Renal enlargement as a primary presentation of acute lymphoblastic leukaemia

It is not uncommon to see renal involvement in children with the established diagnosis of acute lymphoblastic leukaemia (ALL). Previous reports suggest renal enlargement in 24% of all diagnosed ALL patients (Hann et al, 1981). In severe cases there is marked bilateral and symmetrical enlargement of both kidneys. The calyces and the infundibula are markedly stretched and these appearances are similar to those seen in adult polycystic kidneys. However, in ALL stretching of the calyces and the infundibula is not associated with cysts. These appearances led to the presumptive diagnosis of ALL in two children.