Polypoid leukemic infiltration of the large bowel

Ms, Rabin; Ag, Bledin; Lewis, Dean

doi:10.2214/ajr.131.4.723

Cited by 12 publications

(4 citation statements)

References 4 publications

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“…Microscopic infiltrates have been reported in 55% in one series [6]. Leukemic infiltration may involve the esophagus [5À7], stomach [5,6,8], small intestine [5,6,9], and colon [5,6,10]. None of these previous reports describes involvement of the gall bladder.…”

Section: Discussionmentioning

confidence: 99%

Cholecystitis as the presenting manifestation of acute myeloid leukemia

et al. 2002

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We report a case of acute leukemia, which presented as cholecystitis in a previously healthy middle-aged adult. Leukemic involvement of the gastrointestinal tract is a wellknown clinicopathological entity. However, leukemic infiltration of the gall bladder wall is a rare occurrence. It has only been previously described in the setting of relapsed disease and, to our knowledge, has never been reported as the primary manifestation of de novo acute leukemia. The patient in question was treated with standard induction and consolidation chemotherapy and remains in complete remission 19 months after his presentation with symptoms consistent with cholecystitis. Am.

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Section: Discussionmentioning

confidence: 99%

Cholecystitis as the presenting manifestation of acute myeloid leukemia

et al. 2002

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“…These locally raised mucosal lesions rarely cause an intussusception on their own. The pathogenesis is actually due to the lymphoid tissue which acts as a lead point in the initiation process for the formation of an intussusception [8]. Chien et al studied 364 patients, who were diagnosed with acute leukemia and found that only 11 patients (3%) had developed acute abdominal complications, including intussusception.…”

Section: Discussionmentioning

confidence: 99%

Intussusception in a child with Acute Lymphoblastic Leukemia: a remarkable presentation with literature review – a case report

Majumder

Misra

Kumar

et al. 2021

J Egypt Natl Canc Inst

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Background Gastrointestinal complications are not uncommon in patients of Acute Leukemia. Intussusception as a complication in leukemia, although described, is exceedingly rare. Also, it is usually seen after chemotherapy and not as a part of the native disease process. This case report aims to highlight such a rare association which warrants clinical and pathological attention. Case presentation A 14 year old male presented with an acute abdomen. Initial routine investigations revealed a deranged blood picture. On further examination of bone marrow aspirate, biopsy and detailed immunohistochemical studies a diagnosis of B-Acute Lymphoblastic Leukemia (B-ALL) was made. Concurrent ultrasound of the abdomen to find a cause for severe abdominal pain revealed an Ileo-colic intussusception. The patient was started on steroids; however he succumbed to his illness after two days, before surgery could be attempted. Conclusion Rare presentations of relatively common diseases are a hurdle for timely and effective medical intervention. Although a rare condition in itself in leukemic patients, the occurrence of Intussusception in this particular patient, especially when no chemotherapy was initiated, is a very rare event. This case report was made to add to the relatively scarce literature available on this particular association. As it is a surgically treatable condition and since delay in diagnosis may lead to poorer prognosis, possibility of co-existence of ALL and intussusception should be borne in mind by all treating physicians and hematopathologists for effective patient care.

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“…A review of colonoscopies in leukemia shows that most lesions are aphthoid and small ulcers due to leukemic infiltration 17 . Also reported are reddish, flat or slightly elevated lesions, nodular lesions, and polypoid masses 12,18,19 . The last two may cause intussusception, bowel obstruction, or simulate colonic carcinoma 2,20 .…”

Section: Gastrointestinal Involvementmentioning

confidence: 99%

Gastrointestinal manifestations of leukemia

Ebert

Hagspiel

2012

J of Gastro and Hepatol

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Gastrointestinal (GI) manifestations of leukemia occur in up to 25% of patients at autopsy, generally during relapse. Its presence varies with the type of leukemia and has been decreasing over time due to improved chemotherapy. Gross leukemic lesions are most common in the stomach, ileum, and proximal colon. Leukemia in the esophagus and stomach includes hemorrhagic lesions from petechiae to ulcers, leukemic infiltrates, pseudomembranous esophagitis, and fungal esophagitis. Lesions in the small and large bowel are usually hemorrhagic or infiltrative. Infiltration of lymphoreticular organs, mainly spleen, liver, and lymph nodes, is more prominent in chronic than acute leukemia. Neutropenic enterocolitis, a necrotizing process involving the cecum, ascending colon, and terminal ileum, is increasing in incidence due to greater intensity of chemotherapy. Distension of bowel leads to mucosal breaches, permitting entry of organisms that grow profusely in the absence of neutrophils. Ischemic necrosis follows, leading to perforation and/or peritonitis. Patients present with fever, abdominal pain, diarrhea, nausea, vomiting, abdominal distension and tenderness. Ultrasound and computed tomography scans show thickening of the bowel wall. Treatment is supportive with surgery for necrosis and perforation. The main GI causes of death in leukemia are hemorrhage, infection, and necrotizing enterocolitis.

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Polypoid leukemic infiltration of the large bowel

Cited by 12 publications

References 4 publications

Cholecystitis as the presenting manifestation of acute myeloid leukemia

Cholecystitis as the presenting manifestation of acute myeloid leukemia

Intussusception in a child with Acute Lymphoblastic Leukemia: a remarkable presentation with literature review – a case report

Gastrointestinal manifestations of leukemia

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