Acute lymphoblastic leukemia first presenting with ascites: A case report.

Area of Science:

• Hematology
• Oncology

Background:

• Acute lymphoblastic leukemia (ALL) commonly presents with extramedullary infiltrates in various organs.
• Unusual sites of ALL infiltration include the cervix, gastrointestinal tract, lungs, and thyroid gland.
• Ascites as an initial presentation of ALL is exceedingly rare.

Purpose of the Study:

• To report a rare case of ALL presenting initially with ascites.
• To enhance understanding of ALL's diverse clinical manifestations.
• To improve early detection and management of ALL.

Main Methods:

• A 30-year-old male presented with ascites.
• Initial diagnosis of suppurative peritonitis was made via abdominal puncture.
• Computed tomography revealed ileocecal lesions; treatment for peritonitis was ineffective.
• Subsequent readmission and imaging showed enlarged abdominal lymph nodes, leading to suspicion of hematological malignancy.
• Bone marrow cytology confirmed the diagnosis of Acute Lymphoblastic Leukemia (ALL).

Main Results:

• The patient was admitted to the hematology department for treatment.
• Despite interventions, the patient unfortunately passed away.

Conclusions:

• Clinicians should consider leukemia in the differential diagnosis for patients presenting with ascites.
• This is particularly important when initial treatments for other conditions are ineffective.
• Recognizing rare presentations of ALL can improve patient outcomes.