Acute lymphoblastic leukemia ALL is one of the most common malignancies of childhood. Peripheral blood and bone marrow involvement is common. Extramedullary involvement of central nervous system liver spleen skin and testicles are seen. ALL presenting as nephromegaly is exceedingly rare. This case is reported for its rare presentation as nephromegaly. Bone marrow aspirate showed features of acute lymphoblastic leukemia and immunophenotyping by flow cytometry confirmed the diagnosis.
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