute lymphatic leukemia (ALL) is a common childhood cancer.
- Urinary tract complications can occur in patients with ALL.
- Diagnostic imaging plays a crucial role in monitoring ALL patients.
Observation:
- Two pediatric patients with ALL presented with urinary tract opacities.
- Imaging findings included dense material in the renal calyces, pelves, and ureters.
- The opacities were visualized using sonography and computed tomography.
Findings:
- One patient was undergoing chemotherapy, while the other was not.
- Opacities were visible on plain films in the chemotherapy patient but not the other.
- The dense material resolved spontaneously in both patients.
Implications:
- This suggests a potential, transient urinary tract manifestation in pediatric ALL.
- Further research is needed to understand the composition and cause of these opacities.
- Close monitoring of the urinary system in ALL patients is important.
Abstract:
Our index patient, a 14-year-old male on chemotherapy for acute lymphatic leukemia had extensive opacification of the urinary tract on the preliminary film for an intravenous urogram. Sonography and computed tomography also demonstrated dense material in the calyces, renal pelves and ureters. Since then, we have found another patient, a 9-year-old female with acute lymphatic leukemia who was not receiving chemotherapy, with a similar pattern on sonography and computed tomography. These densities unlike those in our first patient were not visible on a plain film of the abdomen. All of the material disappeared spontaneously in both patients.