Chronic myelomonocytic leukemia revealed by uncontrollable hematuria

Nephrectomy was performed for uncontrollable unilateral hematuria in an app arently healthy 72-year-old man. The suburothelial connective tissue of the kidney was infiltrated by primitive myeloid cells with associated acute va sculitis and foci of extramedullary hematopoiesis. Subsequently, the patien t was shown to have chronic myelomonocytic leukemia. Although renal involve ment and vasculitis have been recorded previously in chronic myelomonocytic leukemia, this is the first occasion, to our knowledge, where their concur rence resulted in such a spectacular presentation.