case_images: PMC5642469_01
case_images: Abdominal computed tomography scan showing the bilateral enlarged kidney as well as retroperitoneal lymphadenopathy.
case_images: CNCS-5-060-01.jpg
case_images: PMC5642469_01_CNCS-5-060-01.jpg
case_images: Figure1
case_images: Abdominal computed tomography (CT) showed homogeneously enhanced soft tissues occupying the bilateral enlarged kidney as well as retroperitoneal lymphadenopathy (Figure 1).
case_images: A: The kidney was diffusely involved with atypical small to medium blasts (H & E, x200). B: The blasts exhibited minimal cytoplasm, a high nuclear: cytoplasmic ratio, convoluted hyperchromatic nuclei, and inconspicuous nucleoli (H & E, x400).
case_images: CNCS-5-060-02.jpg
case_images: PMC5642469_01_CNCS-5-060-02.jpg
case_images: Figure2
case_images: A percutaneous renal biopsy indicated that the renal interstitium was diffusely infiltrated with atypical small to medium round cells (Figure 2A), which were characterized by minimal cytoplasm, a high ratio of nuclear to cytoplasm, convoluted hyperchromatic nuclei, and inconspicuous nucleoli (Figure 2B).
case_images: A: The blast cells were positive for TdT (x200). B: CD10 staining was positive in the blast cells (x400). C: CD79alpha staining was partly positive in the blast cells (x400).
case_images: CNCS-5-060-03.jpg
case_images: PMC5642469_01_CNCS-5-060-03.jpg
case_images: Figure3
case_images: Immunohistochemical staining revealed that the leukemic cells were positive for TdT (Figure 3A) and CD10 (Figure 3B), partly positive for CD79alpha (Figure 3C), and negative for vimentin, CD99, NSE, CD20, BCL-2, CD5, CD23, cyclin-D1, BCL-6, CD3, and MPO.