Urolithiasis in Pediatric Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma (ALL/LLy): A Single-Center Case Series of Clinical, Metabolic, and Imaging Features

Background: Urolithiasis is an underrecognized complication in pediatric acute lymphoblastic leukemia/lymphoma (ALL/LLy), often associated with glucocorticoid therapy. Observations: We report 4 cases of urolithiasis occurring at different diagnostic and treatment phases, 3 requiring intervention. Presenting symptoms included flank pain, hematuria, and urinary discomfort. In 1 case, renal abnormalities were incidentally identified on PET/CT performed for remission assessment. Conclusions: Urolithiasis may occur across ALL/LLy diagnosis and treatment, particularly after glucocorticoid exposure and in patients with additional risk factors. Early recognition in patients with unexplained abdominal or urinary symptoms is essential to prevent complications.