A CASE OF LEUKEMIC INFILTRATION INTO THE APPENDIX WITH INITIAL SYMPTOMS OF APPENDICITIS

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 64; no. 9; pp. 2203 - 2206
• Main Authors: IZAWA, Yoshimitsu, TAMURA, Akihiko, OHZEKI, Miho, MATSUDA, Junichi, AKAMATSU, Hidetoshi, MATSUI, Junichi
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 25.09.2003
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.64.2203

A 65-year-old woman with a right lower abdominal pain and fever was admitted to our hospital and diagnosed as having acute appendicitis. As her symptoms were mild, she was treated initially with intravenous antibiotics. Although he showed a temporary improvement, resumption of ingestion caused a recurrence of symptoms, and a CT scan indicated marked inflammation around the appendix. Sixteen days after admission, a celiotomy was performed and the inflammation of the appendix and cecum was found to be very severe. Since the possibility of malignancy could not be ruled out, an ileocecal resection was performed. Macroscopically, the specimen showed findings of acute gangrenous appendicitis with no signs of malignancy. After the surgery, however, the patient's leukemic count sharply increased and surpassed 60, 000/μl, with a number of blast cells present. Histopathological examination revealed a diffuse infiltration of leukemic cells into the appendix and cecum and mild inflammation of the appendix. She was diagnosed as having AML (M2) by bone marrow biopsy. Although leukemic cells occasionary infiltrate the gastrointestinal tract, the observation of appendicitis as an initial symptom of leukemia is very rare. Determining why the leukemic cells entered the appendix, resulting in appendicitis, is also of interest.