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Concurrent pancreatic and renal leukemic cell infiltration.
Subramaniyan Ramanathan1, Mahesh Prakash2, Niranjan Khandelwal2
1Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, ON Canada.
Summary
Pancreatic involvement is rare in adult acute lymphoblastic leukemia (ALL), but this case highlights simultaneous pancreatic and kidney infiltration. Early consideration of pancreatic involvement is crucial in leukemic patients with related symptoms.
Area of Science:
- Oncology
- Gastroenterology
- Radiology
Background:
- Pancreatic involvement in acute lymphoblastic leukemia (ALL) is uncommon, particularly in adult patients.
- Leukemic infiltration of the pancreas can manifest as obstructive jaundice, pancreatitis, or remain asymptomatic.
Observation:
- A 28-year-old male with B cell ALL presented with simultaneous pancreatic and bilateral kidney involvement.
- Computed tomography revealed diffuse pancreatic infiltration with multiple tiny hypodense lesions and similar lesions in both kidneys.
Findings:
- The patient was asymptomatic despite the unusual pancreatic leukemic infiltration.
- Imaging demonstrated characteristic hypodense lesions indicative of neoplastic infiltration in both organs.
Implications:
- This case underscores the importance of considering pancreatic infiltration in leukemic patients, even when asymptomatic.
- Clinicians should suspect pancreatic involvement in leukemic patients presenting with pancreatic enlargement, cholestatic jaundice, or pancreatitis.
