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Colonic involvement in a patient with chronic lymphocytic leukaemia

P E T Arkkila1, H Nuutinen, F Ebeling

  • 1Department of Gastroenterology, Helsinki University Central Hospital, 00290 Helsinki, Finland. perttu.arkkila@fimnet.fi

Gastroenterology Research and Practice
|September 17, 2008
PubMed

Insights

Chronic lymphocytic leukemia (CLL) can infiltrate the gastrointestinal tract, even with normal colonoscopy findings. Diagnosis requires biopsies to detect subtle leukemia infiltration in the ileum and colon, especially in patients with unexplained anemia.

Area of Science:

  • Hematology
  • Gastroenterology
  • Oncology

Background:

  • Chronic lymphocytic leukemia (CLL) is a B-cell malignancy.
  • Gastrointestinal (GI) manifestations of CLL are recognized but can be subtle.
  • Anemia is a common complication in CLL patients.

Observation:

  • A 69-year-old male patient with CLL and anemia presented with normal macroscopic findings during colonoscopy.
  • Histological examination of biopsy specimens revealed lymphocytic leukemia infiltration in the ileum and colon.

Findings:

  • Subtle GI infiltration by CLL can occur despite normal endoscopic visualization.
  • Histopathology is crucial for diagnosing GI involvement in CLL.
  • Ileal and colonic biopsies confirmed leukemia infiltration.

Implications:

  • Endoscopic evaluation with adequate biopsies is essential for CLL patients presenting with GI symptoms or unexplained anemia.
  • Early diagnosis of GI involvement can guide treatment and improve patient outcomes.
  • This case highlights the importance of histological confirmation in suspected CLL-related GI complications.

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