Liver and Kidney Tumor Masses as the Initial Presentation of B-Cell Acute Lymphoblastic Leukemia

We described a 13-year-old girl who presented unexplained paroxysmal sharp pain in the right upper abdomen for 3 days. CT and MRI showed multiple masses in the liver and kidneys, initially diagnosed as lymphoma. The hepatic mass biopsy confirmed B-cell lymphoblastic lymphoma. FDG PET/CT examination found that the liver and kidney masses demonstrated high metabolic activity, with concomitant increased metabolic activity in the skeleton. Bone marrow biopsy revealed extensive skeletal involvement. The final diagnosis was B-cell acute lymphoblastic leukemia. This case highlights the effectiveness of FDG PET/CT as an adjunct imaging modality for diagnosis.