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Summary
A 66-year-old female presented with hematuria and was diagnosed with well-differentiated monocytic leukemia. Monoblasts were identified in urine, differentiating it from renal carcinoma.
Area of Science:
- Hematology
- Oncology
- Nephrology
Background:
- A 66-year-old female presented with hematuria.
- Initial differential diagnoses included renal pelvis or renal cell carcinoma.
Observation:
- Peripheral blood and bone marrow studies revealed well-differentiated monocytic leukemia.
- Elevated muramidase levels supported the leukemia diagnosis.
- Intravenous pyelogram identified a left renal mass.
Findings:
- Cytologic urine studies were negative for carcinoma cells.
- Numerous monoblasts were identified in urine samples, both cytologically and cytochemically.
- This finding helped distinguish leukemia from renal malignancy.
Implications:
- Highlights the importance of comprehensive hematologic and cytologic evaluation in cases of hematuria with renal masses.
- Demonstrates how specific cell identification can alter diagnostic pathways.
- Underscores the potential for leukemic cells to manifest in renal findings.