Polypoid colon mucosa in a leukemia patient

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• A patient with chronic myeloid leukemia (CML) on dasatinib therapy presented with new-onset digestive disorders.
• Her medical history included recurrent Helicobacter pylori gastritis and polymyalgia rheumatica.
• Routine blood work, including leukocyte count, was normal.

Purpose of the Study:

• To investigate the cause of new-onset digestive disorders in a CML patient.
• To characterize the endoscopic and histopathological findings of colonic lesions.

Main Methods:

• Routine physical examination and patient history.
• Colonoscopy with biopsy.
• Histopathological examination of colonic biopsies.
• Immunohistochemistry (CD3, CD5, CD20, CD79).

Main Results:

• Endoscopy revealed multiple small (<5mm) nodular lesions throughout the colon with abnormal vascularization.
• Microscopic examination showed architectural distortions and a mixed inflammatory infiltrate (neutrophils, eosinophils, lymphocytes).
• Immunohistochemistry excluded lymphoma, and no malignant or dysplastic cells were identified.

Conclusions:

• The colonic lesions in this CML patient on dasatinib were not indicative of malignancy or lymphoma.
• The findings suggest an inflammatory process, potentially related to underlying conditions or medication side effects.
• Further investigation may be warranted to determine the precise etiology of the observed colonic changes.